NewsNews

Public health round-up

More health workers needed Meeting demand for the oral cholera vaccine Some countries in the WHO European Region may not have enough health workers to respond to the growing health needs of their ageing populations in coming years, according to a WHO report. The report, entitled Core health indicators in the WHO European Region 2015, with a special focus on human resources, shows that health workforce shortages and imbalances constitute a major public health concern for the region that requires prompt action. Although the number of health- care workers has increased overall in Pezzoli the region by nearly 10% over the last decade, this growth was uneven between WHO/L countries and not necessarily in the The global oral cholera vaccine supply is set to double to 6 million doses this year after the countries where health professionals are World Health Organization (WHO) approved a third producer of the vaccine, Eubiologics most needed, the report said. Co., Ltd based in the Republic of Korea. Vaccine manufacturers must be approved under One in three physicians is more the WHO’s pre-qualification programme so that United Nations agencies can buy their than 55 years old, an increase of 6 per- vaccines. The photograph shows a 2015 cholera vaccination campaign in Malawi. centage points over the past 7 years. http://www.who.int/cholera/vaccines/double The report found that there were five times more physicians in some countries than in others, and that some countries had nine times fewer nurses Ebola transmission ends in virus after 42 days or two incubation than others calculated per head of popu- Guinea cycles of the Ebola virus since the last lation. Greece registered 619 physicians known case tested negative twice. per 100 000 population in 2013, for Guinea is undergoing a period of More than 2500 people died of example, while Albania had 128. heightened surveillance after WHO an- Ebola during the outbreak in Guinea, The number of medical graduates nounced on 29 December that the Ebola in addition to about 9000 in Liberia and must increase to replace them, for ex- virus was no longer being transmitted in . ample, in Albania, Bosnia and Herze- the West African country. Since WHO announced the end of govina, Kyrgyzstan and Turkey, where If no Ebola cases are reported before Ebola transmission in Liberia new cases the number of physicians per 100 000 the end of March, Guinea – where the have been reported as a result of the re- habitants is below 200. In Albania, only outbreak began 2 years ago – can be emergence of the virus persisting in a 261 physicians graduated in 2013. considered free of the disease. previously infected patient. The report is an annual publication The Ebola outbreak in West Africa Screening for persistent virus providing an overview of the European began in December 2013 in the south among survivors is still needed as the health situation. The most recent edi- Guinean town of Guéckédou before microorganism may be present in the tion provides key statistics on health spreading to neighbouring Liberia and semen of some male survivors for as workforce employment and education. Sierra Leone and, later, to seven other long as 12 months. The report also includes other key countries. WHO is currently working with health statistics, such as mortality and “This is the first time that all the governments of the three West Af- morbidity data, demographic and so- three countries – Guinea, Liberia rican countries to ensure that survivors cioeconomic indicators, health services and Sierra Leone – have stopped the receive adequate medical and psycho- utilization and health expenditure. original chains of transmission that social care. “Human resources are the cor- were responsible for starting this dev- WHO announced the end of trans- nerstone of the health system in any astating outbreak 2 years ago,” said mission of the virus in Sierra Leone in country, and the planning, regulation Dr Matshidiso Moeti, WHO Regional November. and management of the health work- Director for Africa. http://apps.who.int/ebola/cur�- force requires extensive intersectoral A country is considered free of rent-situation/ebola-situation-report- collaboration – both topics are at the human-to-human transmission of Ebola 6-january-2016 heart of the Health 2020 policy,” says

80 Bull World Health Organ 2016;94:80–81 | doi: http://dx.doi.org/10.2471/BLT.16.010216 News

“WHO is deeply concerned about adding that comprehensive smoke-free laws Cover photo the continuous lack of humanitarian are the only effective means of eliminating access to Taiz City, depriving people the risks associated with passive smoking. Somali refugees leaving Shimbiro Beach of basic health care and violating their http://www.euro.who.int/__data/ to board smugglers’ boats to . essential human rights,” said Dr Ahmed assets/pdf_file/0005/276557/How- The photograph was shortlisted for the Prix Pictet photo competition in 2015. Shadoul, WHO Representative in Yemen. can-we-best-protect-non-smokers,- It is from a collection entitled A million “WHO re-emphasizes the crucial Evidence-Brief-Eng.pdf?ua=1 shillings: escape from by London- need for uninterrupted delivery of based photographer Alixandra Fazzina. health services and calls upon all con- Neglected tropical diseases The competition was sponsored by the cerned parties to respect the basic rights United Nations refugee agency and the of all Yemenis to access health-care A new neglected tropical diseases proj- International Organization for Migration. services,” Shadoul said. ect began in Africa last month, aiming to http://www.emro.who.int/media/ eliminate five diseases – onchocerciasis, news/who-calls-for-immediate-access- lymphatic filariasis, trachoma, schisto- to-taiz-city-for-delivery-of-life-saving- somiasis and soil-transmitted intestinal health-supplies.html worms – by 2020, through mass drug administration. Smoke-free policies The Expanded Special Project for Elimination of Neglected Tropical Indoor smoking bans to protect non- Diseases (ESPEN) is the new technical smokers from exposure to tobacco arm of the Neglected Tropical Diseases Alixandra Fazzina ©Prix Pictet Ltd 2015 Ltd Pictet ©Prix Fazzina Alixandra smoke have won broad public support in Programme and will provide technical nine European countries, according to a support to endemic countries in their WHO policy brief released last month. efforts to meet the 2020 elimination Dr Zsuzsanna Jakab, WHO Regional The 20-page policy brief entitled target. Director for Europe, referring to its How can we best protect non-smokers This technical support includes the core strategy. from exposure to tobacco smoke? re- prevention and management of disabili- http://www.euro.who.int/en/da�- viewed surveys and studies in Albania, ties, such as blindness, with the overall ta-and-evidence/core-health-indica- Bulgaria, Greece, Ireland, Malta, Spain, goal of alleviating poverty and raising tors-in-the-who-european-region/ Turkey, Turkmenistan and the United productivity and quality of life for the core-health-indicators-in-the-who- Kingdom of Great Britain and Northern communities affected. european-region-2015.-special-focus- Ireland. The US$ 10 million project is host- human-resources-for-health It found that strong public support ed by the WHO Regional Office for for comprehensive smoke-free policies Africa and takes over from the African Medicines for Yemen in these countries had led to a high level Programme for Onchocerciasis Control of enforcement – and compliance with that was established in 1995 and ended WHO delivered more than 100 000 – such policies. last year. kilos of medical supplies and medi- Smoke-free policies include laws or It is the result of a consensus reached cines to Taiz governorate in Yemen, health and safety regulations that ban by endemic countries, neglected tropical but was unable to distribute them all smoking in indoor public places such disease stakeholders and WHO at con- because of continued fighting in spite as offices, restaurants and bars as well sultative meetings in April and July 2015, of the 15 to 21 December ceasefire as buses and trains. and will be officially launched in May. agreement. The WHO policy brief noted that http://www.afro.who.int/en/media- The supplies were destined for some such measures had resulted in consid- centre/pressreleases/item/8239-the-apoc- 3 million people in need of humanitar- erable savings for the health systems closes-and-a-new-body-set-up-to-elimi- ian assistance in eight districts, includ- of these countries and concluded that nate-neglected-tropical-diseases.html ■ ing 392 000 internally displaced persons. smoke-free measures do not deter As of early January, drugs and tourism or result in economic losses for medical supplies had been distributed government budgets since tobacco taxes to 13 hospitals and health centres and can be increased. Looking ahead had helped to refill the contingency “Smoke-free legislation works, but 25–26 February – Ministerial stock in Taiz. it is of key importance that certain in- Conference on Immunization in These provisions included oxygen dicators are not measured prematurely. Africa, in Addis Ababa, cylinders, surgical devices and trauma Doing so would raise the risk of incor- (http://immunizationinafrica2016.org). management equipment. rectly portraying low levels of impact 24 March – World Tuberculosis Day. But WHO was unable to distribute and, thus, of jeopardizing political 7 April – World Health Day. The 2016 22 000 kilos of medical aid to health support of the policy,” the policy brief theme is diabetes. facilities in three districts of Taiz City, says, adding that only countries that had 24–30 April – World Immunization where 400 000 people were in desperate implemented smoke-free laws for at least Week. need of items such as oxygen cylinders, 2 years were evaluated. 23–28 May – Sixty-ninth World Health fluids and consumables for kidney There is no safe level of exposure to Assembly, Geneva, Switzerland. dialysis. second-hand smoke, the policy brief notes,

Bull World Health Organ 2016;94:80–81| doi: http://dx.doi.org/10.2471/BLT.16.010216 81