"New Year's Wishes"

May you get a clean bill of health from your dentist, your cardiologist, your gastro-enterologist, your urologist, your proctologist, your podiatrist, your psychiatrist, your plumber and the I.R.S.

May your hair, your teeth, your face-lift, your abs and your stocks not fall; and may your blood pressure, your triglycerides, your cholesterol, your white blood count and your mortgage interest not rise.

May New Year's Eve find you seated around the table, together with your beloved family and cherished friends. May you find the food better, the environment quieter, the cost much cheaper, and the pleasure much more fulfilling than anything else you might ordinarily do that night.

May what you see in the mirror delight you, and what others see in you delight them.

May someone love you enough to forgive your faults, be blind to your blemishes, and tell the world about your virtues.

May the commercials on TV not be louder than the program you have been watching, and may your check book and your budget balance - and include generous amounts for charity.

May you remember to say "I love you" at least once a day to your spouse, your child, your parent, your siblings; but not to your secretary, your nurse, your masseuse, your hairdresser or your tennis instructor.

And may we live in a world at peace and with the awareness of God's love in every sunset, every flower's unfolding petals, every baby's smile, every lover's kiss, and every wonderful, astonishing, miraculous beat of our heart.

Thanks to the author

Research: Mapping public health education in Africa

Source: Bulletin of the World Health Organization 2007;85:914–922.
CB IJsselmuiden,a TC Nchinda,b S Duale,c NM Tumwesigyed & D Serwaddad
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Introduction

In most African countries, health is in crisis. Staffing and resourcing remain serious problems in all aspects of health care,1 including essential public health functions and research.2 At the same time, there is a new optimism: Africa is definitely not where it was 50 years ago.3 Many years of capacity-building have increased the number of senior staff in spite of the continued “brain drain”, and globalization of communication has contributed to an increasing democratization and accountability of education and politics. Combined with attitudinal changes in donor countries and institutions,4 there is a stronger awareness of the need to phrase answers to problems in terms of local ability rather than of foreign assistance interests, although problems in “vertical programming” remain.5 While it is too early to judge the sustainability of these political realities, it is time to greatly enhance system support to enable nations and regions in Africa to govern and manage their health sectors. In particular, it is high time to enable Africa to educate its own leaders in public health – those needed to execute essential public health functions, improve system performance and form an African voice for public health.

Results
Overall, 29/53 countries (54.7%) offer no postgraduate training in public health, 11/53 countries (20.7%) have one programme and 11/53 countries (20.7%) offer more than one programme. If the analysis is stratified by language group, major differentials appear: anglophone sub-Saharan African countries as well as those in north Africa have more developed postgraduate public health training programmes than francophone, lusophone and the one Hispanic country

It is obvious that the largest gap occurs in lusophone countries (91% of the population lives in countries without graduate public health programmes) followed by francophone Africa (34%; Fig. 1, Table 2).

In total, there are 854 staff members working in institutions offering postgraduate public health programmes, only 493 of whom work full-time. Male staff is in the majority (63%) and this differential increases if having a doctoral degree is taken into consideration (73%). Viewed in another way, 89.2% of male staff have either a master’s or doctoral qualification, in contrast to only 71.6% of female staff (Table 3, Table 4).

The age-distribution of staff skews towards younger age groups: 15% are aged 35 years or younger, 66% are aged between 36 and 50 years, and only 19% is older than 51 years of age. There is therefore a shortfall of senior staff in institutions of public health. This study did not allow an understanding of this dynamic, including whether it relates to migration, illness, internal transfer to better-paying externally funded positions, or to other causes. Finally, there are few foreign staff members working in institutions in Africa: of the 554 staff about whom information was available, 11 (2%) were nationals from other African countries and 40 (7%) were nationals from outside Africa.

Traditional medicine supplies falling as demand rises

Carol Campbell
27 December 2007
Source: SciDev.Net

A dwindling supply of wild medicinal plants is threatening South Africa's traditional medicine industry, according to new research.

In a paper published by the nongovernmental organisation Health Systems Trust this month (4 December), researchers found that the demand for traditional medicine is higher than ever — stimulated by HIV/AIDS, unemployment and rapid urbanisation.

"Many customers report that they choose to use traditional healers as they feel the treatment is more holistic than western medicine," the authors write. They go on to explain that it is this dual "spiritual and physiological treatment" that customers appreciate.

South Africa's traditional medicine industry is estimated to be worth 2.9 billion rand (around US$415 million) — 5.6 per cent of the country's health budget.

The researchers say that at least 133,000 households are dependent on the trade in medicinal plants. The majority of those harvesting the plants are rural women who depend on money they make from selling the plants to feed their families.

At risk are 550 plant species. At least 86 per cent of the plant species harvested will result in the death of the entire plant. African Wild Ginger, for example, is now reportedly extinct in the wild.

The authors make practical suggestions on how a crisis can be averted. Most obvious is developing communication between all players, followed by the development of a strategic vision for the industry.

They also suggest incentives that promote the development of technology in harvesting, farming, storage, packaging, dosage and treatment.

Sazi Mhlongo, chairman of the National Professional Association of Traditional Healers in South Africa, told SciDev.Net, that traditional healers understood the issues surrounding the sustainability of medicinal plants and were planting what they needed.

"We are holding meetings with role players to discuss the building of warehouses in Johannesburg and Durban where herbs can be packaged and sold on to traditional healers," says Mhlongo. This way, he says, plant gatherers could also be told when a certain herb was not needed to avoid waste.

"There are also plans to register traditional healers and plant gatherers to ensure better control," he adds.

The Danger of Chewing Khat and smoking cigarettes: Study in North West Ethiopia

The Work of GAVI

DNDi Receives 25.7M Dollars From The Bill & Melinda Gates Foundation To Develop New Medicines For Neglected Diseases

The Drugs for Neglected Diseases initiative (DNDi) has received a USD 25.7 million grant from the Bill & Melinda Gates Foundation to research and develop new medicines to treat human African trypanosomiasis (HAT), also known as sleeping sickness, and visceral leishmaniasis (VL).

"The Bill & Melinda Gates Foundation grant will help DNDi fill critical gaps in the HAT and VL drug development pipelines by supporting our lead optimization drug discovery programs for HAT and VL, which will in turn fuel our drug development projects," stated Dr. Bernard Pecoul, Executive Director of DNDi. "With the goal of providing better, low-cost treatments, we are intensifying neglected diseases research and are endeavoring to rekindle the hopes of the many people who suffer from these diseases in the poorest regions of the world."

The grant, to be disbursed to DNDi over five years, will provide critical funding for the research and development of new drug candidates for HAT and VL. DNDi will foster the development of the drug candidates through the preclinical stages and select one lead candidate for each disease to advance into Phase I human clinical trials.

"The pledge of $25.7M highlights the urgent need to accelerate R&D for neglected diseases," remarked Dr. Shing Chang, Director of Research & Development at DNDi. "This important commitment to HAT and VL drug discovery will serve to encourage research into new, innovative treatment options for these diseases."

"Far too little R&D is devoted to neglected diseases such as trypanosomiasis and visceral leishmaniasis, which threaten millions of people in the developing world but are virtually unheard of in rich countries," said Dr. Regina Rabinovich, Director of Infectious Diseases Development at the Gates Foundation. "By helping to close this research gap, DNDi is bringing us closer to the day when the word 'neglected' no longer applies to these diseases."

About the Diseases - HAT and VL

A fatal disease if not treated, HAT threatens more than 50 million people in 36 countries in sub-Saharan Africa. The few drugs currently in existence to treat either Stage 1 or Stage 2 of the disease have a number of serious limitations including severe toxicity, the difficulty of administration, cost, and lost efficacy in several regions. The difficulty of diagnosis, stage determination, and increasing numbers of treatment failures pose additional clinical challenges.

The urgent need for new drugs to treat VL is also deeply compelling. A potentially fatal disease, VL threatens 200 million people in 62 countries and has a fatality rate as high as 100% within 2 years in some developing countries. Of the 500,000 new cases each year, almost all (~90%) arise from recurrent epidemics in poor, rural areas of the Indian subcontinent, Brazil, and Sudan, with approximately 60,000 deaths each year. Therapeutic options for VL are limited as there are significant drawbacks like route of administration, toxicity, or cost.

About DNDi

The Drugs for Neglected Diseases initiative (DNDi) is an independent, not-for-profit drug development initiative established in 2003 by five publicly-funded research organisations - the Malaysian Ministry of Health, the Kenya Medical Research Institute, the Indian Council of Medical Research, the Oswaldo Cruz Foundation Brazil, and the Institut Pasteur - as well as an international humanitarian organisation, Médecins Sans Frontières. The UNICEF/UNDP/World Bank/WHO's Special Programme for Research and Training in Tropical Diseases (TDR) is a permanent observer. With a current portfolio of 18 projects, DNDi aims to develop new, improved, and field-relevant drugs for neglected diseases, such as malaria, leishmaniasis, human African trypanosomiasis, and Chagas disease that afflict the very poor in developing countries.

DNDi needs an additional EUR 200 million in funding in order to achieve its objectives of building a robust pipeline and delivering six to eight new treatments by 2014. To date, DNDi has secured EUR 74 million from public and private donors, including a significant initial contribution from Médecins Sans Frontières/Doctors Without Borders