"Breast-feeding rates are decreasing because health services are not receiving the support they need," said Dr. Shigeru Omi, director for Western Pacific of the World Health Organization, at a three-day consultative meeting on breast-feeding protection, promotion, and support organized by the WHO and the United Nations Children's Fund (UNICEF). "Informing and counseling mothers and families are not sufficient if there is no crackdown on violations of the International Code of Marketing of Breast-Milk Substitutes, which was adopted by WHO in 1981," he added.

    Breast-feeding has been proved to be the "single most effective intervention to prevent childhood deaths." According to the WHO, 13 percent of deaths of children under five could be prevented if infants were exclusively breast-fed for six months, and six percent more could be prevented with adequate and safe complementary feeding.

    Infants less than five months old who are not breast-fed have sevenfold and fivefold increased risks of death from diarrhea and pneumonia respectively, compared with infants who are exclusively breast-fed, the WHO said.

    Aside from its direct effects on the health and well-being of babies, breast-feeding has a profound impact on the economy.

    "Breast-feeding strengthens the economy by adding significantly to the national food supply. The economic value of mothers' milk production is large, worth billions of dollars even in small countries," said Dr. Julie Smith of the Australian Center for Economic Research on Health, Australian National University. In the Philippines, Filipinos spend an estimated PhP21.5 billion a year on infant formulas.

    "Mothers' efforts to breast-feed represent an important national investment in building high-quality human capital. It is also an investment that lowers national and family-health costs and reduces future burdens on the health system," she added.

    Citing an Australian research, Smith pointed out that as infant-formula sales increase, the number of breast-feeding mothers goes down. Local infant-formula companies spend above $100 million a year to promote their products. This is in contrast to poorly funded public-health systems that fail to provide health workers with the skills and knowledge needed to promote breast-feeding.

    David Clark, legal project officer of UNICEF, noted that the market for baby foods in the Asia-Pacific Region accounts for the largest share of the global market at 36.6 percent. Among countries in East Asia and the Pacific Region, only the Philippines and Palau currently have laws regulating the marketing and promotion of on infant formulas.

    "Support for breast-feeding must go beyond the hospital, and involve communities, workplaces, local governments, workers' unions, mass organizations, and consumer associations, in addition to the already very active nongovernment organizations," Omi stressed. M

 

 

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Bird-flu human cases stabilize

GENEVA

The bird-flu epidemic appears to have stabilized as far as humans go but several developing nations have not been able to stem its spread among poultry and domesticated birds. "The number of human cases of bird flu appears to be stable when compared to the same period last year," Gregory Hartl, World Health Organization media office, said.

    The WHO reported 56 new human cases of bird flu until July 25 this year, 34 of which were fatal. There were a total of 115 cases last year and 79 deaths. The WHO has so far recorded 319 cases of bird flu in humans worldwide, 192 of which were fatal.

    "In the northern hemisphere, the number of cases in summer has declined marginally from the winter," Hartl said. "Human-to-human transmission are very rare. We think there have been three cases-in Vietnam, Cambodia and Indonesia. And each time the person has had prolonged and direct contact with an affected person."

    Dr. Margaret Chan, WHO director general, recently said a fifth of the population in some of the affected countries could contract the potentially fatal H5N1 strain of the virus.

    "From experience we do know that what we call the attack rate of a new pandemic would range-based on past experience it does not necessarily apply for the next pandemic-[to] roughly 20 percent or thereabout," Chan had said. "If there's a 10-million population, with 20 percent, two million would be affected at different stages. And then the severity of the disease would range from mild to severe."

    Meanwhile, the head of the World Organization for Animal Health, Bernard Vallat, said that the "presence of the virus is clearly lower among domestic birds this year when compared to the previous year." But he warned of a "recrudescence of the virus among wild birds in Europe," and underlined that four of the 25 countries where avian influenza has been detected have not been "able to control the situation" and that the virus had turned "endemic."

    These four countries are Indonesia, Bangladesh, Egypt, and Nigeria, Africa's most populated nation. Vallat said the levels of veterinary services are not up to scratch in Indonesia while lack of coordination and resources are hampering the fight against bird flu in the other three countries.

No sharing

    Meanwhile, Indonesia said it will not share bird-flu samples with the WHO until it is guaranteed access to affordable medicines to treat victims of the deadly virus.

    The WHO has accused Indonesia, which has suffered the highest number of human deaths from the H5N1 virus, of putting the world at risk by failing to share its samples. Passing on laboratory samples would allow the WHO to keep track of any mutations that might spark development of an even deadlier pandemic strain of influenza, according to the UN health agency.

    But Lily Sulistyowati of Indonesia's health ministry said Indonesian authorities were awaiting a new mechanism that would put new guidelines on sample sharing in place. Indonesia wanted a system that was transparent and allowed developing countries affordable access to medicine supplies to treat bird flu, she said.

    This was because "we had difficulties when we wanted to buy Tamiflu," she said, referring to the main drug used to treat victims of the virus. "We could not get it directly. The WHO told us that we had to queue up with other countries, developed countries, where they don't really have any cases."

    Indonesia stopped sharing virus samples with foreign laboratories in December 2006, saying it feared multinational drug companies could use them to develop vaccines that were not affordable for poor countries.

    Jakarta said in May it had resumed sending H5N1 specimens to a WHO laboratory in Tokyo, but a senior WHO official said three specimens sent did not contain live flu viruses, and two were from the same person.

    Negotiations are underway to reach an agreement on detailed international virus-sharing guidelines at a special meeting of WHO member states in November. M AFP

 

 

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Impact of doctor migration limited

PARIS

The migration of doctors and nurses from the developing to the developed world has only a limited impact on the crisis in health care in poor countries, the Organization for Economic Cooperation and Development (OECD) said in a report.

    It noted that increased immigration of medical personnel to the 30 industrialized economies in the OECD had sparked fears of a "brain drain" that is depriving poor countries of critically needed health professionals.

    But the OECD, in its 2007 International Migration Outlook, said its research showed that the "global health workforce crisis goes far beyond the migration issue."

    It said the number of immigrant medical workers in OECD countries represents "only a small fraction"-12 percent in Africa, for example-of the needs of health-care sectors in developing countries, as estimated by the World Health Organization.

    "In short, although stopping the flow, if this were indeed possible, 1would alleviate the problem, it would not by itself solve the shortage issue," the OECD maintained.

    The report argued for increased financial assistance from the developed world to health-care sectors in poor countries and backed a WHO initiative to draft a "global code of practice" governing the international recruitment of medical personnel.

    The OECD report challenged the perception that health professionals are over-represented among skilled immigrants, noting that in 2000, 11 percent of nurses and 18 percent of doctors employed on OECD countries were foreign-born.

    Half of the immigrant doctors and nurses working in OECD members are in the United States, 40 percent in Europe, and the rest in Australia and Canada. Filipino nurses and Indian doctors each represent about 15 percent of all nurses and doctors in the OECD.

    But the OECD maintained that in countries such as India, the Philippines, and China, which are big suppliers of overseas medical personnel, "the number of health professionals working overseas, although high, is low relative to the domestic supply and the number of doctors per person has not been strongly affected."

    It said that while most OECD countries try to make it easier for highly skilled professionals to immigrate, there are few migration programs specifically targeting health care workers. M AFP

 

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