In May 2015 the World Health Organization published a Technical Note on its 2017 reporting to the United Nations General Assembly on the progress achieved in the implementation of national commitments included in the 2011 UN Political Declaration and the 2014 UN Outcome Document on NCDs. The Technical Note was updated in September 2017 to ensure alignment with the updated set of WHO ‘best-buys’ and other recommended interventions for the prevention and control of non communicable diseases that was endorsed by the World Health Assembly in May 2017. The Progress Monitor provides data on the 19 indicators on progress in NCDs and their control and management for all of WHO’s 194 Member States. The indicators include setting time-bound targets to reduce NCD deaths; developing all-of-government policies to address NCDs; implementing key tobacco demand reduction measures, measures to reduce harmful use of alcohol and unhealthy diets and promote physical activity; and strengthening health systems through primary health care and universal health coverage.
Equity in Health
The chemical nonoxynol-9, which is found in at least 18 over-the-counter spermicides sold worldwide, does not reduce the spread of HIV as once thought and could increase the likelihood of HIV transmission, according to a joint report released last week by the World Health Organization and Eastern Virginia Medical School's Contraceptive Research and Development Program.
Faced with a rising toll of occupational-related death, injury and sickness, the World Health Organization (WHO) and the International Labour Office (ILO) marked the World Day for Safety and Health at Work by highlighting the need for a preventative safety culture worldwide. According to new estimates by the ILO, the number of job-related accidents and illnesses, which annually claim more than two million lives, appears to be rising because of rapid industrialization in some developing countries.
The 5th Report on the World Nutrition Situation outlines how reducing malnutrition is central to the achievement of the Millennium Development Goals (MDG), citing evidence that links nutrition to a range of other development outcomes. It highlights how a nutrition perspective can strengthen key development mechanisms and instruments such as poverty reduction strategies, health sector reform, improving governance and human rights, and trade liberalization. The Report makes specific suggestions about how nutrition can be engaged in a practical programme and policy context. This contribution is timely, as progress towards the 2015 MDG targets has been slower than anticipated.
The Mozambican Association of Doctors in the Fight Against AIDS (MCS) has warned that the poor quality of the diet of many HIV-positive people, who are receiving anti-retroviral drugs, is a motive for serious concern. The MCS warns that poor nutrition risks undermining anti- retroviral treatment.
Obesity prevalence is increasing globally and contributes substantially to the burgeoning burden of non-communicable diseases. South Africa is particularly affected by this increasing trend and cross-sectional evidence suggests socioeconomic and behavioural variables as possible drivers. However, no large scale longitudinal study has attempted the direct identification of risk factors for progression towards obesity. This study analysed data on 10,100 South African adults (18 years and over) randomly selected in 2008 and successfully recontacted in 2010 and 2012. Latent Growth Modelling was used to estimate the average rate of change in body mass index (BMI) during the study period, and to identify baseline characteristics associated with different trajectories. The overall rate of change in BMI during the study period was +1.57 kg/m 2 per decade, and it was higher among women than among men. Female gender, younger age, larger waist circumference, white population group and higher household income per capita were baseline characteristics associated with higher rates of change. The association between tobacco use and obesity was complex. Smoking was associated with greater waist circumference at baseline but lower rates of increase in BMI during the study period. Quitting smoking was an independent predictor of BMI increase among subjects with normal weight at baseline. Among subjects with baseline BMI lower than 25 kg/m 2 , rates of changes were higher in rural than urban areas, and inversely related to the frequency of physical exercise. A strong positive trend in BMI remains in South Africa and obesity prevalence is likely to increase. Trends are not homogeneous, and high risk groups (subjects with high socioeconomic status, rural dwellers, young women) and modifiable risk factors (physical inactivity) can be targeted. Subjects quitting smoking should receive additional weight-loss support in order that the numerous health benefits of cessation are not reduced by increasing BMI. Centrally obese subjects should be targeted in campaigns.
Occupational health and safety (OHS) provision for public servants is southern Africa is poor. Many factors may contribute to this grave situation. Managers of government departments often lack knowledge of their responsibilities regarding occupational health and safety. Training in health and safety for managers and workers is limited by inadequate budgets, bureaucratic obstacles to procuring the training and lack of available approved trainers. Resources to improve the working conditions in the public sector are scarce. What is needed to ensure the health and safety of the public sector in Southern Africa are adequate policy and legislation, enforcement and monitoring of compliance in public service departments, OSH programmes in public sector workplaces, access to adequate treatment and rehabilitation for those affected by workplace hazards, and adequate social security for those disabled and the survivors of those who die on the job. Even if they are motivated to act against unsafe conditions, many categories of worker are precluded from the right to strike as they are considered providers of ‘essential services’.
In Kenya, the Jua Kali (“hot sun,” in Swahili) industry is a major economical component of the urban informal sector, consisting primarily of outdoor manufacturing and repair shops. In August 2005, a cross-sectional survey was conducted in a large Jua Kalii area in Eldoret, Kenya. Most of the interviewees described their working conditions as poor, with about 30% of the subjects without easy access to toilets. They identified the three occupational risks as: breathing difficulties due to exposure to smoke, fumes or gases; work accidents; and eye injuries. In many of the work facilities, tools and practices require major improvements in order to provide appropriate working conditions in compliance with modern scientific knowledge and current legislation in Kenya. Changes in these areas require major financial investments and administrative commitments that are probably not easily achievable, the authors warn. But in such areas as institutional training, safety practices, and prevention, much can be accomplished with limited, affordable resources, including the provision of safe drinking water, accessible clean toilets, changes in working conditions (chairs, tables, lighting), training in safe work practices, the provision of basic protective devices such as goggles, gloves and aprons, improved methods of handling hazardous materials, and assistance in training to update work skills in light of changing technologies in their areas of employment.
Awareness is growing that the world's population is rapidly ageing. Although much of the related policy debate is about the implications for high-income countries, attention is broadening to less developed settings. Middle-income country populations, in particular, are generally ageing at a much faster rate than was the case for today's high-income countries, and the health of their older populations could be substantially worse. However, little consideration has been given to issues of old age in sub-Saharan Africa, which remains the world's poorest and youngest region.
While attention has focused on the rapid pace of urbanisation as the sole or major factor explaining the proliferation of informal settlements in developing countries, this paper argues that there are other factors that may have an effect. The paper accounts for differences in the prevalence of informal settlements among developing countries using data drawn from the recent global assessment undertaken by the United Nations Human Settlements Programme. The empirical analysis identifies substantial inter-country variations in the incidence of these settlements both within and across the regions of Africa, Asia as well as, Latin America and the Caribbean. Further analysis indicates that higher GDP per capita, greater financial depth and increased investment in infrastructure reduces the incidence of slums. Conversely, external debt burden, inequality in the distribution of income, rapid urban growth and the exclusionary nature of the regulatory framework governing the provision planned residential land directly contribute to the prevalence of informal settlements.