Every tobacco death is an avoidable tragedy. The epidemic must stop here | Margaret Chan

Tobacco use, the leading cause of death from non-communicable diseases such as heart and lung disorders and cancer, claims about 6m lives a year. On Monday, countries will gather in Delhi, India, for the seventh conference of the parties to the World Health Organisation framework convention on tobacco control, a treaty that has sparked global action to stem the epidemic.

The treaty is already one of the most widely embraced in UN history. One of my proudest accomplishments at the helm of the World Health Organisation has been rallying global efforts to drive down tobacco use. I’m pleased to say that, following the adoption of the agreement, governments around the world have taken decisive steps not only to reduce tobacco use, but also to stand up to the multinational tobacco companies standing in the way of global progress.

The tide of tobacco use is beginning to turn. After decades of Big Tobacco targeting low- and middle-income countries and years of steadily increasing sales, tobacco sales show signs of dropping.Countries are passing stronger laws to reduce demand for tobacco products not envisioned even a few years ago, and tobacco companies are losing the legal challenges they mount against these measures. From Uruguay to Australia, countries large and small have stood up to the tobacco industry by implementing plain packaging and large pictorial health warning labels. Where tobacco companies have tried to threaten and bully nations, governments have responded with firm measures to protect public health.

However, amid these clear signs of progress, the tobacco industry has made it absolutely clear that it has no intention of abandoning a business model that depends on enticing millions of new users – especially young people – to its deadly products.

The impetus of the global movement to reduce tobacco use should not be lost. More than ever, decisive action is needed. Now is the time for countries to build on the momentum established and protect their citizens. By raising tax on tobacco products, requiring graphic warning labels, conducting hard hitting mass media campaigns and banning tobacco industry advertising and marketing, countries can improve the health of their citizens, reduce healthcare costs and prevent the tobacco industry from addicting another generation of children.

Illicit trade in tobacco threatens the progress governments make in tobacco control by making cheap and unregulated products available. I am pleased to note that governments are increasingly taking action and becoming parties to the new international treaty to eliminate illicit trade in tobacco products.

I urge global leaders convening in India to see this as an opportunity to bend the course of public health history

We need to work together, as allies in global health, to fight to protect people from the dangers of tobacco. I recently appointed Michael Bloomberg as WHO global ambassador for non-communicable diseases because of his track record in tobacco control, which includes more than 10 years of support for low- and middle-income countries. Advocates like him, and many others who champion tobacco control, stand with the WHO to support governments in this fight.

I am also heartened by progress on standardised or “plain” packaging – a measure introduced by the treaty and pioneered in Australia, where smoking rates have now fallen to record lows. The early evidence from Australia shows that plain packaging, as part of a comprehensive approach to tobacco control, is diminishing the appeal of tobacco products, increasing the effectiveness of health warnings and reducing the ability of the pack to mislead. France and the UK have begun implementing plain packaging laws, and New Zealand and Hungary have recently passed legislation. Many other countries are close behind.

We have made great strides, but we have so much more to do. Tobacco use remains one of the most vexing challenges we face in the global health arena.

I urge global leaders convening in India to see this moment as an opportunity to bend the course of public health history and commit to returning home with a renewed dedication to fully implement the WHO framework convention. To make the event effective, it is vital that governments recognise the inherent conflict between public health and the interests of the tobacco industry. Representatives from the latter should be completely excluded from government delegations.

Every death from tobacco is an avoidable tragedy. It is our task to reverse the tide, effecting an irreversible decline in the number of such deaths.

We need history to show us that the turning point in the tobacco epidemic is now. We know what to do and we know how to do it. We now need to ensure that every country moves forward and no one is left behind. Future generations depend on us.

Every tobacco death is an avoidable tragedy. The epidemic must stop here | Margaret Chan

Antibiotic resistance is an avoidable disaster

We really do not want the inconvenience of even the mildest infection, believing that medication is there to deal with our each ailment, and yet at the very first signal of improvement, we quit taking it.

Final week, the chief medical officer, Dame Sally Davies, suggested the public not to argue with medical professionals who really don’t want to prescribe antibiotics. As well usually, medical professionals tire of arguing, and simply give in and dish them out. There’s a element of all of us that desires a quiet life. In just a generation, we have forgotten the worth of antibiotics, taking them for granted and as a correct.

There is also the law of unintended consequences. We want cheap meat and yet we fail to see that this relies on trying to keep animals in unnaturally close proximity, so infections spread like wildfire and hefty doses of antibiotics are required to end them. It takes a certain kind of idiocy to convince ourselves that we can buy an complete chicken, for example, for just a number of lbs, with out there getting another price even more down the line.

Yet again, in just a generation our expectations have dramatically changed. Whilst 50 years in the past meat was a treat, eaten when or twice a week, now we expect it every day. Our greed for low-cost, plentiful meat has fuelled the rise in antibiotic resistance.

David Cameron’s answer is to push for far more antibiotics to be identified. The unsightly truth is that this is a Sisyphean job. Unless we reduce demand for antibiotics, we will want a by no means-ending stream of new medication.

We want to consider far more drastic action. That is not to say we have to become vegan. But there is a valid argument that all varieties of factory farming ought to be banned and that antibiotic use in animals ought to stop. Surely, the price of meat and dairy would rise. But I’d rather some folks could dwell than afford to consume meat every single day. We’ll also have to accept that when we have a minor infection, we should allow our body to deal with it.

I keep in mind a buddy of mine, a burly, rugby-enjoying medic, currently being brought close to tears as he watched an elderly lady die of a superbug she’d caught in hospital – and his horror at realising that there was nothing at all that present day medicine could do for her. He stopped consuming meat the night she died. How numerous far more will have to die prior to we all realise the predicament we are in?

Time for yet another size- debate

First we had the dimension- debate, in which the prominence of style models in dimension- clothes (dimension 6 in Britain) was criticised for encouraging unrealistic entire body images in younger girls. It would seem not everyone was listening to the chorus of disapproval.

US garments producer Abercrombie &amp Fitch was, until finally recently, marketing dimension-000 clothing (British size ) so tiny that only an individual with less than a 23in waist can put on them.

It looks extraordinary that as girls acquire much more prominence in public existence, the ideal body image is obtaining smaller sized. Ladies are vanishing to a zero.

The craze is fuelled by the emaciated photos posted on the web by designs and celebrities, this kind of as Alexa Chung. I at present operate in an consuming-disorder unit in north London, and see on a every day basis the outcomes of this pernicious view of women’s bodies. Quite significantly anybody who can fit into a 000 dress is severely underweight.

I challenge anyone who can match into a size 000 to show they really do not have an abnormal partnership with meals. That social media and celebrities can endorse this kind of an unhealthy entire body shape strikes me as utterly repugnant. Remember: there are 3 billion women who don’t look like supermodels and only eight who do.

New Great tips on cot death are clear and proof-based mostly

Cot death dominated headlines for considerably of the Eighties and Nineties. It appeared to be the distillation of every parent’s worst nightmare that, in spite of taking every precaution, your infant could die with out any discernible lead to. The mystery manufactured it all the far more horrifying.

Nevertheless cot death seemed to slip from the front webpage. I recently asked on Twitter whether it still occurred. I was surprised to find out that costs had dropped right after a public well being campaign named Back to Sleep (now Risk-free To Sleep), which developed on investigation linking cot death – or Sudden Infant Death Syndrome – to babies sleeping on their fronts, and encouraged dad and mom to place young children to sleep on their backs.

Even now, 250 infants a yr carry on to die of this situation in England and Wales. The National Institute for Well being and Care Excellence (Great) has now warned parents against making it possible for their infants to fall asleep in their arms, and known as for much better awareness of protected sleeping routines.

Generally, I am wary of overly prescriptive suggestions, specifically for younger parents. They are bombarded with contrary tips from all method of “professionals”, generating early parenthood an anxious sufficient time. But right here, Nice is carrying out what it need to: giving dad and mom clear suggestions primarily based on study and evidence.

I hope it will mean that cot death stays off the front pages forever.

Max Pemberton’s most current guide, ‘The Doctor Will See You Now’ is published by Hodder. To order a copy, call Telegraph Books on 0844 871 1515

Antibiotic resistance is an avoidable disaster

Mid Staffordshire NHS trust fined for "avoidable and tragic death"

Gillian Astbury died at Stafford hospital in 2007. Photograph: Rui Vieira/PA

The Mid Staffordshire NHS basis trust has been fined £200,000 and ordered to spend far more than £27,000 in expenses over what the judge described as “the wholly avoidable and tragic death of a vulnerable patient”.

The Overall health and Safety Executive brought an unprecedented criminal case against the believe in above the death of Gillian Astbury, 66, who died in 2007 due to the fact nurses at Stafford hospital failed to give her the program insulin she needed to remain alive.

The Francis inquiry into bad requirements of care at Mid Staffs looked in detail at the Astbury situation and criticised the HSE for an apparent inability to determine whether it should prosecute, despite the inquest jury’s findings that there had been a gross failure to give care. The HSE announced last August that it would bring the situation. In court, the trust pleaded guilty to an offence under the Wellness and Safety at Perform Act.

The court heard that health-related personnel did not comply with – and often did not even search at – Astbury’s healthcare notes, which plainly stated that she essential insulin, normal blood exams and a specific diet regime. Problems had been made as her ward underwent as a lot of as eight shift adjustments and 11 medicines rounds per day. The technique for handovers, when nurses arriving for the next shift ought to be informed of the demands of the individuals, was “inconsistent and at times non-existent”, the believe in admitted.

“Mid Staffordshire NHS basis trust failed to apply a correct handover technique, or to oversee the correct completion of nursing records and the monitoring of care ideas,” stated Peter Galsworthy, HSE head of operations in the West Midlands. “In performing so, they put Gillian Astbury at risk. The trust’s programs have been just not robust adequate to make sure that staff regularly followed concepts of very good communication and record retaining. Gillian’s death was completely preventable. She just essential to be provided insulin.

“Gillian Astbury and her loved ones were failed by Mid Staffordshire NHS foundation believe in. Each hospital patient has the right to expect much more. Significant security management flaws had been recognized by our investigation. We expect lessons to be learned across the NHS to avert this taking place once again.”

Astbury, who had been admitted to the hospital in 2007 due to the fact of fractures to her arm and pelvis, lapsed into a coma right after nurses failed to give her the insulin injections she needed to stay alive. Two nurses had failed to notice her high blood sugar levels – each have been disciplined and 1 was struck off by the Nursing and Midwifery Council final year.

“It was a wholly avoidable and tragic death of a vulnerable patient admitted to hospital for care but who died simply because of a lack of it,” said the judge, Mr Justice Haddon-Cave.

“A important fine is referred to as for to reflect the gravity of the offence, the loss of a lifestyle and in purchase to send out a robust message to all organisations, public or private, accountable for the care and welfare of members of the public.”

Mid Staffordshire NHS trust fined for "avoidable and tragic death"

1,000 hospital sufferers die each and every month from avoidable kidney issues

Surgeons performing kidney operation. Photograph: Christopher Furlong/Getty Pictures

At least 1,000 hospital sufferers in England die each and every month from avoidable kidney difficulties, according to a examine commissioned by the NHS.

Researchers identified that 15,000-forty,000 excess deaths every single 12 months are induced by acute kidney injury (AKI), which triggers a loss of kidney perform and can produce extremely speedily. It can happen in folks who are already sick with conditions such as heart failure or diabetes and these admitted to hospital with infections.

AKI can also create following significant surgical treatment, this kind of as some types of heart surgical treatment, due to the fact the kidneys can be deprived of normal blood movement during the procedure. Severe dehydration is one particular of the primary brings about of the condition.

AKI charges the wellness services more than £1bn each year, in accordance to a study commissioned by NHS Bettering High quality.

The study, carried out by kidney disease specialists and Insight Well being Economics, identified that AKI is five instances much more prevalent in English hospitals than previously considered.

The report’s co-writer Prof Donal O’Donoghue, advisor renal doctor at Salford Royal NHS basis trust, stated: “We know that at least a thousand individuals a month are dying in hospital from AKI due to poor care.

“These deaths are avoidable. This is totally unacceptable and we can’t enable it to continue. Very good fundamental care would conserve these lives and conserve millions of pounds for the NHS. Medical doctors and nurses require to make elementary checks to stop AKI. In basic, people who are getting surgical procedure shouldn’t be asked to go with out water for longer than two hrs.

“Occasionally that is unavoidable, but then health-related employees need to check out their patients are not becoming dehydrated. They also require to be aware that some frequent medicines enhance the risk of AKI.”

Marion Kerr, health economist at Insight Well being Economics, explained the £1bn annual expense to the NHS “is more than we devote on breast, lung and bowel cancer combined”.

She extra: “Every single day, much more than thirty people are dying needlessly. Compare that to MRSA which was killing about 4 people a day at its peak. Easy enhancements in simple care could conserve the NHS £200m a yr and, more importantly, conserve 1000′s of lives.”

A spokesman for NHS England explained: “We have taken steps to guarantee the NHS puts in place coherent lengthy-phrase strategies to minimize avoidable deaths in our hospitals, and to improve the way data is utilised in selection producing.

“Overall health investigation primarily based on true lifestyle proof like this is vitally crucial for NHS commissioners in deciding on where to target their sources.”

1,000 hospital sufferers die each and every month from avoidable kidney issues