Progress on malaria deaths at risk without big boost in funding, UN warns

Real progress in driving down infections and deaths from malaria will be at risk if substantially more funding is not forthcoming, according to the latest annual report on the epidemic.

Last year, more than 400,000 people (pdf) – mostly small children and pregnant women – died from malaria. Insecticide-impregnated bed nets to sleep under and effective drug treatments have brought the number of deaths down by nearly 30% worldwide in the five years from 2010 to 2015; the number of new cases over the same period is down by more than 20%. But the report, published by the World Health Organisation, shows there are substantial gaps in the coverage.

Some countries such as Sri Lanka and Kyrgyzstan have eliminated malaria and the WHO says the target of elimination in ten countries by 2020 will be met. Last year at least ten countries had 150 cases or fewer and nine more had between 150 and 1,000.

But the task of reducing the toll of malaria in the heavily endemic countries of sub-Saharan Africa, which have 90% of cases and 92% of deaths, is hard and needs more resources, says the report.

“We are definitely seeing progress,” said Dr Pedro Alonso, director of the WHO Global Malaria Programme. “But the world is still struggling to achieve the high levels of programme coverage that are needed to beat this disease.”

On the positive side, more children are being tested to determine whether they have malaria, so that the treatment is effective, and more pregnant women are being given drugs to prevent them getting malaria.

But an estimated 43% of the population of sub-Saharan Africa was not protected by nets or indoor spraying to kill the mosquitoes that transmit the disease last year. A third of the children with fever in 23 African countries were not taken to a health facility where they could be tested and appropriately treated.

While funding went up steeply between 2000 and 2010, it has flatlined for the last five years. It is estimated that $ 6.4bn (£5bn) per year is needed to keep the global malaria elimination efforts on target in 2020, but in 2015 it was only $ 2.9bn, or 45%. A third of that is provided by the governments of countries where malaria is endemic. Last year the US contributed 35% of the total and the UK put in 16%. The report says that substantially more money is needed both from international donors and from the affected countries.

“If this flatlining remains, we will not be able to achieve the ambitious goals and targets the world agreed on a year ago,” said Alonso. In 2015, the World Health Assembly adopted a global technical strategy for malaria, with milestones every five years until 2030. It calls for a 40% reduction in malaria cases between 2015 and 2020. Only 40 of the 91 countries with endemic malaria are on track to achieve that.

Progress on malaria deaths at risk without big boost in funding, UN warns

Cancer Moonshot program is "close to gigantic progress", Joe Biden says

Vice-president Joe Biden’s Cancer Moonshot initiative to speed the development of cancer treatments has made some important strides such as increased information-sharing among researchers but still faces challenges in many areas, according to a report on Monday.

The White House is still seeking about $ 700m from Congress for the project. With Barack Obama leaving office in January, it is also unclear how much of the initiative will continue under a new administration.

Microsoft and Amazon have committed to creating cloud storage for the effort, according to the report, which summarizes the work completed so far and outlines a path forward over the next five years.

Ride-sharing services Uber and Lyft will help patients get to the doctor and to clinical trials.

“I’m going to devote the rest of my life to working on this, and I think we’re perilously close to making some gigantic progress,” Biden told reporters.

The $ 1bn moonshot project was announced by Obama during his State of the Union address in January. Since then, Biden, whose son Beau died last year at age 46 from brain cancer, has announced multiple investments and collaborations in support of the project.

The Cancer Moonshot initiative has also spurred the defense department to use artificial intelligence to analyze its collection of tissue from tumors to look for patterns.

The US Patent and Trademark Office has launched a pilot program to cut in half the time to review certain cancer therapy patent applications from an average of about two years to less than 12 months.

Obama praised Biden for his leadership on the issue and said his administration was laying the groundwork for future presidents to continue the fight against cancer.

“While we are going to be leaving soon, what I think we are going to be able to leave behind is an architecture and a framework” for advancing cancer research, Obama told reporters after his meeting with Biden.

Cancer Moonshot program is "close to gigantic progress", Joe Biden says

Julia Gillard: "We"ve made progress in education and gender equality – but more must be done"

A few years ago, an outbreak of cholera and other deadly diseases swept through one of the poorest villages in the northern region of Ghana, taking the life of Ruhainatu’s mother, Jamila.

Ruhainatu was in her teens. A decade ago, Jamila’s death would have extinguished Ruhainatu’s chances of getting the education she needs to succeed in life. Instead of going to school, she would have taken on her mother’s role of caring full time for her home and family.

But efforts by the Ghanaian government, together with development partners like the Global Partnership for Education, have strengthened the country’s education system. Now Ruhainatu and girls like her have a more hopeful prospect for life. One of the top performing students in the local school, Ruhainatu has ambitions to go away to university to become a nurse and then return to her village to help others remain healthy.

Ruhainatu has ambitions to go away and train as a nurse. Photograph: GPE/ Stephan Bachenheimer

Her story is one of countless affirmative real-life testimonials showing how educating girls can help them be healthier, more economically prosperous and become more civically empowered women. Their new knowledge can also improve the health and wellbeing of others around them.

But enabling children to succeed requires the right combination of support, so that they will be healthy, well-nourished and can attend a quality school that has access to clean drinking water and toilets.

Providing school meals and deworming programmes, for example, can have an important impact. The 2016 Unesco global education monitoring report notes that school meals and deworming programmes promote better education outcomes, especially for girls. For very poor families, the prospect that their daughter will be fed means that sending her to school is a more attractive option than keeping her at home so she can attend to domestic duties, farm work or taking goods to market. Greater access to clean water can also translate into education improvements for girls, by reducing the time they take to collect water for the family and giving them more time for school.

This give-and-take between education and other social development factors has received more emphasis since the unveiling of the sustainable development goals (SDGs) last year. We are breaking down the silos that have historically divided development sectors. Education and global health groups now understand that improvements in each are essential to progress for both and we are already creating opportunities for deeper collaboration.

Now the evidence of what works is increasingly clear, let’s just get on with it and drive progress on the mutually reinforcing goals for global education (SDG 4) and gender equality and women’s empowerment (SDG 5).

For groups like the Global Partnership for Education, whose board I chair and which partially funded the program in Ghana that helped Ruhainatu, “getting on with it” includes continuing to support countries to close the gender gaps in their education systems.

We are breaking down the silos that have historically divided development sectors.

Closing those gaps requires recognising and breaking down barriers to gender equality. Poverty is the biggest, but other significant factors include ethnicity, language, disability, early marriage, the distance from home to school, gender-biased pedagogy, fragility and conflict, absence of proper sanitary facilities, pressure to take care of family or earn money, and insecurity within and on the way to school.

We – in education or in any other related development sectors – could accomplish much more in less time if there was sufficient political support and enough financing. This includes first and foremost more domestic financing for education by developing countries themselves. But it also requires more donor funding. We can’t “just get on with it” when education’s share of overseas development aid has fallen from 13% to 10% since 2002. The International Commission for Financing Global Education Opportunities, notes in its just-released report that under present trends, only one in 10 young people in low-income countries will be on track to gain basic secondary-level skills by 2030. Clearly, this is completely unacceptable.

The Education Commission, on which I serve as a commissioner, advocates for a range of far-reaching transformations to improve education. The commission’s work provides new evidence on what works and costs out what it would take for the world to educate every child.

The call to action in financing is to increase total spending on education from $ 1.2tn (£0.9tn) per year today to $ 3tn (£2.3tn) by 2030. That’s a big jump but not an insurmountable one.

Making the leap starts with developing countries, donors, NGOs, the private sector and many others choosing right now to just get on with it.

Join our community of development professionals and humanitarians. Follow @GuardianGDP on Twitter.

Julia Gillard: "We"ve made progress in education and gender equality – but more must be done"

Marriage in recovery: R is grumpy but apologises for it progress

‘R is behaving specifically like the man or woman who journeys over in public and then appears down at the ground and curses the pavement.’

The kitchen air is thick with burnt-toast smoke. The children wave their hands in front of their faces dramatically and I attempt to crack a joke to R: “Are you providing every person a sensory expertise of smog?” He does not laugh, let alone smile. He does a thing with his mouth, the place his lips go all thin and indicate, that tells me he finds my jibes tedious. He then pulls his mobile phone from his pocket and starts prodding at the display, a indicator that he has much better places to be.

For once he cannot escape the chaos of morning due to the fact I have to depart early for a meeting. I wave at everyone via the smoke. As R waves back, he knocks a vase of flowers more than on its side. This in itself is not funny, but when he starts chiding the cat for becoming so clumsy (the cat, previously R’s best ally, looks at him with incredulity since he is nowhere close to), we all laugh. R is behaving precisely like the particular person who trips above in public and then looks down at the ground and curses the pavement.

Even now laughing, the boys search to their father, prepared him to see the funny side. But R does not laugh. He provides us all an uptight seem that says “God, you are pathetic” and then tells me I should clear up the spilt water and broken flowers if I discover it all so hilarious. Generally I would want to stick an imaginary axe into the back of his head, or consider to myself, “I am never ever obtaining intercourse with you once more, you moody git.” Alternatively I say: “Clear it up your self, you arse. I have to go.” Which is probably not very mature in front of the young children. But even now.

Just before stepping out of the house, I say to myself, “This also will pass.” It really is some thing I picked up from Al-Anon, and like a lot of of the most memorable aphorisms, I locate it useful (even if I have a tendency to misquote). I like this a single since it sounds mildly romantic, but also due to the fact it recognises that existence is in no way static. No matter what occurs, no matter what modifications from a single 2nd to the following, moves every little thing on. It could get worse, it might get much better, but focusing so heavily on a moment as if it defines an hour, a day, week, month or 12 months, is a pretty fruitless factor to do. We have to keep moving.

Yet here I am worrying about leaving the residence while R is in such a mood. Even though anything as innocuous as him being all humourless is hardly a cause to get upset, it tends to make me keep in mind the times when his behaviour was unpleasant to dwell with. When he was drinking heavily, household mealtimes, get-togethers or group activities so usually buzzed with a tension that could not be blamed on one issue, but left every person feeling sick at ease. Typically, I needed to scoop up the youngsters and run away. I wouldn’t tolerate such sore days now, but on mornings this kind of as these I concern that issues will go back to how they had been.

But as I walk to the bus, I remind myself that weekday breakfasts have often been an angry time for R. Since we met, nothing has truly transformed. I employed to feel that he was silently raging in the morning since he was hungover, and when he stopped consuming I imagined he was grumpy simply because he was an insomniac.

I came to the conclusion that R is typically just angry at breakfast. Just as I am usually fairly angry at evening when I have a checklist of items to do, when I’m dog-tired and would truly rather be reading through or acquiring in a bath. Rather, I plunge my rubber-gloved hands into scorching water, loudly crashing pots and pans, making all the awake people around consider recognize.

On the bus, I get a text. “You are right. I was being an arse. I have said sorry to the children. I’m sorry to you, also. It is just hard. Not consuming can be so tiresome.”

Inside seconds of feeling depressed that things may possibly be slipping, I realise how distinct things are. How rapid R has been to move issues on with an apology. How fast he has been to operate out what may be wrong. How fast to realize that he may possibly not be capable to make everything far better, all at when, just as I can’t make everything fine all the time.

Marriage in recovery: R is grumpy but apologises for it progress

Will an anti-innovation culture in the NHS kill off technological progress?

An an NHS hackday, clinicians and computer software writers layout and publish an app to assist resolve a ‘real-ward’ difficulty. Photograph: Kay Nietfeld/dpa/Corbis

Two many years ago, I came across a great new way of writing healthcare computer software at an NHS hackday. The concept behind a hackday is that clinicians and software program writers choose on an app for solving a “genuine-ward” issue style and compose it within 24 hrs.

This disrupts the conventional way of creating hospital software, exactly where administrators give a series of Chinese whispers to systems analysts in an intergalactic application house potentially on the other side of the Atlantic. The systems analysts transmit even more Chinese whispers to a set of programmers who have no notion what takes place in an NHS hospital. The resulting method overruns by many years, fees millions and proves to be non-implementable by nurses and medical professionals on the ward.

The hackday technique has a greater possibility of good results, since the clinician is at the heart of the design and style procedure. The technique is created to be tweaked if it does not perform, it can be binned, and because it is written in open source, it can be latched on to mainstream systems.

Attracted as I was by all this disruptive contemplating, I was anxious that the youthful chaps creating apps would not realise 3 factors the importance of producing their programmes interoperable, that regulators will demand evidence that the apps are protected, and that offering and advertising and marketing software program in the NHS IT chaos is a nightmare.

To see how these disruptive guys have been acquiring on, I attended the Handi Digital Wellness Spring Symposium last month. Handi (Wellness Apps Network for Advancement and Innovation) assists startups to create apps for healthcare and is the intellectual powerhouse behind the hackday method to writing healthcare application. It believes in open source, quick prototyping, co-manufacturing (clinicians and geeks), crowdsourcing, several platforms – PCs, tablets and smart phones – and disruption, to keep the hospital IT bosses rattled.

At the symposium, I found that the Handi individuals were not just progressive geeks with bright concepts, but had been effectively conscious of the “actual globe”. They have to get via a bureaucratic NHS approval and regulatory method, to have the app registered on the NHS app retailer. 1 speaker claimed that testing could get eight months.

They had to learn how to layout consumer interfaces that are suitable for the consumer. The interface for clinicians, nurses and sufferers would have to be quite different from one one more. The healthcare material has to be “each reliable and engaging”.

They have to cope with an evolving and rather chaotic world of standards: syntactical, communications and semantic. A single speaker claimed that “semantic interoperability in health is impossible”. And even if an app developer conforms to interoperability requirements, they will have to let for fussy hospitals to make hospital-distinct tweaks.

But the actual nightmare is advertising the apps. The developers will have to cope with the NHS’s pervasive NIH (not invented here) syndrome. “Kent may well order your app but Sussex will not.” And it is no great striving to get central support for your app, as the neighborhood degree will reject any directive “prime down” from the centre. And clinicians will demand proof of the effectiveness of your app. They look to consider that proof is the outcome of the sort of RCT (randomised controlled trial) that is employed in approving medicines. The startup software program property would be bankrupt by the time such an RCT were completed. Not a quite helpful setting, then, for apps to flourish.

One fruitful approach would be for developers to associate themselves with hospital trusts or charities, and function with them to produce apps. That curiosity from trusts interested in co-operation of this sort was proven by the variety of delegates from trusts – about a third of the total – who attended the symposium.

An additional target of co-operation is large laptop organizations. Final week, there was a breakthrough. Apple launched Healthkit, a platform on its iPhone, iPad and iMac, to gather “health-associated data from a range of sources”. In the previous, Apple and other developers have created overall health applications, but these have been standalone. Healthkit is “created to give users a large-image appear at their entire overall health profile: exercise, rest, consuming and even metrics like blood strain and glucose amounts”.

Apple is signalling its entry into the healthcare market place. Samsung created a equivalent announcement the earlier week. We can count on the mobile apps market place to burgeon more than the up coming handful of many years, with sensor-laden iWatches and other wearable units.

I hope British Handi-type apps developers will join, or perhaps lead, the gold rush. But the danger is that the fragmented anti-innovation culture of the NHS will destroy them off.

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Will an anti-innovation culture in the NHS kill off technological progress?

Dwell Q&A: could technologies accelerate progress in direction of the MDGs?

M Pesa has offered mobile banking to millions outdoors the traditional banking technique. Photograph: Simon Maina/AFP/Getty Photographs

With the deadline for the millennium advancement goals (MDGs) looming, how far will technological innovation support attain its targets?

Helen Clark, head of UNDP, argues technology is taking us in direction of “higher-definition development”. It offers the potential not only to acquire information that helps paints an exact image of poverty, but to facilitate transparency inside of the growth industry.

The hope is that it will also support to allow progress around distinct millennium advancement targets in areas this kind of as well being, education, and hunger.

Tasks such as Zero mothers die, have sought to increase maternal and kid mortality prices, by using mobile phones to disseminate important data to communities lacking in health infrastructure. In agriculture, providers this kind of as IKSL have utilized a comparable engineering to share useful market place and crop info with one.3 million farmers across 18 states of India. In Kenya and Tanzania, M Pesa has effectively enabled hundreds of thousands of individuals left out of the traditional banking technique, to deposit and withdraw money on a mobile cellphone.

Whilst challenges stay about accessibility and affordability, engineering obviously has the possible to educate, empower and contain individuals typically excluded. However, to attain the MDGs, do we need a deeper knowing of how local contexts decide the uptake and affect of a particular technology?

There has been a excellent deal of pleasure about information and communication technologies (ICTs), but is it all about mobile phones and cutting-edge apps? By focusing only on the latest types, it is possible we miss out on a entire swathe of other, now typical, technologies that may possibly be more efficient in the offered context. Must we depart it up to the communities themselves to make a decision what kind of engineering they need to have?

Join us on Thursday 15 Might from 1pm – 3pm BST to examine these and other questions.

The live chat is not video or audio-enabled but will take area in the feedback area (under). Get in touch through globaldevpros@theguardian.com or @Guardiangdp on Twitter to recommend an individual for our specialist panel. Follow the discussion employing the hashtag #globaldevlive.

Reside chat studying checklist

• Generating ICTs operate for social justice and improvement

• How ICT tools are improving efficiency of agricultural improvement

• Linked females: employing mobile phones to shield migrants

Dwell Q&A: could technologies accelerate progress in direction of the MDGs?

Yemen law on little one brides and FGM gives hope of wider progress | Suad Abu-Dayyeh

Schoolgirls in Sana’a, Yemen. A new law promises to safeguard beneath-18s from marriage. Photograph: Mohammed Huwais/AFP

Yemen is poised to vote on a complete Kid Rights Act more than the coming months, which would ban kid marriage and female genital mutilation (FGM).

The new law would establish the minimum age for marriage as 18, in line with the international human rights normal. Fines would be imposed on guardians, signatories, marriage officials and any other witnesses aware of any contravention.

The push for official legislation on this kind of troubles has been endorsed by Hooria Mashhour, the Yemeni human rights minister, and supported by others in government.

If accepted by the prime minister and cabinet, the legislation would go to a parliamentary vote. Even so, profitable passage of the law is far from specified. In 2009, an try to make 17 the minimal age of marriage for women was blocked by conventional and religious leaders and the parliament’s sharia committee.

The president, Abd Rabbuh Mansur Hadi, now has the power to overrule such selections. It is far from specific whether or not he would intervene, but proof of expanding support for guarding ladies from early marriage may influence his outlook.

In accordance to the UN, more than half of Yemeni ladies are married by the age of 18, which can have serious physical, psychological and educational repercussions.

As a report by Equality Now factors out, youngster marriage does not take area in a vacuum but is rather part of a cycle of abuse and discrimination that usually consists of sexual violence and FGM.

With this is mind, posts in the Kid Rights Act that propose banning FGM – which affects 23% of Yemen’s female population – as nicely as other varieties of violence towards children, such as little one labour, are to be welcomed.

In dealing with the rights of women in a holistic way, Yemen is recognising that an interlinked method is important to guaranteeing individuals at risk are protected early on from the prospect of a lifetime of abuse. However, this kind of an strategy demands that the health, schooling and justice techniques are adequately resourced financially, and that each and every actor is aware of their function and obligation in ensuring the law is effectively implemented and women are correctly educated about their rights.

Neighbouring countries have manufactured moves in each directions. In Pakistan’s Sindh province,, the neighborhood assembly last month voted in favour of a law establishing 18 as the minimum age of marriage. In Saudi Arabia, regulations had been drafted last yr but have nevertheless to be introduced.

But proposed legislative adjustments in the region have not all been optimistic. While a draft law that would permit 9-year-previous Iraqi ladies to marry has been shelved, it is indicative of the possible for progress to be undermined.

It is hoped that in Yemen, the authorities will seize the chance to make main advances not only for the female population, but for the complete country. 

We hope that, on this occasion, standard and religious leaders will ensure the law is passed by the sharia committee. This would be a huge step towards a brighter future for Yemen, 1 exactly where the rights of ladies are firmly at the forefront.

Suad Abu-Dayyeh is Equality Now’s Middle East and North Africa advisor

Yemen law on little one brides and FGM gives hope of wider progress | Suad Abu-Dayyeh

Yemen law on youngster brides and FGM delivers hope of wider progress | Suad Abu-Dayyeh

Schoolgirls in Sana’a, Yemen. A new law promises to defend below-18s from marriage. Photograph: Mohammed Huwais/AFP

Yemen is poised to vote on a thorough Little one Rights Act above the coming months, which would ban youngster marriage and female genital mutilation (FGM).

The new law would establish the minimum age for marriage as 18, in line with the international human rights standard. Fines would be imposed on guardians, signatories, marriage officials and any other witnesses conscious of any contravention.

The push for official legislation on this kind of concerns has been endorsed by Hooria Mashhour, the Yemeni human rights minister, and supported by others in government.

If accepted by the prime minister and cabinet, the legislation would go to a parliamentary vote. Nonetheless, profitable passage of the law is far from specified. In 2009, an try to make 17 the minimal age of marriage for ladies was blocked by conventional and religious leaders and the parliament’s sharia committee.

The president, Abd Rabbuh Mansur Hadi, now has the electrical power to overrule such selections. It is far from specified regardless of whether he would intervene, but evidence of growing help for guarding girls from early marriage may influence his outlook.

According to the UN, a lot more than half of Yemeni girls are married by the age of 18, which can have significant bodily, psychological and educational repercussions.

As a report by Equality Now points out, kid marriage does not take spot in a vacuum but is rather part of a cycle of abuse and discrimination that typically involves sexual violence and FGM.

With this is mind, articles in the Kid Rights Act that propose banning FGM – which affects 23% of Yemen’s female population – as properly as other forms of violence towards young children, including child labour, are to be welcomed.

In dealing with the rights of girls in a holistic way, Yemen is recognising that an interlinked approach is important to guaranteeing people at chance are protected early on from the prospect of a lifetime of abuse. However, such an approach demands that the well being, education and justice systems are adequately resourced financially, and that every single actor is aware of their position and accountability in making sure the law is successfully implemented and women are appropriately educated about their rights.

Neighbouring countries have produced moves in the two directions. In Pakistan’s Sindh province,, the local assembly final month voted in favour of a law establishing 18 as the minimal age of marriage. In Saudi Arabia, regulations had been drafted final year but have however to be introduced.

But proposed legislative modifications in the area have not all been positive. While a draft law that would permit nine-yr-outdated Iraqi ladies to marry has been shelved, it is indicative of the possible for progress to be undermined.

It is hoped that in Yemen, the authorities will seize the possibility to make significant advances not only for the female population, but for the complete country. 

We hope that, on this event, classic and religious leaders will make sure the law is passed by the sharia committee. This would be a massive step towards a brighter long term for Yemen, one exactly where the rights of ladies are firmly at the forefront.

Suad Abu-Dayyeh is Equality Now’s Middle East and North Africa consultant

Yemen law on youngster brides and FGM delivers hope of wider progress | Suad Abu-Dayyeh

Progress overview: contraception use amid adolescent ladies

Indian younger brides are typically presurised to have children soon following they marry. Photograph: Sam Panthaky/AFP/Getty Pictures

Empowering adolescent women to entry and use contraception is a global public overall health priority. Large unmet want for contraception translates into higher numbers of unintended pregnancies, and into higher maternal mortality in nations with poor maternal overall health care methods. That is why minimizing the unmet require for contraception is a essential target in millennium advancement objective five.

Globally, progress is being manufactured in lowering the unmet require for contraception, but it is slow with far more progress in some countries than in other people. Bangladesh and Malawi are cited as accomplishment stories. In Bangladesh, the use of contraception amid married females aged 10 to 49 rose from 49% in 1996/97 to 61% in 2011. However, amongst married adolescents aged 15 to 19 years, contraception use rose by a lesser margin – from close to 33% in 1996/97 to 47% in 2011. In Malawi, the use of contraception in women aged 15 to 49 years rose from 13% in 1992 to 46% in 2010, whereas between adolescents aged 15 to 19 many years, it rose from 7% in 1992 to about 29% in 2010.

Barriers adolescents encounter in obtaining and making use of contraception

Erratic availability, value, laws and policies stop unmarried adolescents in lower and middle revenue countries from accessing contraceptives. Even when there are no legal restrictions, health staff usually refuse to supply unmarried adolescents with contraceptives since they do not approve of premarital intercourse. And when they do provide contraceptives, they frequently limit these to condoms, wrongly believing that long-acting hormonal approaches and intra-uterine gadgets are inappropriate for all youthful ladies and individuals who have not had youngsters.

Even when adolescents are able to receive contraceptive strategies, social pressure might avert their use. First, in several spots younger females are under pressure to bear young children quickly soon after marriage. Contraception is regarded – if it is deemed at all – following the first kid is born. Second, the stigma surrounding contraception prevents their use by adolescents who are not in steady relationships. A young lady who proposes condom use, for illustration, runs the chance of currently being regarded as ‘loose’. Third, adolescents in numerous areas have misconceptions about wellness results of contraceptives, which includes their potential capability to bear children. As a result, they tend to favor standard remedies or to use ineffective strategies such as withdrawal. Fourth, a lot of adolescents have poor knowing of how contraceptive strategies perform and use them incorrectly. Ultimately, sporadic and infrequent intercourse prospects to an inconsistent use of contraceptives. But even within stable relationships, the use of condoms tends to decline more than time since they recommend a lack of believe in.

Efforts to conquer these barriers

An excellent illustration of overcoming the barriers that adolescents encounter accessing contraception is Pathfinder International’s Prachar task. Intended to promote modify in reproductive behaviour of adolescents undertaking in Bihar, India, events have been held for newly married couples to celebrate their marriage and emphasise the rewards of delaying having youngsters and offered couples with a small supply of oral contraceptive tablets and condoms. Even more, male and female counsellors spoke to young married males and ladies individually in their properties on reproductive health. The undertaking also targeted unmarried adolescents aged 15 to 19 with workshops on sexual and reproductive wellness. The programme successfully delayed marriage of both male and female participants. It led to important increases in contraceptive demand and contraceptive use between married females underneath 25 and delayed childbearing.

The challenge is to build on the lessons discovered from projects this kind of as Prachar to build huge scale and sustained nationwide programmes. Core aspects of that task are now being utilized at scale in India’s Bihar state, but that is uncommon. A lot of other projects aimed at delivering contraceptive info and providers to adolescents in India and elsewhere carry on to be small-scale and time-constrained.

But there is developing readiness between government officials to change this. At the Family Planning 2020 partnership (FP2020), there is a genuine possibility to translate this readiness into action. FP2020 is a worldwide partnership which aims to support the rights of females and girls to determine freely and for themselves, no matter whether, when and how numerous kids they want to have. It works with governments, civil society, multilateral organisations, donors, the personal sector and the investigation and growth neighborhood to enable 120 million far more women and ladies to use contraceptives by 2020. This is very good news for adolescent sexual and reproductive health.

Venkatraman Chandra-Mouli is adolescent wellness and improvement co-ordinator at the World Well being Organisation. Follow @WHO on Twitter

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Progress overview: contraception use amid adolescent ladies

What progress has been manufactured given that the Francis report?

A good deal has happened because the Francis report was published but there is even now significantly to be carried out, writes John Illingworth. Photograph: Martin Godwin

Right now marks a year considering that the publication of the Francis report. And on the encounter of it, considerably appears to have happened.

The Care Good quality Commission (CQC) has designed a new technique to regulation and inspection, NHS England has published clinical outcomes across 10 new specialities, and a key new patient safety collaborative programme is properly under advancement.

But in the same period we have also noticed the police launch a formal inquiry into Colchester hospital, following reviews that workers were bullied into altering cancer waiting time data. Keep track of has doubled the number of its interventions into NHS trusts and the chair of the CQC has warned of a dysfunctional rift amongst NHS managers and clinical staff which is putting the security of sufferers at risk.

This tells us that progress has been manufactured on establishing some centrally-driven initiatives to increase security. It also suggests that there inevitably stays a challenge close to culture.

It is no shock that progress on culture is not instantly evident. Not only is it a difficult point to lay your hands on, the public inquiry itself was focused on “the function of the commissioning, supervisory and regulatory bodies”, the first inquiry in 2010 targeted on the care delivered to patients at Mid Staffordshire and these levers are not the way to positively influence culture.

So even though the government and NHS England plays a pivotal position in creating the correct environment for alter, it is down to individuals on the ground to make the changes deemed required.

The Francis report follows on from a preceding independent investigation that was carried out in 2010 by Francis which regarded individual situations of patient care. Our examination suggests that only 44 of the 290 suggestions – that’s close to 15% – are solely within the remit of NHS organisations to do one thing about, and only an extra 7 can be addressed by staff at the frontline.

In his report on patient security, Don Berwick talked about the NHS embodying the objective of consistent studying as the implies to achieve real enhancements in patient security and safety culture. We believe this could manifest itself in immediate action by NHS organisations, regardless of whether it requires executive teams generating an surroundings in which blunders can be openly talked about with no worry of reprisal, or frontline specialists shifting their practice as they better comprehend the hazards in their solutions.

The Health Foundation has produced a programme to allow health specialists to identify the dangers in a distinct service ahead of they lead to harms in sufferers. This has involved the teams producing a safety case, the place proof is collected from a wide assortment of sources to show that risk controls have been place in place and that there is a method for monitoring the system’s ongoing safety. They are employed in other safety vital industries, and often form the basis for a declare about the degree of security being achieved, frequently boiled down to a a single in x opportunity of failure.

In further discussions about how this strategy could be applied in healthcare, a question that keeps coming up is no matter whether we are prepared for the difficult concerns that arise from such an method. Can we take care of the reality? Are NHS believe in boards open to hearing about the dangers associated with their services? Will regulators react positively to problems getting proactively raised by organisations? Is the media prepared to unearth the improvements created as a result of security troubles, as well as the problems caused by them? And is there an appetite amid the public for this type of data relating to their healthcare?

The solution to the initial 3 inquiries might be “yes, but it depends”. But I think the answer to the fourth could simply be “yes”. If there is 1 factor that irks the public far more than the occurrence of bad care, it is the tolerance and concealment of poor care. And this brings us back to the ‘c’ word. We feel that the method of proactively identifying dangers and being open about them would radically modify the culture of security. Healthcare is a risky company, but now is the time to be candid about it if we’re going to make any progress towards the concerns identified in the Francis inquiry.

John Illingworth is a policy manager at the Overall health Basis

This write-up is published by Guardian Professional. Join the Healthcare Pros Network to acquire standard emails and unique gives.

What progress has been manufactured given that the Francis report?

Chemicals in Consumer Items: New Progress in Transparency

The states of Washington and California are breaking new ground by offering consumers with details on potentially hazardous chemicals in the items they get and use on a daily basis. Washington’s emphasis is on items meant for young children California’s law spotlights cosmetics.

Each states demand organizations to submit data on certain known or suspected carcinogens, reproductive toxins and developmental toxins Washington exclusively adds endocrine disruptors. They’ve published the resulting databases on their state websites — with much of the data previously unavailable.

Why did Washington and California get these initiatives, and why are other states now contemplating following the exact same path? Significant motivations include the rapidly expanding sum of scientific info available on chemical hazards and overall health impacts, the increasing understanding of the ubiquitous presence of several of these chemicals in our setting and our bodies, and increasing buyer pressure for safer items.

Not a Fairly Image

The data Washington and California have gathered from companies and reported on their internet sites previously provides a wealth of details for customers about potential threats:

• Formaldehyde in 22 children’s products and 89 cosmetic items, which includes hair conditioners, skin moisturizers and anti-wrinkle products


• Phthalates in goods this kind of as footwear, perfumes, fragrances and nail polish.


• Parabens — which includes two the European Union has proposed banning for young children below 3 — in child lotion, physique wash, and lip balm for youngsters, with the highest concentrations in Halloween makeup.


• Lead acetate in hair styling and coloring items.


• Methyl ethyl ketone in clothing.

For children’s toys, clothing, footwear, bibs, and so forth., possessing a extensive database of hazardous chemicals in specific products is fully new. But what about cosmetics? Even though Meals and Drug Administration (FDA) rules call for listing of cosmetic ingredients, they exempt fragrances. In order to defend the secrets of their scents, companies might simply specify ‘fragrances’ on the label rather than listing the fragrance’s elements.

So what can shoppers discover from searching at California’s database that isn’t already clear from the item labels?

Initial, whilst the California rules call for companies to report the presence in cosmetics of any of the toxic chemical substances, when including those in fragrances that are on the state’s checklist, organizations may possibly declare trade secrecy to keep away from listing a specific fragrance ingredient. The California database contains the solution and lists the ingredient as “trade secret” with the following comment:

If “trade secret” is listed as an ingredient for a merchandise on this web site, it means that 1 or much more components have been reported as a acknowledged or suspected carcinogen or reproductive/developmental toxin, but that the reporting business has elected to designate the information as “trade secret.”

California’s database lists 1,456 products from 22 firms with this kind of “trade secret” ingredients. Whilst not specifically transparent, this nonetheless provides consumers with otherwise unavailable hazard details — and possibly a sense of unease that may lead to demands for safer alternatives.

Second, the lists of elements on a lot of cosmetic products are hard to interpret. By listing only those chemical substances in the solution that meet distinct toxicity worries, and supplying information on the chemical’s pertinent hazard, the California database supplies buyers with a lot more usable info.

These state initiatives are not the only databases supplying higher transparency on chemical ingredients in customer merchandise. Other organizations have also been operating to educate buyers on possible hazards. One particular prominent instance is Skin Deep, a publicly available database on chemical components in cosmetics designed by the Environmental Operating Group. But Washington and California have raised the visibility and credibility of this data for numerous buyers, with transparent choices on which chemical hazards to contain in their programs based on established governmental and worldwide lists of health hazards.

Even though the lists offer essential info for customers, each sector spokesmen and Washington Department of Ecology scientists agree that the mere presence of a toxic chemical in a merchandise does not suggest that it poses any danger. Both the concentrations and bioavailability of the ingredients are essential concerns. But in addition to aiding consumers, these databases might help spur added study. Cobalt, for instance, is the most frequently reported chemical in the Washington database. A scientist who researches chemical results on brain advancement commented: “I do not consider I have ever noticed a review on its possible toxicity in young children — or adults. If it is a typical exposure and it is bioavailable, then it ought to be looked at.”

Major companies are acting

Many main companies, rather than debating the extent to which chemical hazards are acceptable, have led the way in developing alternatives. Johnson &amp Johnson, for illustration, has just announced the release of a reformulated little one shampoo that eliminates 1,four-dioxane and chemical compounds that generate formaldehyde. In addition, J&ampJ ideas to reformulate other products to move away from phthalates, parabens and triclosan by the finish of 2015. P&ampG is in the process of eliminating phthalates, phosphates and triclosan from all of its products this yr. And major merchants Walmart and Target have also announced programs to minimize or eradicate many chemicals of concern from the items they sell. Some of the world’s strongest companies are shifting to a new paradigm that recognizes and embraces consumers’ worries about the safety of the merchandise they use.

Washington and California have made main contributions to the new age of chemical transparency with an method that provides simple info to customers, offering them the opportunity to make safer alternatives for themselves and their families. In doing so, they have also shifted the ground principles on transparency for chemical elements in client items, and offered a basis for broader consumer-education initiatives in the long term. Even in as technically complex an region as chemical hazards, knowledge is power. Armed with this expertise, consumers are probably to demand nevertheless much more information and — the ultimate goal here — safer ingredients.

Jordan Markuson is the Founder of Aqua Wellness Labs. He has been a nutritionist, author and entrepreneur for more than 10 many years. He is an activist supporting consumption of raw, renewable, and natural foods. Jordan believes that based on all available scientific proof, as soon as food is cooked it loses the vast majority of its crucial nutrients. He is really interested in marine-primarily based phytoplankton as a fish oil substitute since of the pure omega-three crucial fatty acids it generates.

Particular Thanks to Bob Kerr of www.sustainablebrands.com for his contribution.

Chemicals in Consumer Items: New Progress in Transparency