Tuberculosis surpassed HIV as the leading cause of death from infectious disease in the world in 2014, according to a report released Wednesday by the World Health Organization.

Tuberculosis Caused More Deaths than HIV in 2014

But it's not because more people are getting infected. Global health officials said on Wednesday that they are able to better track cases to report more accurate numbers. This year, 1 million new cases were reported in Indonesia, significantly revising data from last year, which showed half that number.

Cases also were higher among children than previously thought – nearly double the number reported last year. Data show 140,000 children died from TB and 1 million were infected.

WHO estimates overall totals could be even higher, with nearly 40 percent of cases undiagnosed worldwide.

Still, global health efforts have greatly reduced the incidence of the disease since the 1990s, shows the report, the 20th annual Tuberculosis Report.

TB mortality has fallen by nearly half since 1990, with nearly all improvement taking place since 2000, when the United Nations set Millennium Development Goals for reducing the incidence of the disease. From 2000 to 2014, about 43 million lives were saved because of better diagnosis and treatment.

"We can now begin to imagine the end of tuberculosis," said Dr. Ariel Pablos-Mendez, assistant administrator for global health at USAID, at a news conference Wednesday held in the District of Columbia at the National Press Club. "We never imagined we would be at this stage."

TB is caused by airborne bacteria that damage the lungs, resulting in fever and coughing up blood or mucus. It is curable through medication, but easily can be transmitted from one person to another.

Of the new TB cases in 2014, 58 percent were in the Southeast Asia and Western Pacific regions, with India having the largest percentage of cases at 23 percent. The African region had 28 percent of the world's cases in 2014, but the most severe burden relative to population: 281 cases for every 100,000 people – more than double the global average of 133. More than half of the world's TB cases (54 percent) occurred in China, India, Indonesia, Nigeria and Pakistan.

Despite advances, TB killed more than 1.5 million people in 2014.

This is slightly higher than HIV's death toll, estimated at 1.2 million, which included 400,000 deaths among people who had both TB and HIV, which is also treatable, through the use of antiretroviral drugs. People who are HIV-positive are more susceptible to TB because they have a weakened immune system. Worldwide, 9.6 million people contracted TB in 2014, 12 percent of whom were HIV positive.

Dr. Eric Goosby, United Nations special envoy on TB, called for more funding so that global health officials could reach their goals to reduce TB deaths by 90 percent and TB cases by 80 percent by 2030.

To do so, the report says, better detection systems need to be in place and tools developed to better diagnose people, and a vaccine should be developed. This will require more funding. WHO estimated a funding gap of $1.4 billion for interventions in 2015. For research, WHO estimates it is short $1.3 billion.

Dr. Mario Raviglione, director for WHO's global TB program, noted during the news conference that the U.S. had given the highest investment to combating TB. "Despite the gains, the progress is far from sufficient," he said.

Even with adequate investment, the world faces another looming threat: TB that has become resistant to the drugs used to treat it. The WHO report noted that about half of people who are infected with this type are effectively treated.

TB Is Now The Top Infectious Killer (Even Though Deaths Are Down)

Tuberculosis is now killing more people each year than HIV, according to new data from the World Health Organization.

WHO estimates there were almost 10 million new cases of TB last year; the disease caused 1.5 million deaths. By comparison, 1.2 million lives were claimed by HIV.

That makes TB the number one infectious killer.

But dig into the numbers and you'll find some surprises. TB deaths have actually been going down in recent years. The number of deaths from the disease each year has dropped by nearly half since 1990.

HIV deaths, however, are falling far faster.

And these death numbers are a bit complicated. Some 400,000 fatalities were double-counted — included under each disease — because the deceased had both infections.

There's another TB statistic that's particularly worrisome. The new report estimates that there were roughly half a million cases of multi-drug resistant TB last year, double the number from the year 2000. Conventional antibiotics can't cure MDR-TB. Treatment can take 2 years or more with drugs that cause severe side-effects; some patients are left completely deaf.

"MDR-TB is rampant in some parts of the world such as the former Soviet Union, where up to a third of all [TB] cases are MDR," says Dr. Mario Raviglione, the director of WHO's global TB program. "Something is not going well there."

Much of the rise in regular TB cases is the result of new diagnostic tools that make the disease far easier to diagnose and of better reporting. Those are the reasons behind an increase of hundreds of thousands of "new" cases from Indonesia and India. Indonesia's reported incidents of TB doubled last year to 1 million cases. India's tally was up 29 percent.

Maria Carmen Castro, 46, of Lima, Peru, is a survivor of MDR-TB — multidrug-resistant tuberculosis. Partners In Health treated her and loaned her money to open a small store. "Because of my TB and thanks to God and Partners In Health, now I have my own business," she says.
GOATS AND SODA
TB Patients That The World Writes Off Are Getting Cured In Peru
Jenny Tenorio Gallegos, 35, in Lima, Peru, is being treated for drug-resistant TB. The treatment lasts two years and may rob her of her hearing.
GOATS AND SODA
She's Got One Of The Toughest Diseases To Cure. And She's Hopeful
So public health officials are worried. Progress against TB is not moving as fast as progress against some other diseases — and not as fast as they'd like.

"The number of deaths caused by TB and HIV are pretty similar," says Raviglione. But he says TB doesn't attract nearly the funding for research or treatment that goes to HIV.

According to data gathered by WHO, roughly $6.6 billion was spent fighting TB last year compared to $20.2 billion invested to fight HIV/AIDS in low- and middle-income countries.

"Our point is that we should have the same type of investment going to TB and as of yet that hasn't been achieved," Raviglione says.

Patient advocates are not as diplomatic.

"We're in this dire situation because the vigorous community response, massive research effort and political leadership that distinguished the response to HIV are utterly absent from TB," said Mark Harrington, executive director of Treatment Action Group, in a statement.

Raviglione stresses that the world neglects TB at its peril: "After all it's airborne and can spread fairly easily."

Global fight against TB advancing, but disease still a leading cause of death

The global fight against tuberculosis is advancing, with this year's death rate nearly half of what it was in 1990. However, the disease is still a public health concern, ranking alongside HIV/AIDS as a major cause of global death, according to the World Health Organization.

The WHO released the Global Tuberculosis Report 2015 on Wednesday, giving a snapshot of how far the international health community has come in combating TB.

According to the report, close to 1.5 million people died from TB in 2014. By comparison, HIV's death toll in 2014 was estimated at 1.2 million, according to the WHO.

The report found that most of the gains in combating TB have come since 2000, the year the UN's Millennium Development Goals were established.

Between 2000 and 2015, effective diagnosis and treatment of TB resulted in 43 million lives saved, the report says. Globally, TB incidence has fallen 1.5 per cent per year since 2000, equalling a total reduction of 18 per cent.

But despite these advances, TB continues to be a major cause of death, says Dr. Mario Raviglione, director of WHO's Global TB Programme.

"We are still facing a burden of 4,400 people dying every day, which is unacceptable in an era when you can diagnose and cure nearly every person with TB," he said in a statement.

TB is an infectious disease caused by mycobacterium. The disease typically effects the lungs, and is spread through the air when infected patients transmit bodily fluids from their throat and lungs through coughing or sneezing.

Symptoms of active TB include a chronic cough, chest pains, weakness, fever, night sweats and weight loss. The disease is treatable with a course of antibiotics, however, if left untreated it can result in death.

This year's report found the global total for new TB cases to be 9.6 million cases. This is higher than in previous years, but it may reflect improvements in data collection rather than an actual increase, the WHO said.

Addressing treatment gaps and multi-drug resistant TB
The report shows the need to improve TB detection, close "treatment gaps," boost funding, and develop new drugs and vaccines, the WHO said.

Detection in particular remains a problem, with the WHO finding that about 37.5 per cent of the new TB cases in 2014 went undiagnosed or were not reported to national authorities.

This is especially serious for patients with multidrug-resistant TB (MDR-TB). The WHO estimates that 3.3 per cent of the new patients have MDR-TB, a level that has not changed over the years. MDR-TB is a form of TB infection caused by bacteria that are resistant to common drug treatments.

"Detection and treatment gaps are especially serious among people with MDR-TB, which remains a public health crisis," the WHO said in a statement. "Of the 480, 000 cases estimated to have occurred in 2014, only about a quarter – 123 000 – were detected and reported to national authorities."

The WHO report found that fewer people were diagnosed with MDR-TB globally in 2014 than in 2013, although the total estimated number of people who developed MDR-TB remained the same.

The WHO said 43 countries reported cure rates for MDR-TB patients of more than 75 per cent. However, global data shows an average cure rate of only 50 per cent for treated MDR-TB patients.

Dr. Grania Brigden, interim medical director from Doctors Without Borders Access Campaign, said the overall picture is "disheartening," and is particularly bleak when it comes to MDR-TB.

"We're losing ground in the battle to control drug-resistant forms of TB, and without considerable corrective action, the vast majority of people with MDR-TB won't ever be diagnosed, put on treatment, or cured," she said.
"Drug-resistant forms of TB will continue to spread unless the gap is narrowed between people with undiagnosed TB disease and people who are diagnosed."

Brigden called for a widespread rollout of existing rapid tests and drug-resistance testing.

The WHO said that in 2016, the global community's goal will shift from controlling TB to ending the epidemic. Its "End TB Strategy," adopted by all WHO member states, will aim to reduce TB incidence by 80 per cent and TB deaths by 90 per cent by 2030.

source: http://www.albanydailystar.com/

Christine Sow is President and Executive Director of Global Health Council, and Susan Barnett is Founder of Faiths for Safe Water.

'This is not an expensive, high-tech problem; it's a problem of prioritization'

The world reacted in horror and indignation this week when a reporter posted a photo of a Syrian woman forced to bath her 20-day-old newborn in a puddle in a refugee camp on the Greek-Macedonian border. The plight of this family is clearly unacceptable; lacking access to a safe water source puts every family member at risk, but especially the children. Today is World Water Day, but for much of the world, you wouldn't know it.

There are 663 million people around the world live without access to safe water. And about 2.2 billion people—one sixth of the world's population—live without the dignity and safety of adequate sanitation. Many are trapped in the cycle of poverty, and without water and sanitation, there is no way out.

Even more surprising, healthcare institutions fair little better. In the U.S. we take for granted that an expectant mother will be admitted to a hospital with running water and sanitation. However, a report published last year by the World Health Organization revealed that almost 40% of healthcare facilities around the world do not have access to safe water and almost 20% do not have even basic sanitation.

This wide-reaching study looked at 54 low- and middle-income countries, and found that even soap for hand-washing, one of the most effective and cost-effective ways to prevent infection, was absent from more than one-third of the facilities. The study's authors note that this "lack of services compromises the ability to provide basic, routine services, and compromises the ability to prevent and control infections." The direct and dire consequences of these conditions were clearly seen during the recent Ebola crisis in West Africa, where the high mortality toll of the disease among health workers has been attributed in part to the lack of adequate water sources and sanitation in healthcare facilities.

Ebola is not a highly contagious disease; it can only be spread by direct contact with infected bodily fluids. However health workers were obliged to work in inhuman conditions where they routinely came in contact with infectious matter and were unable to properly protect and disinfect themselves, their gear, or their physical surroundings. It is estimated that nearly 1 in 12 health workers in Liberia died during the epidemic. The loss of doctors, nurses and midwives was tragic, and it has led to a deadly ripple effect on the health of the population, especially mothers and children. Maternal mortality was estimated to have increased by 111% in Liberia and child mortality by 28% across the three Ebola-hit countries.

The ongoing cholera crisis in Haiti is another example of how the lack of adequate water supplies has led to a deadly water-borne disease traveling across borders to infect a population where it had not been seen for more than 100 years. It's estimated that 8,600 Haitians have died of cholera, brought into Haiti by U.N. peacekeepers from Nepal. Litigation is ongoing around the responsibility of the UN to have prevented this senseless tragedy.

In 2014, during the Haiti cholera crisis and before Ebola became a household name, President Barack Obama launched the Global Health Security Agenda as a partnership of international organizations, non-governmental organizations and some 50 nations, to strengthen the capacity to prevent, detect and rapidly respond to infectious disease threats. The administration's recognition of the global threat posed by infectious disease was timely but has fallen short in addressing the root causes of the spread of infectious disease.

The agenda focuses on strengthening laboratory capacity, surveillance systems and global cooperation in order to ensure health security. All good ideas, however a provision for basic water and sanitation within health facilities and communities does not explicitly appear in any of the its 11 "action packages." The absence of this basic component represents a significant missed opportunity to rally global leaders and policymakers around this immediate—and obvious—need. To put a further point on it, in a recent WHO survey, only 21 out of 86 countries surveyed report having a plan in place to install safe drinking water and sanitation in their health facilities.

This situation is made all the more infuriating because unlike so many crises facing our planet, the lack of access to safe water, soap and sanitation, is solvable. Basic, sustainable, cost-effective approaches abound. This is not an expensive, high-tech problem; it's a problem of prioritization.

Every global health and development policy and piece of legislation must contain provisions for sustainable water and sanitation. Anything less is a plan that is guaranteed to fall short of its goals. At a time of tight budgets, it's smart, logical and cost-effective. But it's also a matter of who lives, and who dies, and who is forced to bath her newborn baby in a mud puddle.

source: http://time.com/

If current trends continue in the Zika virus outbreak, and 'if this pattern is confirmed beyond Latin America and the Caribbean, the world will face a severe public health crisis,' the health organization's director-general says.

The World Health Organization said Tuesday that it expects Brazil will have more than 2,500 babies born with a severe birth defect known as microcephaly if current trends continue in the Zika virus outbreak.

Data from Brazil, the epicenter of an epidemic that has hit more than three dozen countries and territories in the Americas, show that about 39 percent of 2,212 investigated cases of microcephaly are already confirmed for the rare congenital condition. To date, that's 863 babies born with the characteristic abnormally small heads and underdeveloped brains, WHO detailed at a news conference in Geneva.

"If that rate continues, we expect more than 2,500 cases will emerge of babies with brain damage and clinical signs of microcephaly," said Anthony Costello, who heads WHO's department of maternal, newborn, child and adolescent health.

WHO Director-General Margaret Chan said new evidence is becoming clear daily about the mosquito-borne virus. A pattern seems to be emerging: Initial detection of Zika is followed within about three weeks by an unusual increase of Guillain-Barré syndrome, a rare condition that can cause paralysis and sometimes death. Detection of microcephaly and other fetal abnormalities typically comes about six months later, WHO officials said, as pregnancies of infected women come to term.

Brazil and Panama are now reporting cases of microcephaly – including 6,480 suspected cases in Brazil. Panama has one reported case. Colombia is investigating many cases for a possible link. A WHO team is currently in Cape Verde to investigate that country's first reported case of microcephaly, Chan said.

A total of 12 countries and territories have now seen an increase in the incidence of Guillain-Barré or actual lab confirmation of Zika among cases with the syndrome, she said.

Although Zika has hit countries in Latin America and the Caribbean the hardest, Chan warned that no one can predict if it will spread to other parts of the world and trigger the same pattern of health complications. In other affected countries, the virus has not been circulating long enough for pregnancies to come to term, she said.

"If this pattern is confirmed beyond Latin America and the Caribbean, the world will face a severe public health crisis," she said. Chan said the Zika virus initially looked "reassuringly mild," with no hospitalizations or deaths reported when it first showed up in Brazil last May.

But in less than a year, she said, "the status of Zika has changed from a mild medical curiosity to a disease with severe public health implications." The possibility that a mosquito bite could be linked to severe fetal abnormalities "alarmed the public and astonished scientists," she said.

source: http://www.pressherald.com/

Today is International Women's Day, and this year's theme is "Planet 50-50 by 2030: Step it up for Gender Equality!" The reference to 2030 is about the deadline for the newly adopted Sustainable Development Goal (SDGs) which chart out the new roadmap for global development for all countries of the world for the next 15 years.

But what's the big commotion? Many people seem to think that there's no such thing as gender inequality anymore, and that women and girls have reached the same respect, appreciation and acknowledgement as men and boys have as equal members of the societies they live in. Don't we already live in "Planet 50-50"?

The short answer is: No, we don't - and we're not even near yet.

The grim reality is that gender equality has not been fully realized anywhere in the world. Even in the top performing countries, such as the Nordic countries that often are quoted as the most gender equal in the world, inequalities persist that hinder girls' and women's ability to be full rights-bearing members of their societies. For example, in my native country Finland, rates of violence against women continue to be the highest in Europe, with nearly half of women over the age of 15 having experienced some form of sexual pr physical violence. In Iceland, a country with reportedly the smallest gender gap in the world, women continue to face a 20% pay gap compared to men. United States, one of the most powerful and wealthiest nations in the world, is one of only eight countries in the world with a rising maternal mortality rate, and countries like India and China, despite their impressive economic growth, still deal with a plethora of violations of women's rights ranging from incredibly high rates of gender based violence in India to five Chinese feminist being arrested for trying to organize a rally against sexual harassment - on International Women's Day last year. While progress has been achieved, literally everywhere in the world women still have to fight for their right to be treated as full rights bearing human beings.

Sometimes, people will claim that some of these issues aren't about inequality or discrimination. That, for example, challenges related to women's access to health care services aren't about gender equality but about lack of resources. But here's the thing: The allocation of resources is always a value statement. The political decisions made about availability of sexual and reproductive services, family planning or contraceptive access are a reflection of the importance placed on protecting and realizing women's rights, and an indication of what is considered a priority and what isn't. The inability to ensure that all girls and women have equal access to education, training and meaningful employment is not about lack of resources but about lack of political will. The persistently high rates of sexual and physical violence against women in almost every corner of the world aren't an indication of lack of rescues to combat sexual violence, but about power structures, These decisions have long lasting implications on not only women's health and well-being, but their lives and the future of their societies on a much broader level. Without access to education, women can't obtain the skills they need to become independent and economically secure. They can't provide for their families and ensure the wellbeing of their children. Without access to sexual and reproductive health services, women cannot take control over their reproductive decisions, and continue to face unnecessary risks related to pregnancy and childbirth. Women who live under constant threat of violence continue to have their lives and rights hindered and violated by fear and injustice, and even in countries where things like education and healthcare for women are taken care for, women still face numerous obstacles and discrimination based solely on their sex in the job market, in politics and in decision making.

That's why we need a big shift in attitudes, priorities and values to build a "Planet 50-50 by 2030". It will take more than goals and roadmap to reach a day when women and men are truly treated as equals in the world - and before women everywhere in the world can make decisions about their life, their health, their education, their family and their employment based on what they want - not what they are forced into because of gender discrimination. To build a Planet 50-50, we also need to pay more attention to gaps between women themselves. We need to ensure the commitments we make and action we take reach even the most vulnerable, the most marginalized and those women who are the hardest to reach - those who are still too often left behind from development and progress, and whose voices are left out of global debates and discussions about what women need.

Can we have a gender equal planet by 2030? Absolutely. And I think we should aim to get there much faster, because another 15 years of gender inequality should not be considered acceptable. But before we can start truly building that planet, we need to own up to the fact that it is not lack of resources nor know-how that has prevented us from getting there before. It's time to start putting women and girls first - because a Planet 50-50 isn't just in their best interest, but a better world for all of us.

source: http://www.huffingtonpost.com/

Sanford Health's goal in Ghana is a big one:

"To be the No. 1 primary health care provider in the country."

That's according to Jim Slack, vice president of Sanford International Clinics, who is helping lead clinic development in the African nation and worldwide.

Sanford International Clinics was formed as part of T. Denny Sanford's $400 million donation in 2007 with a mission to provide care to underserved populations worldwide. And while it started with pediatric clinics in the U.S., the organization's eye has shifted to Africa, the Argus Leader (http://argusne.ws/1TQlVXV ) reported.

In the past 60 days, Sanford has opened 12 clinics in Ghana, for a total of 17. The plan is to develop at least 300 clinics in the country.

It's a venture that has brought Sanford into a new relationship with Global Health Corps., a New York-based nonprofit led and founded by Barbara Pierce Bush, daughter of former President George W. Bush.

"I'm very impressed and inspired by Sanford International Clinic's commitment to working and supporting partner organizations, at every level, in the areas they work," Bush said in an emailed response to questions.

"It's truly wonderful to be supported by such an innovative and inspiring health care leader. There is a great deal of overlap between our work, so our relationship is a busy two-way street for sharing best practices, networks and insight."

Global Health Corps., or GHC, was founded in 2009 to place professionals from Africa and the U.S. in yearlong paid fellowships to work with local organizations to improve health care access and outcomes. The organization plans to work with Sanford to develop health care professionals and identify and implement best practices in areas such as electronic medical records, supply change management, medication standardization and clinical education.

The two met through philanthropist T. Denny Sanford.

"Denny had a relationship with Laura and Barbara Bush and was aware of Barbara's initiative," Slack said. "The focus of that really looked to align with what we do with Sanford International Clinics. He brought us together."

That was about a year ago, and the organizations started talking about what each was doing in Africa and what synergies might exist.

"For us, it was really quick to identify," Slack said. "She's got thought leaders and fellows and alumni she's recruited from all over the world. She's got top talent knocking at her door to be part of her program. Because of the depth of operations we're building, it just lends to a great experience for these fellows to dig in and find meaningful projects."

Bush, too, praises the new relationship.

"It's not often that you find such a philosophical synergy in a partnership," she said. "I think both of our organizations share that deep commitment to ensuring access to quality health care for everyone and the belief that where someone is born or lives should never dictate how healthy and empowered a life they can live."

source: http://www.washingtontimes.com/

In 2008, an estimated 347 million people in the world had diabetes and the prevalence is growing, particularly in low- and middle-income countries.

In 2012, the disease was the direct cause of some 1.5 million deaths, with more than 80% of those occurring in low- and middle-income countries. WHO projects that diabetes will be the 7th leading cause of death by 2030.

Diabetes is a chronic disease that occurs either when the pancreas does not produce enough insulin or when the body cannot effectively use the insulin it produces. Insulin, a hormone that regulates blood sugar, gives us the energy that we need to live. If it cannot get into the cells to be burned as energy, sugar builds up to harmful levels in the blood.

There are 2 main forms of the diabetes. People with type 1 diabetes typically make none of their own insulin and therefore require insulin injections to survive. People with type 2 diabetes, the form that comprises some 90% of cases, usually produce their own insulin, but not enough or they are unable to use it properly. People with type 2 diabetes are typically overweight and sedentary, 2 conditions that raise a person's insulin needs.

Over time, high blood sugar can seriously compromise every major organ system in the body, causing heart attacks, strokes, nerve damage, kidney failure, blindness, impotence and infections that can lead to amputations.

World Health Day 2016: Key messages

WHO is focusing the next World Health Day, on 7 April 2016, on diabetes because:

1. The diabetes epidemic is rapidly increasing in many countries, with the documented increase most dramatic in low- and middle-income countries.
2. A large proportion of diabetes cases are preventable. Simple lifestyle measures have been shown to be effective in preventing or delaying the onset of type 2 diabetes. Maintaining normal body weight, engaging in regular physical activity, and eating a healthy diet can reduce the risk of diabetes.
3. Diabetes is treatable. Diabetes can be controlled and managed to prevent complications. Increasing access to diagnosis, self-management education and affordable treatment are vital components of the response.
4. Efforts to prevent and treat diabetes will be important to achieve the global Sustainable Development Goal 3 target of reducing premature mortality from noncommunicable diseases (NCDs) by one-third by 2030. Many sectors of society have a role to play, including governments, employers, educators, manufacturers, civil society, private sector, the media and individuals themselves.

Goal of World Health Day 2016: Scale up prevention, strengthen care, and enhance surveillance

The main goals of the World Health Day 2016 campaign will be to:

1. Increase awareness about the rise in diabetes, and its staggering burden and consequences, in particular in low-and middle-income countries;
2. Trigger a set of specific, effective and affordable actions to tackle diabetes. These will include steps to prevent diabetes and diagnose, treat and care for people with diabetes; and
3. Launch the first Global report on diabetes, which will describe the burden and consequences of diabetes and advocate for stronger health systems to ensure improved surveillance, enhanced prevention, and more effective management of diabetes.

source: http://www.who.int/

Taiwan has raised its travel alert for Tonga to yellow, the second lowest on its four-color alert system, after the Pacific island country reported more than 500 suspected Zika virus cases and seven confirmed cases.
In a travel notice the Ministry of Foreign Affairs raised the travel alert for Tonga from gray, the lowest alert level, to yellow, given that the country has declared the mosquito-borne Zika virus an epidemic.

The ministry urged Taiwanese nationals who plan to travel to Tonga to think twice about going there and take precautions to prevent mosquito bites if a visit to Tonga is necessary.

Pregnant women and those planning a pregnancy should postpone trips to the country, it said.

The ministry also noted the World Health Organization's warning of a possible outbreak of the Zika virus in Vanuatu in the South Pacific, saying that it will maintain a yellow alert for the island country.

The ministry has a gray alert in effect for the South Pacific island countries of Fiji and Samoa, as well French dependency New Caledonia and French Polynesia, but it urged pregnant women and those who plan a pregnancy not to visit those areas.

A yellow travel alert remains in effect for the Solomon Islands after that Pacific island country reported five confirmed Zika virus cases and seven suspected cases, the ministry said Thursday.

In addition to the South Pacific region, Taiwan has also issued a travel advisory for Thailand over the Zika virus.

The Centers for Disease Control (CDC) issued its second-highest travel advisory in its three tier system Sunday for Thailand after the World Health Organization listed the country as one of the countries to report indigenous Zika virus cases.

In view of the Zika emergency, the CDC has issued a travel alert for Central and South America and the Caribbean, the second-highest advisory in its three-tier system.

It has also issued a travel watch, its lowest advisory, for Cambodia, Indonesia, Malaysia, the Philippines and Gabon.

The Zika virus disease is caused by a virus transmitted by Aedes mosquitoes and the virus is known to circulate in Africa, the Americas, Asia and the Pacific, according to the World Health Organization.

Zika viral transmission since 2007 has been documented in 46 countries and territories,

A total of 34 countries have reported locally acquired infections between 2015 and 2016, six have indications of viral circulation, five have been exposed to the Zika virus but the outbreak has ended, and one has a locally acquired case but without vector borne transmission, the WHO said.

source: http://www.chinapost.com.tw/

The government issued the tenth economic stimulus package last week, opening up several commercial sectors to foreign investors. One of the sectors is that of raw materials for medicine, where businesses can now be 100 percent owned by foreigners, an increase from the previous 85 percent maximum ownership under Presidential Decree No. 39/2014. The government is hoping that the new ownership policy will attract more investment to the industry of pharmaceutical raw materials, reduce dependence on imports and, in turn, bring down medicine prices.

Raw materials account for 60 percent to 80 percent of production costs in the pharmaceutical industry, while 90 percent to 95 percent of the raw material is still imported from China, India, Europe and the US. The strong reliance on imported content makes the industry sensitive to exchange rate fluctuations, while at the same time the industry has a domestic market orientation.

Indonesia's pharmaceutical market still holds future potential, given the country's large population and the fact that medicine is a basic need. The local pharmaceutical market value has grown by 11 percent for the past five years and reached an estimated value of Rp 69 trillion this year. Prescription medicines make up 59 percent of the market, while over-the-counter (OTC) drugs account for 41 percent.

There are some important drivers for growth in the local pharmaceutical industry. First, Indonesia is currently increasing its residents' access to health services with the implementation of general insurance through BPJS Kesehatan. Second, there is rising health awareness, backed by rising per-capita income and improving economic conditions.

Indonesia's large market has driven investment in the pharmaceutical sector. In 2015, the combined chemicals and pharmaceutical investment amounted to Rp 45.2 trillion, or 8.3 percent of Indonesia's total investment. Of the total, 54 percent was foreign investment. Realized domestic investment in the pharmaceutical sector grew by 44.7 percent per year over the 2010-2015 period, much higher than foreign investment, which grew by an average annual rate of 19.8 percent. Recently, the Investment Coordinating Board (BKPM) recorded investment interest from India, Japan, South Korea and China, and several foreign companies proposed joint ventures with Indonesian ones.

To promote the development of the pharmaceutical raw material industry, the government has issued Health Ministry Regulation No. 87/2013 on the development of medicinal raw materials. Several pharmaceutical companies are pioneering the development of raw materials in Indonesia. For example, Kimia Farma has built a plant for pharmaceutical salt (the construction started in 2015 and is scheduled to be completed in 2016) and will build another for atorvastatin, simvastatin, rosuvastatin, clopidogrel, and pantoprazol this year. Pharmaceutical salt is a common raw material for intravenous liquids, tablets, vaccines, syrup, oral rehydration salt (ORS), hemodialysis liquids and health drinks, among others.

However, the development of the medicinal raw materials industry still faces major problems. First, it lacks supplies from domestic petrochemical industries to produce synthetic medicines, resulting in higher production costs, because those supplies need to be imported. Second, it requires a large amount of investment and is a long-term process that needs an excellent and supportive business environment. Third, the development of the medicine industry and its derivatives is subject to price fluctuations, discouraging investors to enter the business.

Fourth, there is a lack of synergy among academia, private businesses and the government. Research on the development of pharmaceutical raw materials by Indonesian experts is still limited to pilot and laboratory-scale projects and rarely commercially exploited at an industrial level. Fifth, the national market for medicinal raw materials is relatively small in comparison to the minimum production capacity in order to achieve low production costs. To date, domestically produced raw materials have not yet reached an optimal production scale, rendering them uncompetitive with materials from foreign suppliers.

Will the foreign ownership in the industry have a significant impact on Indonesia's pharmaceutical industry? We assert that the policy is supportive for the development of the domestic pharmaceutical industry, though its impact can only be materialized in the medium or long term. Furthermore, we believe that the new foreign ownership policy should be synergized with other policies to develop the raw material industry for medicines, for example, tax incentives for companies that are able to produce raw materials at their own production facilities. In addition, any import taxes for supplies that are needed by the medicinal raw material industry should be removed.

Moreover, the development of the pharmaceutical raw material industry should prioritize materials that have potential in both the domestic and export markets — mainly ASEAN — such as paracetamol, penicillin and pharmaceutical salt. Accordingly, we can expect its production capacity to meet a minimum production scale in order to achieve low-cost production.

The ASEAN market has great potential, especially in the context of the ASEAN Economic Community. The Indonesian Pharmaceutical Association estimates that nine to 11 pharmaceutical companies in Indonesia have exported their products to ASEAN countries. In 2013, Indonesia commanded 30 percent of the ASEAN pharmaceutical market share, the biggest among ASEAN countries.

In addition to the chemical synthetic approach, we should invest more in the development herbal and biotechnological medicine to exploit Indonesia's biodiversity. Finally, we should also redouble efforts to strengthen synergies among academia, businesses and the government through working groups and national research centers to help develop the pharmaceutical raw material industry.

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