Monday, April 4, 2011

UN report: 1.6 mln HIV carriers in Latin America, Caribbean

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UN report: 1.6 mln HIV carriers in Latin America, Caribbean

English.news.cn 2011-04-01 09:50:45

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PANAMA CITY, March 31 (Xinhua) -- Latin America and the Caribbean have about 1.6 million people carrying the Human Immunodeficiency Virus (HIV) that can cause the deadly disease AIDS, the Joint United Nations Program on HIV/Aids (UNAIDS) said on Thursday.

Latin America has not registered any improvement in the fight against the spread of HIV/AIDS, said UNAIDS Regional Director Cesar Nunez, releasing the findings of a new report for the state of HIV/AIDS.

Nunez, urging governments across Latin America and the Caribbean to increase efforts to combat the spread of HIV, suggested governments to focus their work on the prevention among younger people and at schools in order to avoid the spread of HIV in the region.

"At this time of crisis, let us optimize the means and let us not fall into complacence," he said.

But Nunez said that Latin America, however, is the region with the best coverage of medicine available to HIV carriers, as about 51 percent of those living with the virus have access to HIV/AIDS medicine.

"In the South American countries we have a (medical) coverage of 70 percent which encourage us to believe we can increase the coverage level in Central America," he said. According to the report, there are now 33 million HIV carriers in the world.

Editor: Xiong Tong

Circumcision best for older boys: MD

Health; Benefits only begin during teen years

BY SHARON KIRKEY, POSTMEDIA NEWS APRIL 4, 2011 4:13 AM

It's an idea that will make grown men squeamish, but a leading Canadian infectious disease expert says it is time to consider circumcising prepubescent boys, and not newborns.

With three large trials from Africa concluding that male circumcision cuts the risk of acquiring HIV by approximately 60 per cent in heterosexual men- data the World Health Organization calls "compelling" - Dr. Noni MacDonald says there may be merit in offering circumcision to young boys "rather than their baby brothers."

Writing in the Canadian Medical Association Journal, the professor of pediatrics at Halifax's Dalhousie University says the potential benefits of circumcision only begin to set in once males become sexually active.

"There's been a lot written about how important circumcision is now that we know about the African data," MacDonald told Postmedia News. The data also show a decrease in the risk of contracting human papilloma virus, or HPV, a virus that can cause genital warts, as well as penile cancer.

"The (infant) isn't at risk of HIV and sexually transmitted diseases, because they're not sexually active, so why are we rushing to do it at that time?" MacDonald said. "If you're really going to do this, we need to think of the timing. Why aren't we offering it to peripubertal boys, when it's going to be relevant?"

Men - and women - may squirm at the idea of routinely offering circumcision to older boys, worried it would be too painful and uncomfortable, she said. But babies feel the same pain.

"Why are we fine with doing it to a baby but not a young man?

"It's curious that a painful elective procedure of no major benefit to the infant until years later would ever be deemed more acceptable than the same procedure for a peripubertal boy," Mac-Donald writes in the CMAJ. What's more, unlike infant boys, older boys can give consent.

"The baby gets no choice, the parents make the decision," she said. "An 11-, 12-, or 13-year-old boy could really make a decision on their own about this."

It would also be an opportune time for parents to broach the subject of sex, she says.

"We could really talk about the other ways that you can decrease your risks."

"I think most boys would choose not to have it done. But it would be a prime time to discuss it."

Just how relevant the African studies - which all involved adult male circumcision - are for Canada and other countries that have far lower HIV rates isn't clear. A recent U.S. analysis estimated that neonatal circumcision would reduce the 1.87-per-cent lifetime risk of HIV among men by only about 16 per cent.

"It's not a huge decrease," says MacDonald. In addition, giving boys the HPV vaccine might be cheaper and far more effective at preventing HPV than circumcision, she said.

The Canadian Paediatric Society is in the process of trying to decide what to say about the topic. Several committees are reviewing the African data, said executive director Marie Adèle Davis.

The Ottawa-based group's current position is that the benefits and harms of circumcision are so evenly balanced that it does not support recommending circumcision as a routine procedure for newborns.

Circumcisions, which are uncommon in northern European countries, Central and South America and Asia, are largely a North American phenomenon.

The procedure involves cutting away the inner and outer layers of the foreskin. The cells of the foreskin are thought to be more susceptible to HIV infection.

Sesler: Canadian health-care system leaves us envious - Local Columns - GoErie.com/Erie Times-News

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While doing some research on health-care reform, I came across an interesting story.

In 2004, the Canadian Broadcasting Co. conducted polls for Canadians to nominate their choice for the man or woman whom they felt was the best Canadian in history. The person who won was Tommy Douglas.

I had heard of famous Canadians like Alexander Graham Bell, Wayne Gretzky and Dr. Frederick Banting (the inventor of insulin), but I had no idea who Tommy Douglas was.

It turns out that Douglas was the leader of the New Democratic Party, and he is considered the founder of the Canadian Healthcare System. He was (horrors!) a socialist and the seventh premier of Saskatchewan from 1944 to 1961. He led the first socialist government in North America and introduced public health care in Canada.

This tells me that Canadians must think a lot of their health-care system. America and Canada had similar health-care systems before Canada went to a single-payer system in the 1970s. Today, the United States spends much more money on health care than Canada, on both a per-capita basis and as a percentage of the GDP.

In 2006, per-capita spending on health care in Canada was U.S. $3,678; in the U.S. $6,714. The U.S. spent 15.3 percent on health care in that year; Canada spent 10 percent. Life expectancy is longer in Canada (80.34 years), compared to 78.6 years in the U.S. But to be fair, there is debate about the underlying causes of these differences.

An economic overview of America's health-care system shows that about 42 million people are not covered at all. Many health-care plans place rigid limitations on which doctors and hospitals people can use; administrative costs are approaching 25 percent of the health-care dollar; managed care is generally structured so that some physicians have incentives to cut costs and gain revenue by withholding care; and many Americans live in fear of losing whatever care they have.

The current system is based on the power of the insurance industry to stifle any challenges from real alternatives.

In contrast, the single-payer system, which Canada has used for the last 25 years, has drastically simplified its administrative costs. One report indicates it takes more people to administer Blue Cross/Blue Shield of Massachusetts than it does to administer the entire health-care system in Canada.

Before Canada implemented its national health-care program, their health costs were the same portion of their economy as in the U.S. After they implemented their program, their costs stabilized at 9 percent, while U.S. costs have increased to 15.3 percent of our GDP.

Canada has a much higher percentage of general practitioners and fewer specialists. Canadian doctors make about one-third less than American doctors, and yet their satisfaction level is high because they have more time to practice medicine because paperwork is minimized.

Europe's Failing Health - WSJ.com

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By JAVIER ESPINOZA

Traditional sources of funding health care in Europe have been branded obsolete and unaffordable. The need for innovation has never been stronger and while some countries, such as the Netherlands and Switzerland, are embracing change, others are resisting any significant overhaul. Indeed, the notion of free, state-backed health care is ingrained in the psyche of most Europeans.

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Read the complete Innovations in Health Care report.

Reformers want to reduce the state's role in health-care delivery and introduce a competitive element. Those against change are adamant that a health-care system without state involvement is health care without a heart. Good for the rich, calamitous for the poor. It is an issue heavily clouded by emotion. But many feel that without innovation, crumbling state-backed systems will collapse as they struggle to cope with aging populations, soaring overheads and, more recently, mounting budget deficits.

The statistics paint a bleak picture. According to the Organization for Economic Cooperation and Development, the European Union will see an increase in health expenditure of 350% by 2050, whereas at the same time the economy is only set to expand by 180%.

Some work has already been done to estimate the real impact on future expenditures. Friedrich Breyer, a professor of economics at the University of Konstanz in Germany, calculates that in Germany alone between 2020 and 2030 there will be a huge spike in the number of elderly people alongside an enormous drop in young and working-age people. "This will mean a dramatic increase in individuals' payroll tax contribution rates to health care to 20.7% in 2030 and over 23% in 2040," he says. This compares to just 11.4% in 1980.

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Reuters

Protesters in London campaign against job cuts and increasing private-sector involvement in the National Health Service.

So which countries offer the closest to a sustainable and effective health-care model and what can others, like the U.K., learn from them? Health-care specialists point to the Netherlands and Switzerland as models to follow in which funding comes from a mixed pool of sources and patients have more control over their health.

Unlike the U.K. health-care system, where the state manages and delivers the services, systems in the rest of Europe, particularly Switzerland, the Netherlands and to some extent Germany, rely more on a system of private insurance. Switzerland has been hailed as the least over-protective system. In that country health insurers are the ones who determine their fees and the services they provide—as long as they adhere to the basic services agreed in the country's Health Insurance Law.

Also unlike the U.K., patients incur fees to cover some ambulance and boarding costs. However, the Swiss authorities also provide subsidies for poorer patients. The system is broken down into the country's 26 cantons (or regions), which largely look after their own services, without relying on a centralized system. Individuals have the advantage of choosing which health service better fits their needs by opting for different competing insurers

Tibetans campaign for 'Mr Tibet contest' to promote their culture - Lifestyle - DNA

Tibetans in exile in Shimla on Sunday campaigned for ‘Mr Tibet contest' and 'Tibetan idol singing contest’ to promote its culture.

The organisers believe that Miss Tibetan pageant, which was held in 2002, got international recognition and the world came to know about the community and their situation.

“We are organising a show named Mr Tibet which is a talent contest and another one is Tibetan idol contest through this we want to promote Tibetan culture and Tibetan issue in the world,” said Mahesh Yadav, organiser of the contest which will take place in June.

The organisers also appealed to China to start dialogue with the Dalai Lama on the issue of the freedom of Tibet. They also urged the international community to pressurise China.

“We being in India want to spread the message of the demand for freedom Tibet, human rights of Tibetans and the method of Dalai Lama be promoted through out the world. The entire world should pressurize China to free Tibet,” Yadav said.

Scores of Tibetans have been living in exile with the Dalai Lama in Dharamsala since 1959, when he fled Tibet following a failed uprising against the Chinese rule.

The Dalai Lama advocates ‘meaningful autonomy’ for Tibet.