On September 19-20 the High-Level Meeting at the UN General Assembly was held to discuss the possibility that non-communicable disorders (NCDs) could become a new global health priority. While many hoped that the conference would generate increased action to target chronic diseases like diabetes, cancer, lung disease and heart disease as well as common underlying risk factors including tobacco, alcohol, poor diet, and inactivity, outcomes were mixed, influenced by strong economic and political factors. The meeting accomplished an elevation of attention for such diseases and laid forth a political declaration calling for national plans by 2013 to address such issues.

For more reflections on the event, tune into the Kaiser Family Foundation event - What Happened at the UN High-Level Meeting on Noncommunicable Diseases? Diverse Perspectives on the Meeting’s Outcomes and Next Steps tomorrow Thursday, September 29, 2011 from 12:30-2:30pm EST. You may RSVP at: http://smartglobalhealth.org/outcomesUNHLM

The Director of the Office of Global Health Affairs at the U.S. Department of Health and Human Services, Dr. Nils Daulaire, will introduce the event with a keynote address on the major achievements and outcomes of the high-level meeting, areas of unresolved tension and disagreement, and critical follow on steps over the next two years. This will be followed by a panel of diverse commentators, including:

Ambassador Ebrahim Rasool, South African Ambassador to the United States
Dr. Trevor Gunn, Senior Director of International Relations at Medtronic
Dr. Peter Lamptey, President of Public Health Programs, FHI 360

WHO Photo

Phots from the UN website

Last week the annual World Hepatitis Day took place on July 28, 2011. Approximately 500 million people, or 1 in 12 people globally, are infected with chronic hepatitis B and/or C, making these viral illnesses one of the largest global chronic disease threats. There is urgent need to develop more effective therapies and deliver them to those struck around the world. This fourth annual World Hepatitis Day focuses on the theme: “This is hepatitis…Know it. Confront it. Hepatitis affects everyone, everywhere”.

World Hepatitis Day

From Washington D.C.'s Department of Health Page

According to a recent study, the estimated number of people living with Diabetes is now at 347 million worldwide. This figure shows that the prevalence of this chronic condition has doubled since 1980.  With 2.7 million participants, this study was the largest of its kind for diabetes. It was led by Majid Ezzati, from Britain’s Imperial College London, and Goodarz Danaei from the Harvard School of Public Health and the results were published in the Lancet.  Diabetes is a progressive condition that can affect all the organ systems of the body leading to serious complications like heart disease, stroke, kidney failure, nerve damage, and blindness. It is as a metabolic ailment in which the body fails to adequately move sugar from the blood stream into tissues.  Diabetes comes in two forms.  Type 1 is an autoimmune disease that is usually acquired in childhood to early adulthood and requires the person with type I to take insulin for their rest of their life in order to survive.  Type 2 accounts for 90 percent of diabetic cases and is more common to develop after the age of 25, even though it is becoming more common for those younger than 25 to develop the metabolic disease. It is controlled by insulin, oral medication and, for some people, it can be controlled with weight loss and exercise.

The WHO defines Non-Communicable Diseases as including:

• cardiovascular disease
• diabetes
• cancers and
• chronic lung diseases

According to the WHO, 36 million of the 57 million global deaths in 2008 were due to Non-Communicable Diseases. Of these deaths due to Non-Communicable Diseases in low- and middle income countries in 2008, 29% occurred before the age of 60. Further, 80% of premature heart disease, stroke and diabetes can be prevented.

With the upcoming UN High Level Meeting on NCDs, there is a current opportunity for a renewed focus and action against Non-Communicable Diseases. For more, check out this recent article from The Huffington Post.

In the book Twelve Diseases That Changed Our World, Irwin Sherman describes how microbes have impacted populations, altered history, devastated populations, felled great thinkers and, in the process, transformed politics, public health, and economics. He discusses how smallpox, tuberculosis, syphilis, AIDS, influenza, bubonic plague, cholera, malaria, yellow fever, hemophilia, porphyria, and the plant disease behind the Irish Potato Famine have altered history in an informing and entertaining manner.

US News and World Report interviewed Sherman about his book and about What Disease Mean in the Modern World. A related article from Nursing Degree.net’s blog entitled 10 Diseases That Totally Changed the World similarly discusses the ways in which diseases have impacted the course of history.

Check out the upcoming Global Pulse issue on “Long-Term Care” in April 2011. If you feel inspired from the issue, consider writing a blog post for this upcoming contest.

With the September 2011 United Nations High Level Meeting on Non-Communicable Diseases (NCDs) approaching, the CSIS Global Health Policy Center wants to focus on the opportunities and challenges of confronting the global epidemic of chronic diseases. In addition to the series of high level speakers coming to CSIS to speak on the topic, they want to hear from you! They will be posting questions in the upcoming months for you to respond to. The winning blog entries will be featured on their home page of our website, SmartGlobalHealth.org.

Their first question of the blog contest is:
What should be the key priority of the upcoming UN High Level Meeting on Non-Communicable Diseases and why?

For more information on the contest’s rules or to submit your entry, please visit: http://smartglobalhealth.org/BlogContest

The latest issue of The Journal of Biological Chemistry reports a surprising new mechanism of beta cell destruction.  Beta cells are the cells in the pancreas responsible for producing the insulin needed to keep the body’s blood glucose levels within a normal range by decreasing excess levels of glucose throughout the day; their destruction is a core defect in Diabetes.  Alpha cells are also found in the pancreas and also play a role in keeping the blood glucose levels normal by producing glucagon.  Glucagon counteracts the action of insulin by raising the blood glucose levels when glucose levels fall below the normal range.    Alpha cells also secrete another substance, glutamate, which acts as a signaling molecule in both the pancreas and brain. The results of this study showed that glutamate is toxic to the beta cell.  The study also found the presence of a key regulator of glutamate concentration near the beta cells called the glial glutamate transporter 1 (GLT1).  GLT1 is located on the plasma membrane of beta cells and is integral in protecting the beta cells from the toxic effects of glutamate. The authors are presently working on developing a diagnostic test for glutamate toxicity in the pancreas. The hope is to eventually develop an intervention that will slow or completely stop the further destruction of beta cells in diabetic patients. This study was a collaborative effort between researchers in Milan, Italy and the University of Texas Health Science Center in San Antonio, TX.

80,000 – the number of manufactured chemicals in use in the US.

62,000 – chemicals that were “grandfathered” in by the 1976 Toxic Substances Control Act (TSCA) and therefore unstudied as to their health and environmental safety.

200 – chemicals tested for their safety under TSCA.

1,000,000+ tons – amount of Bisphenol A (BPA) consumed in the US in 2004, before widespread recognition of its multiple adverse health impacts.

The US public, and now the outsourced manufacturing hubs in China, India and other places worldwide, are essentially participating in a giant experimental trial with the chemicals in our foods, our clothes, our cleaners, plastics, and virtually everything we use.  H.R. 5820 the Toxic Chemical Safety Act, currently under consideration in Congress would begin the process of re-assessing the safety of these chemicals on the loose and replace the ineffective Toxic Substances Control Act.

The new legislation marks a shift in the regulatory philosophy towards new chemicals. Historically, the US favored self-regulation of the industry and allowed the industry to innovate without much concern for long-term effects. This new legislation follows the lead of the Precautionary Principle by beginning to assess the safety of products before they are released into the market.

Perhaps most troubling from a health perspective, aside from the fact that many of these molecules have not been tested for their long term chronic exposure safety, but that even with those that have been tested, few, if any, have had their safety assessed in the context of the myriad of other chemicals that we use on a daily basis. While it has shortcomings, HR 5820 is a step in the right direction.

For more info and perspectives see:

House Panel Tackles Chemical Legislation | EHS Today.

http://www.huffingtonpost.com/rev-fletcher-harper/choose-life-the-religious_b_662234.html

http://www.opencongress.org/bill/111-h5820/show

http://blogs.edf.org/nanotechnology/2010/07/30/not-playing-nice-the-american-chemistry-council-solidifies-its-claim-to-being-the-industry-of-no/

http://mollyannaapproach.blogspot.com/2010/07/house-members-witnesses-clash-over.html

The University of North Carolina at Chapel Hill Program for Ethnicity, Culture, and Health Outcomes (ECHO) 16th Annual Summer Public Health Research Institute and Videoconference on Minority Health is scheduled for Tuesday, June 8, 1:30-4:00pm EDT.  The videoconference entitled “What Will Health Care Reform Mean for Minority Health Disparities?” will feature Mayra Alvarez, M.H.A., Legislative Assistant, U.S. Senator Richard J. Durbin (Illinois); Ralph Forquera, M.P.H., Executive Director, Seattle Indian Health Board and Clinical Assistant Professor with the School of Public Health, Department of Health Sciences at the University of Washington and Tony L. Whitehead, Ph.D., M.S.Hyg., Professor of Medical Anthropology and founding Director, Cultural Systems Analysis Group (CuSAG), Department of Anthropology, University of Maryland. This interactive session will be broadcast with a live audience in the Tate-Turner-Kuralt auditorium at the UNC School of Social Work and can be viewed over the Internet (webcast). Questions will be taken from broadcast participants by email and toll-free telephone.

Check out their website to register and access related materials.

According to the World Health Organization, non-communicable diseases such as heart disease, cancer and diabetes, account for 60% of deaths worldwide, claiming more than 35 million lives per year. In all regions of the world except Africa, mortality rates among men and women age 15 to 59 are higher for non-communicable diseases than for communicable diseases. Further, The World Economic Forum recently highlighted the economic costs of non-communicable diseases, naming this health threat as one of the three most likely and severe risks to the global economy alongside fiscal crises and asset bubbles, a form of inflation. Yet despite this significant impact, non-communicable diseases tend to be overlooked and underfunded. For example, a Center for Global Development report estimates that less than 1% of public and private health funding is allocated to the prevention and control of non-communicable diseases in low- and middle-income countries. In response to this need for a greater focus on non-communicable diseases globally, a recent United Nations resolution has been introduced calling for a summit on non-communicable diseases “in order to develop strategic responses to these diseases and their repercussions.”

The CEOs of the American Heart Association, the American Cancer Society, and the American Diabetes Association comment on this issue in a recent (5/13) CNN opinion article.