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SIGNpost 00640

*SAFE INJECTION GLOBAL NETWORK* SIGNPOST *SAFE INJECTION GLOBAL NETWORK*

Post00640 Funds + No Stick Testing + Abstracts + Job + News 21 March 2012

CONTENTS

1.New funding opportunity: innovation to strengthen immunization systems
2. TED Talk: Myshkin Ingawale: A blood test without bleeding
3. What are the Reasons for Patient Preference? A Comparison between Oral
and Subcutaneous Administration
4. Abstract: Occupational safety training and education for needlestick
injuries among nursing students in China: Intervention study
5. Abstract: Hospital Cluster of HBV Infection: Molecular Evidence of
Patient-to-Patient Transmission through Lancing Device
6. Abstract: Age and years in practice as factors associated with
needlestick and sharps injuries among health care workers in a
Portuguese hospital
7. Abstract: Avastin doesn’t blind people, people blind people
8. Abstract: Review: Preparing injectable medicines safely
9. Abstract: Patient safety in developing countries: retrospective
estimation of scale and nature of harm to patients in hospital
10. Abstract: Serological and molecular study of hepatitis E virus among
illegal blood donors
11. Abstract: Risk factors for hepatitis C virus infection in former
Brazilian soccer players
12. Abstract: Global Fund investments in harm reduction from 2002 to 2009
13. Abstract: HCV seroconversion among never-injecting heroin users at
baseline: No predictors identified other than starting injection
14. Abstract: Methadone Maintenance Therapy Outcomes in Iran
15. Abstract: Needle exchange and the geography of survival in the South
Bronx
16. Abstract:Feasibility and acceptability of gentamicin in the Uniject
prefilled injection system for community-based treatment of possible
neonatal sepsis: the experience of female community health volunteers
in Nepal
17. Abstract: Intra-arterial injection, a rare but serious complication of
sclerotherapy
18. Abstract: News media reports of patient deaths following ‘medical
tourism’ for cosmetic surgery and bariatric surgery
19. No Abstract: China is urged to compensate people infected with HIV
through illegal blood selling
20. Announcement: 19th WHO Expert Committee on Selection and Use of
Essential Medicines
21. WHO Publication: Safety Monitoring of Medicinal Products
22. Regional Procurement and Supply Management Expert, Latin America
23. Announcement: 14th International Symposium on Viral Hepatitis and Liver
Disease
24. News
– Viet Nam: More methadone centres to open
– UK: University graduate unveils groundbreaking medical device
– India: BD and NABH’s National Infection Control Programme
– Greece: Cuts to health budget lead to increases in HIV/AIDS, malaria, TB
incidence in Greece
– USA: Hepatitis C Incidence Increasing in Younger People
– Egypt: Egyptians design ‘faster, cheaper’ hepatitis C test?
– Canada: Melting snow revealing cache of dirty needles
– Global: Narcotic Drug Use Should Be Treated As Illness, U.N. Drug Office
Director Says
– Joint U.N. Statement On Closure Of Drug Detention Camps Is ‘Unequivocal’
– Russia: Russia HIV Infections Rise 5 Percent in 2011: Official
– Australia: Needle exchange program is a health care necessity
– Global: Cuts Hamper Bid to Tackle AIDS

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________________________________*_________________________________

1.New funding opportunity: innovation to strengthen immunization systems

The deadline for submissions is May 15, 2012. For further information about
the immunization topic area and application guidelines, please visit the
Grand Challenges Explorations website.

http://tinyurl.com/GrandChallenge15-May
__________________________________________________________________
From: “ZAFFRAN, Michel Jose” <zaffranm[at]who.int>
date: Sat, Mar 17, 2012
subject: New funding opportunity: innovation to strengthen immunization
systems

Dear colleagues,

Sincere apologies if you have already received this message.

Thanks to your support, we had a very successful first round of the Grand
Challenges Explorations grants program for immunization supply systems,
which received nearly 300 applications from over 50 countries.
Unfortunately, we were not able to fund all of them. The winners will be
announced in early May.

We now have great news that the Bill & Melinda Gates Foundation has
launched a new call for proposals that will run until May 15.

We are again seeking your help to spread this call across your networks and
colleagues. In order to help ensure all applications are as successful as
possible, we have attached a brief “tips and tricks” document that we
encourage you to share as well as a full topic description.

As a reminder, we are seeking new ideas to ensure that the immunization
systems trusted with delivering life-saving vaccines are up to the task.
Grants of US$100,000 grants will be given to help demonstrate new
approaches and ideas that have never been tried in immunization.

All you need to do is submit a two-page proposal outlining why your idea is
innovative, how you will prove it, and the impact it will have.

Priority areas for funding include:
· Vaccine product characteristics.
· Supply system design.
· Environmental impact.
· Information systems.
· Human resources.
· Vaccination acceptance.

Ideal proposals should be responsive to the topic area, daring in premise,
and clearly different from the approaches currently under investigation or
employed. Solutions should focus on the operational aspects of immunization
systems and must have the potential to be scaled up or reproduced in
multiple low-resource settings.

Please circulate this announcement to your colleagues and networks and
encourage them to submit an application.

The deadline for submissions is May 15, 2012. For further information about
the immunization topic area and application guidelines, please visit the
Grand Challenges Explorations website.

http://www.grandchallenges.org/Explorations/Topics/Pages/OptimizeImmunizati
onSystemsRound9.aspx

http://tinyurl.com/GrandChallenge15-May

I thank you again for your support.

Kind regards,
Michel

Michel Zaffran
Senior Adviser WHO/IVB & Director, Project Optimize
_______________________________________________
Optimize – Immunization Systems & Technologies for Tomorrow
A WHO-PATH Collaboration

Department of Immunization, Vaccines and Biologicals
World Health Organization
| 20 Avenue Appia | CH-1211 Geneva 27 Switzerland |
* zaffranm@who.int | (office +41.22.791.5409 | (mobile +41.79.210.4501|

www.who.int/immunization_delivery/optimize
__________________________________________________________________
________________________________*_________________________________

2. TED Talk: Myshkin Ingawale: A blood test without bleeding

Posted from TED with thanks.

TED is a nonprofit devoted to Ideas Worth Spreading – bringing together
people from three worlds: Technology, Entertainment, Design.
__________________________________________________________________
TED Talk: Myshkin Ingawale: A blood test without bleeding

Anemia is a major — and completely preventable — cause of deaths in
childbirth in many places around the world, but the standard test is
invasive and slow. In this witty and inspiring talk, TED Fellow Myshkin
Ingawale describes how (after 32 tries) he and his team created a simple,
portable, low-cost device that can test for anemia without breaking the
skin.

Myshkin Ingawale is the co-founder of Biosense Technologies, which has
built ToucHB, a portable, non-invasive device to test for anemia. Full bio
» http://www.ted.com/speakers/myshkin_ingawale.html

Video at:
www.ted.com/talks/myshkin_ingawale_a_blood_test_without_bleeding.html
__________________________________________________________________
________________________________*_________________________________

3. What are the Reasons for Patient Preference? A Comparison between Oral
and Subcutaneous Administration
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/22422352

Z Orthop Unfall. 2012 Mar 15.

[What are the Reasons for Patient Preference? A Comparison between Oral and
Subcutaneous Administration.]

[Article in German]

Quante M, Thate-Waschke I, Schofer M.

Klinik für Wirbelsäulenchirurgie mit Skoliosezentrum, Klinikum Neustadt.

BACKGROUND: Today there are different subcutaneous and three oral
applicable medications for prevention of venous thromboembolism after knee
and hip replacement. It is a general opinion that patients will prefer oral
administration. However, until today there has been no study that analysed
patient preferences and motives for deciding on the kind of administration.
These data would be of interest since the consideration of patient
preferences could improve adherence. The present study analysed patient
preferences regarding oral or subcutaneous administration of medication
after elective hip or knee replacement surgery. The results will have
implications for clinical practice and for decision-making concerning the
kind of administration.

MATERIAL AND METHODS: This prospective, multi-centric, observational study
was conducted in six emergency hospitals and six rehabilitation hospitals.
178 current hip and knee replacement patients undergoing thromboprophylaxis
and at least one further oral medication were interviewed. Subjective
assessment data of patients were collected on study-specific questionnaires
(epidemiological data, amount and background of general oral medication,
details on subcutaneous thromboprophylaxis, preference of administration,
causes for preference).

RESULTS: 71.91 % of the interviewed patients preferred the daily intake of
a tablet, whereas only 14.61 % favoured the daily subcutaneous injection.
Main causes for the preference of oral administration were easier (86.6 %
of nominations) and less complex (73.1 % of nominations) handling. 70.9 %
reported that one more oral application would be unproblematic.
Painlessness of oral administration was relevant for 65.7 %. Causes for
preferring subcutaneous administration were “safety” (55.3 % of
nominations) and an assumption of a generally better effectivity of
subcutaneous (47.4 % of nominations) administration. Subjective discomfort
induced by subcutaneus administration increased with the time interval
since surgery. Less than 5 % of patients prefer subcutaneous administration
due to the high volume of their existing oral medication.

CONCLUSION: Patient approval of oral administration is governed by
practical and comfort issues. In general, patients on existing oral
medications are uncritical concerning a temporary additional oral
medication. The clear discomfort measured in association with subcutaneous
administration supports the idea that the oral route will have advantages
for patient adherence. In particular this is of relevance with increasing
time interval since surgery. Patients who have a very high volume of oral
medications will probably profit from subcutaneous administration. The main
reasons that patients gave for the preference of subcutaneous
administration are based on incorrect knowledge. Therefore it is necessary
to improve patient education concerning the existing alternatives for
thromboprophylaxis.

© Georg Thieme Verlag KG Stuttgart · New York.
__________________________________________________________________
________________________________*_________________________________

4. Abstract: Occupational safety training and education for needlestick
injuries among nursing students in China: Intervention study
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/22405342

Nurse Educ Today. 2012 Mar 7.

Occupational safety training and education for needlestick injuries among
nursing students in China: Intervention study.

Yang B, Yao WX, Yao C, Huang CH, Qian YR.

School of Architecture, University of Sheffield, Sheffield S10 2TN, South
Yorkshire, United Kingdom.

OBJECTIVES: To confirm the effect of occupational safety training and
education programs (OSTEP) on needlestick injuries (NSIs) among nursing
students in China.

METHODS: Compare the rates and the nature of NSIs before and after OSTEP
among the nursing students in China. Firstly, questionnaires were delivered
to 248 randomly selected nursing students from seven training hospitals to
obtain basic information concerning relevant occupational NSIs. Then
regular intervention measures through OSTEP on 246 nursing students had
been introduced for four years. And the resultant information concerning
relevant occupational NSIs was obtained afterwards. Finally, the data
analysis was performed using SPSS software, version 11.5.

RESULTS: The rate of NSIs among these nursing students was relatively high
before the OSTEP in China (average, 4.65 events/nurse). However, it
decreased rapidly to 0.16 events/nurse average after the OSTEP.
Occupational safety awareness and behavior in handling NSIs was improved in
China. There was a significant difference in the results of Chi-square
value (P<0.005).

CONCLUSIONS: NSIs are common in nursing students in China. The OSTEP can
reduce NSIs and change practical behavior markedly among nursing students
in China. We should perform OSTEP on nurse students before and during the
clinical practice. We must also provide effective preventive measures to
reduce this kind of problem in future.

Copyright © 2012 Elsevier Ltd. All rights reserved.
__________________________________________________________________
________________________________*_________________________________

5. Abstract: Hospital Cluster of HBV Infection: Molecular Evidence of
Patient-to-Patient Transmission through Lancing Device
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/22412991

PLoS One. 2012;7(3):e33122.

Hospital Cluster of HBV Infection: Molecular Evidence of Patient-to-Patient
Transmission through Lancing Device.

Lanini S, Garbuglia AR, Puro V, Solmone M, Martini L, Arcese W, Nanni Costa
A, Borgia P, Piselli P, Capobionchi MR, Ippolito G.
Source
National Institute for Infectious Diseases “Lazzaro Spallanzani”, Rome,
Italy.

INTRODUCTION: In western countries the transmission of hepatitis B virus
(HBV) transmission through multi-patients lancing devices has been inferred
since early ’90s, however no study has ever provided biological evidence
which directly link these device with HBV cross-infection. Here we present
results of an outbreak investigation which could associate, by molecular
techniques, the use of lancing device on multiple patients with HBV
transmission in an Italian oncohematology unit.

METHODS: The outbreak investigation was designed as a retrospective cohort
study to identify all potential cases. All cases identified were eventually
confirmed through molecular epidemiology techniques. Audit of personnel
including extensive review of infection control measures and reviewing
personnel’s tests for HBV was done identify transmission route.

RESULTS: Between 4 May 2006 and 21 February 2007, six incident cases of HBV
infection were reported among 162 patients admitted in the oncohematology.
The subsequent molecular instigation proved that 3 out 6 incident cases and
one prevalent cases (already infected with HBV at the admission)
represented a monophyletic cluster of infection. The eventual environmental
investigation found that an identical HBV viral strain was present on a
multi-patients lancing device in use in the unit and the inferential
analysis showed a statistically significant association between undergoing
lancing procedures and the infection.

DISCUSSION: This investigation provide molecular evidence to link a HBV
infection cluster to multi-patients lancing device and highlights that
patients undergoing capillary blood sampling by non-disposable lancing
device may face an unacceptable increased risk of HBV infection. Therefore
we believe that multi-patients lancing devices should be banned from
healthcare settings and replace with disposable safety lancets that
permanently retract to prevent the use of the same device on multiple
patients. The use of non-disposable lancing devices should be restricted to
individual use at patients’ home.

Free full text:
http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0033122
__________________________________________________________________
________________________________*_________________________________

6. Abstract: Age and years in practice as factors associated with
needlestick and sharps injuries among health care workers in a
Portuguese hospital
__________________________________________________________________

http://www.ncbi.nlm.nih.gov/pubmed/22405233

Accid Anal Prev. 2012 Jul;47:11-5.

Age and years in practice as factors associated with needlestick and sharps
injuries among health care workers in a Portuguese hospital.

Martins A, Coelho AC, Vieira M, Matos M, Pinto ML.

Hospital Center of Trás-os-Montes and Alto Douro, Avenida da Noruega,
Lordelo, 5000-508 Vila Real, Portugal.

Health care workers are attributed to the group at highest risk of
occupationally acquired bloodborne diseases as the result of contact with
blood and body fluids.

A cross sectional study was conducted between November 2009 and February
2010 in the North of Portugal, to identify potential risk factors for
needlestick and sharps injuries. A questionnaire was provided to 363 health
care professionals. Logistic regression was used to identify risk factors
associated to needlestick and sharps injuries, calculating odds ratio (OR)
and their 95% confidence interval (CI).

Sixty- five percent of health care workers (64.5%, 234/363) reported
needlestick and sharps injuries in the previous 5 years. Of the injured
workers, 74.8% were nurses. Of the total injuries reported, the commonest
were from syringe needle unit. The multivariate logistic regression model
showed that the strongest risk factor was having more than 10 years or more
of work in health services (OR 3.37, 95% CI 1.82, 6.24). Another
significantly related factor was being over 39 years-old (OR 1.94, 95% CI
1.03, 3.63).

In Portugal, there is a lack of epidemiological evidence related to
needlestick and sharps injuries. Considering that patients infected with
hepatitis B and C virus are commonly encountered in the hospital
environment and that the prevalence of HIV infection in Portugal is one of
the highest in Europe, these results should be considered in the design of
biosafety strategies at the Hospital Center.

Copyright © 2012 Elsevier Ltd. All rights reserved.
__________________________________________________________________
________________________________*_________________________________

7. Abstract: Avastin doesn’t blind people, people blind people
__________________________________________________________________

http://www.ncbi.nlm.nih.gov/pubmed/22264942

Am J Ophthalmol. 2012 Feb;153(2):196-203.e1.

Avastin doesn’t blind people, people blind people.

Gonzalez S, Rosenfeld PJ, Stewart MW, Brown J, Murphy SP.

Department of Ophthalmology, Bascom Palmer Eye Institute, University of
Miami Miller School of Medicine, Miami, FL 33136, USA.

PURPOSE: To review the appropriate preparation of bevacizumab for
intravitreal injection by compounding pharmacies with specific
recommendations designed to prevent microbial contamination.

DESIGN: Perspective.

METHODS: A review and discussion of compounding issues with supporting
literature, clinical experience, illustrations, and expert opinion.

RESULTS: Closer examination of the events surrounding the recent clusters
of infectious endophthalmitis cases occurring after the intravitreal
injection of bevacizumab suggest that the vision loss is not the result of
the drug or the injection technique, but rather of the compounding
procedures used to prepare the syringes containing the bevacizumab.
Noncompliance with recognized standards and poor aseptic technique are the
most likely causes of these outbreaks. The key to preventing these
catastrophic occurrences depends on the implementation of and strict
adherence to United States Pharmacopoeia Chapter 797 requirements.

CONCLUSIONS: Recommendations arising from a root cause analysis of
infectious endophthalmitis outbreaks should focus on the procedures used by
pharmacies to compound bevacizumab. Microbial contamination of bevacizumab-
containing syringes prepared from the same vial of drug can be avoided by
using a single vial of bevacizumab for each eye or by following strict
adherence to United States Pharmacopoeia Chapter 797 requirements when
compounding a single vial of bevacizumab into multiple syringes.

Copyright © 2012 Elsevier Inc. All rights reserved.
__________________________________________________________________
________________________________*_________________________________

8. Abstract: Review: Preparing injectable medicines safely
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/22359855

Nurs Times. 2012 Jan 17-23;108(3):20-3.

Review: Preparing injectable medicines safely.

Beaney AM, Black A.

Newcastle upon Tyne Hospitals Foundation Trust.

Risks to patients are greater when injectable medicines are prepared in
clinical areas (wards, theatres, clinics or even patients’ homes), rather
than provided in ready-to-use form. This article describes the risks
involved in preparing injectable medicines in such areas and outlines key
principles to ensure they are prepared safely. It also suggests that high-
risk injectable medicines be provided in ready-to-use form, either in
house, by pharmacy or by pharmaceutical companies.
__________________________________________________________________
________________________________*_________________________________

9. Abstract: Patient safety in developing countries: retrospective
estimation of scale and nature of harm to patients in hospital
__________________________________________________________________
Free Article at: http://www.bmj.com/content/344/bmj.e832

BMJ 2012;344:e832

Patient safety in developing countries: retrospective estimation of scale
and nature of harm to patients in hospital

R M Wilson, chief medical officer1, P Michel, director2, S Olsen, fellow3,
R W Gibberd, conjoint professor4, C Vincent, professor3, R El-Assady,
technical officer5, O Rasslan, president6, S Qsous, director7, W M
Macharia, professor and chair8, A Sahel, coordinator9, S Whittaker, chief
executive officer10, M Abdo-Ali, assistant professor11, M Letaief,
professor12, N A Ahmed, national focal point13, A Abdellatif, director6, I
Larizgoitia, coordinator 14 for the WHO Patient Safety EMRO/AFRO Working
group

Correspondence to: R Wilson ross.wilson@nychhc.org
Accepted 25 November 2011

Objective To assess the frequency and nature of adverse events to patients
in selected hospitals in developing or transitional economies.

Design Retrospective medical record review of hospital admissions during
2005 in eight countries.

Setting Ministries of Health of Egypt, Jordan, Kenya, Morocco, Tunisia,
Sudan, South Africa and Yemen; the World Health Organisation (WHO) Eastern
Mediterranean and African Regions (EMRO and AFRO), and WHO Patient Safety.

Participants Convenience sample of 26 hospitals from which 15?548 patient
records were randomly sampled.

Main outcome measures Two stage screening. Initial screening based on 18
explicit criteria. Records that screened positive were then reviewed by a
senior physician for determination of adverse event, its preventability,
and the resulting disability.

Results Of the 15?548 records reviewed, 8.2% showed at least one adverse
event, with a range of 2.5% to 18.4% per country. Of these events, 83% were
judged to be preventable, while about 30% were associated with death of the
patient. About 34% adverse events were from therapeutic errors in
relatively non-complex clinical situations. Inadequate training and
supervision of clinical staff or the failure to follow policies or
protocols contributed to most events.

Conclusions Unsafe patient care represents a serious and considerable
danger to patients in the hospitals that were studied, and hence should be
a high priority public health problem. Many other developing and
transitional economies will probably share similar rates of harm and
similar contributory factors. The convenience sampling of hospitals might
limit the interpretation of results, but the identified adverse event rates
show an estimate that should stimulate and facilitate the urgent
institution of appropriate remedial action and also to trigger more
research. Prevention of these adverse events will be complex and involves
improving basic clinical processes and does not simply depend on the
provision of more resources.
__________________________________________________________________
________________________________*_________________________________

10. Abstract: Serological and molecular study of hepatitis E virus among
illegal blood donors
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/22408360

World J Gastroenterol. 2012 Mar 7;18(9):986-90.

Serological and molecular study of hepatitis E virus among illegal blood
donors.

Cheng XF, Wen YF, Zhu M, Zhan SW, Zheng JX, Dong C, Xiang KX, Xia XB, Wang
G, Han LF.

Xian-Feng Cheng, Ming Zhu, Sheng-Wei Zhan, Jin-Xiu Zheng, Chen Dong, Ke-Xia
Xiang, Xiao-Bing Xia, Ma Anshan Center for Disease Control and Prevention,
Maanshan 243000, Anhui Province, China.

AIM: To investigate the seroprevalence and molecular characteristics of
hepatitis E virus (HEV) in the illegal blood donors (IBDs) of central China
in the early 1990s.

METHODS: A total of 546 blood samples were collected from the IBDs in
Maanshan city, a questionnaire was completed by each subject, detailing the
age, sex, and periods of blood or plasma donation. Anhui Province and
tested for the anti-HEV antibodies. The seropositive samples were subjected
to nested reverse transcription-polymerase chain reaction and sequencing to
analyze HEV partial genome.

RESULTS: The prevalence of IgG and IgM HEV antibody in IBDs was 22.7% and
1.8%, and genotype 4 was the dominant circulating HEV type in IBDs. The
prevalence of anti-HEV IgG was significantly related to sex (OR = 4.905, P
= 0.004) and increased with age (OR = 2.78, P = 0.022), which ranged from
13.0% in those < 40 years old to 30.6% among older persons aged > 60 years.

Moreover, frequency of blood donation was significantly associated with HEV
seropositivity (OR = 2.06, P = 0.006). HEV partial sequences of ORF2 and
obtained 3 sequences in serum samples of 10 IBDs which developed HEV
specific IgM.

CONCLUSION: This study helps define one of the possible routes of
transmission of sporadic HEV infection and provides guidance to screen HEV
in the blood donors so as to guarantee safe blood banks in China

Free Article http://www.wjgnet.com/1007-9327/full/v18/i9/986.htm
__________________________________________________________________
________________________________*_________________________________

11. Abstract: Risk factors for hepatitis C virus infection in former
Brazilian soccer players
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/21439103

Epidemiol Infect. 2012 Jan;140(1):70-3.

Risk factors for hepatitis C virus infection in former Brazilian soccer
players.

Azevedo TC, Filgueira NA, Lopes EP.

Department of Internal Medicine, Hospital das Clinicas, Federal University
of Pernambuco, Recife, Brazil.

We evaluated the occurrence of hepatitis C virus (HCV) infection in 97
former soccer players who played in Recife, Brazil in the 1960s and 1970s,
and analysed the risk factors for infection, such as history of
transfusions, surgery, tattoos, piercings, and the use of illicit drugs or
injectable vitamin complexes. Immunochromatographic testing was performed
to detect anti-HCV antibodies.

All former soccer players were men (mean age 59·2 years), of whom 62 (64%)
and 35 (36%) were classified as amateurs and professionals, respectively.

Seven (7·2%) tested positive for anti-HCV antibodies; three (4·8%) were
amateurs, and four (11·4%) were professionals.

In univariate analysis, transfusion, surgery, and use of injectable vitamin
complexes were associated with HCV infection, while in multivariate
analysis, only the use of injectable vitamin complexes was related (P=
0·0005).

We observed a high frequency of HCV infection in former soccer players,
especially in professionals who used injectable vitamin complexes.
__________________________________________________________________
________________________________*_________________________________

12. Abstract: Global Fund investments in harm reduction from 2002 to 2009
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/22421551

Int J Drug Policy. 2012 Mar 13.

Global Fund investments in harm reduction from 2002 to 2009.

Bridge J, Hunter BM, Atun R, Lazarus JV.

The Global Fund to Fight AIDS, Tuberculosis and Malaria, Chemin de
Blandonnet 8, 1214 Vernier, Geneva, Switzerland.

BACKGROUND: Injecting drug use has been documented in 158 countries and is
a major contributor to HIV epidemics. People who inject drugs have poor and
inequitable access to HIV services. The Global Fund to Fight AIDS,
Tuberculosis and Malaria is the leading multilateral donor for HIV
programmes and encourages applicants to include harm reduction
interventions in their proposals. This study is the first detailed analysis
of Global Fund investments in harm reduction interventions.

METHODS: The full list of more than 1000 Global Fund grants was analysed to
identify HIV grants that contain activities for people who inject drugs.
Data were collected from the detailed budgets agreed between the Global
Fund and grant recipients. Relevant budget lines were recorded and analysed
in terms of the resources allocated to different interventions.

RESULTS: 120 grants from 55 countries and territories contained activities
for people who inject drugs worth a total of US$ 361million, increasing to
US$ 430million after projections were made for grants that had yet to enter
their final phase of funding. Two-thirds of the budgeted US$ 361million was
allocated to core harm reduction activities as defined by the United
Nations. Thirty-nine of the 55 countries were in Eastern Europe and Asia.
Only three countries with generalised HIV epidemics had grants that
included harm reduction activities.

CONCLUSION: This study represents the most comprehensive assessment of
Global Fund investments in harm reduction. This funding, while substantial,
falls short of the estimated needs. Investments in harm reduction must
increase if HIV transmission among people who inject drugs is to be halved
by 2015.

Copyright © 2012 Elsevier B.V. All rights reserved.
__________________________________________________________________
________________________________*_________________________________

13. Abstract: HCV seroconversion among never-injecting heroin users at
baseline: No predictors identified other than starting injection
__________________________________________________________________

http://www.ncbi.nlm.nih.gov/pubmed/22421554

Int J Drug Policy. 2012 Mar 13.

HCV seroconversion among never-injecting heroin users at baseline: No
predictors identified other than starting injection.

Bravo MJ, Vallejo F, Barrio G, Brugal MT, Molist G, Pulido J, Sordo L, de
la Fuente L; the ITINERE Project Group.

Centro Nacional De Epidemiología, Instituto de Salud Carlos III, Madrid,
Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Spain.

BACKGROUND: Heroin users who do not inject constitute a large pool of drug
users with a potentially important impact on public health. We aimed to
estimate the incidence of hepatitis C virus (HCV) among heroin users who
had never injected (NIDUS) at baseline, and the effect of starting
injecting during follow-up, other percutaneous exposures, sharing snorting
paraphernalia, cocaine/crack use, and risky sexual behaviour on HCV-
seroconversion.

METHODS: Prospective cohort of 305 HCV-negative NIDUs at baseline, aged
18-30 and street-recruited in three Spanish cities in 2001-2003. Computer-
assisted personal interviews were conducted and dried blood-spot samples
were collected. Bivariate and multivariable Poisson models were used.

RESULTS: Among the 305 never-injectors who were HCV-negative at baseline,
197 (64.6%) were followed-up and 21 seroconverted [HCV-incidence rate=
5.8/100 person-years at risk (pyar) (95% CI: 3.6-8.9)]. HCV incidence in
new- injectors was 28.4/100pyar [(95% CI, 14.7-49.7) vs. 2.8/100pyar (95%
CI, 1.3-5.4)] among NIDUs. Of the risk exposures considered, starting
injecting was the only predictor of HCV-seroconversion [adjusted relative
risk=10.1, 95% CI: 3.8-26.7].

CONCLUSION: The HCV-seroconversion rate was 10 times higher among new-
injectors than never-injectors. No predictors other than starting injecting
were found for HCV-seroconversion. Harm reduction interventions to prevent
HCV infection should include prevention of drug injection.

Copyright © 2012 Elsevier B.V. All rights reserved.
__________________________________________________________________
________________________________*_________________________________

14. Abstract: Methadone Maintenance Therapy Outcomes in Iran
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/22416897

Subst Use Misuse. 2012 Mar 15.

Methadone Maintenance Therapy Outcomes in Iran.

Noori R, Narenjiha H, Aghabakhshi H, Habibi G, Khoshkrood Mansoori B.

1Dariush Institute, Research Center of Substance Abuse and Dependency,
Tehran, Iran.

Introduction: Because of the increasing number of injecting drug users
(IDUs) in Iran and the risk of the spread of HIV infection, harm reduction
programs have been considered for conventional law enforcement measures.
The aim of this study was to evaluate the efficacy of methadone maintenance
therapy (MMT) in IDUs and the associated health and social outcomes.

Material and Methods: This case-control study was conducted at the
Persepolis Harm Reduction Center in Tehran during the year 2006. Data were
gathered from two groups of randomly chosen patients. The first group
consisted of 75 IDU patients who had undergone at least 6 months of
methadone treatment (the MMT group), and second group consisted of 75 newly
admitted clients (the control group). Participants were assessed on their
dangerous injection and sexual behaviors, social well-being, and patterns
of drug use. The results were compared between the two groups.

Results: The mean age of participants in the two groups was almost the same
(34.28 years in the control group and 35.68 years in the MMT group, p
>.05). Prevalence of drug injection in the MMT group was less than that in
the control group (16% vs. 100%). There was also a dramatic difference in
needle and syringe sharing (40% in the control group vs. 4% in the MMT
group) but not in crimes and arrests (p = .4). Those in the MMT group had a
better relationship with their families, partners, coworkers, and neighbors
compared with controls. There was no considerable difference in dangerous
sexual behaviors between the two groups.

Conclusions: Given the large number of HIV-positive cases among IDUs and
considering that injection drug use is the main spreading factor for HIV,
MMT would play a major role in controlling the HIV epidemic through
reduction of heroin injection and the risk behaviors related to it. High
inflation rate, lack of interorganization coordination, budget limitation,
and no follow-up were the most important limitations of this study.
__________________________________________________________________
________________________________*_________________________________

15. Abstract: Needle exchange and the geography of survival in the South
Bronx
__________________________________________________________________

http://www.ncbi.nlm.nih.gov/pubmed/22417824

Int J Drug Policy. 2012 Mar 12.

Needle exchange and the geography of survival in the South Bronx.

McLean K.

The Graduate Center, The City University of New York, Doctoral Program in
Sociology, 365 Fifth Ave., New York, NY 10016, USA; National Development
and Research Institutes, Inc., Behavioral Sciences Training Program, 71
West 23rd St., 8th Floor, New York, NY 10010, USA.

This paper explores the position of needle exchange programmes (NEPs) in
the “geography of survival” in the South Bronx neighbourhood of New York
City. Stemming the spread of HIV through the provision of sterile injecting
equipment, needle exchange promotes the survival of injection drug users
(IDUs) in the starkest sense; yet NEPs also attract a diverse population of
service users whose attendance is not necessarily related to drugs.

This paper locates NEPs among a larger constellation of social services
accessed by residents of poor neighbourhoods, including injection drug
users, the homeless, the hungry, and those in need of medical services or
just safe space. Drawing on ethnographic and interview data from a needle
exchange in the South Bronx, I describe how both IDUs and others employed
the organisation to make ends meet, elaborating four “off-label” usages of
needle exchange: as a place to obtain basic necessities, as a source of
income, as a safe space, and as a site of social contact. As harm reduction
in the United States moves towards an increasingly clinical model of care,
this paper considers these latent functions of needle exchange within the
context of a larger struggle over the content and meaning of harm reduction
services.

By themselves, NEPs are clearly an unsatisfactory solution to the economic
and political circumstances that drive a variety of individuals through
their doors; yet, in a country that lacks a comprehensive welfare system,
needle exchange arguably represents an important thread within a social
safety net that is being woven from the ground up.

This study may be used to argue for a (re)expanded mission for harm
reduction in the United States, in the face of constant moves to narrow its
mandate and reduce its
budget.

Copyright © 2012 Elsevier B.V. All rights reserved.
__________________________________________________________________
________________________________*_________________________________

16. Abstract:Feasibility and acceptability of gentamicin in the Uniject
prefilled injection system for community-based treatment of possible
neonatal sepsis: the experience of female community health volunteers
in Nepal
__________________________________________________________________

http://www.ncbi.nlm.nih.gov/pubmed/22422117

J Perinatol. 2012 Mar 15. doi: 10.1038/jp.2012.20.

Feasibility and acceptability of gentamicin in the Uniject prefilled
injection system for community-based treatment of possible neonatal sepsis:
the experience of female community health volunteers in Nepal.

Coffey PS, Sharma J, Gargi KC, Neupane D, Dawson P, Pradhan YV.

PATH, Seattle, WA, USA.

Objective:Explore feasibility and acceptability of gentamicin in the
Uniject prefilled injection system, in combination with oral cotrimoxazole-
p and an appropriate newborn weighing scale, for treatment of possible
neonatal sepsis when administered in the community by female community
health volunteers.

Study Design:In a community-based program in Nepal, 45
volunteers recorded 422 live births. Among these, 82 infants were
identified as having possible severe bacterial infection. In all, 67 of
these infants were treated with gentamicin in Uniject and 15 were referred
to the health facility. Mixed methods were used to collect data about
Uniject performance, acceptability and safety.

Result:Volunteers
successfully treated 67 infants with gentamicin in Uniject. Gentamicin in
Uniject performed well and was acceptable.Conclusion:Gentamicin in Uniject,
in combination with cotrimoxazole-p and an appropriate newborn weighing
scale, is a feasible and acceptable option for treatment of possible
neonatal sepsis in the community by female community health
volunteers.

Journal of Perinatology advance online publication, 15 March 2012
__________________________________________________________________
________________________________*_________________________________

17. Abstract: Intra-arterial injection, a rare but serious complication of
sclerotherapy
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/22422795

Phlebology. 2012 Mar 15.

Intra-arterial injection, a rare but serious complication of sclerotherapy.

Hafner F, Froehlich H, Gary T, Brodmann M.

Division of Angiology, Department of Internal Medicine, Medical University
of Graz, Graz, Austria.

Intra-arterial injections represent the most feared complication of
sclerotherapy for varicose veins. We present a case of an inadvertent
intra-arterial injection of polidocanol at the left medial calf in a 59-
year-old woman with subsequent arterial occlusions of the posterior tibial
artery and foot arteries. Despite several therapeutic interventions, lower-
limb amputation could not be prevented.

We conducted a PubMed search for articles reporting arterial complications
related to sclerotherapy, in order to evaluate aetiology, clinical
presentation, therapeutic management and outcome of sclerotherapy-
associated intra-arterial injections during the past 50 years.

Intra-arterial injection of a sclerosing solution was reported in 63 cases,
mostly after injection near the ankle region or the distal medial calf.
Clinical presentation was frequently characterized by immediate pain during
injection and distal ischaemia with subsequent tissue loss. Despite several
treatment approaches, amputation could not be prevented in 31 cases
(52.5%).

The pathophysiology of arterial complications related to intra-arterial
injection and advisable therapeutic interventions are discussed.
Inadvertent intra-arterial injection represents a limb-threatening
complication of sclerotherapy. Target- oriented and prompt therapy seems
inevitable in order to reduce the risk of permanent tissue loss and
amputation.
__________________________________________________________________
________________________________*_________________________________

18. Abstract: News media reports of patient deaths following ‘medical
tourism’ for cosmetic surgery and bariatric surgery
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/22420449

Dev World Bioeth. 2012 Apr;12(1):21-34.

News media reports of patient deaths following ‘medical tourism’ for
cosmetic surgery and bariatric surgery.

Turner L.

University of Minnesota Center for Bioethics, USA.

Contemporary scholarship examining clinical outcomes in medical travel for
cosmetic surgery identifies cases in which patients traveled abroad for
medical procedures and subsequently returned home with infections and other
surgical complications. Though there are peer-reviewed articles identifying
patient deaths in cases where patients traveled abroad for commercial
kidney transplantation or stem cell injections, no scholarly publications
document deaths of patients who traveled abroad for cosmetic surgery or
bariatric surgery.

Drawing upon news media reports extending from 1993 to 2011, this article
identifies and describes twenty-six reported cases of deaths of individuals
who traveled abroad for cosmetic surgery or bariatric surgery. Over half of
the reported deaths occurred in two countries.

Analysis of these news reports cannot be used to make causal claims about
why the patients died. In addition, cases identified in news media accounts
do not provide a basis for establishing the relative risk of traveling
abroad for care instead of seeking elective cosmetic surgery at domestic
health care facilities.

Acknowledging these limitations, the case reports suggest the possibility
that contemporary peer-reviewed scholarship is underreporting patient
mortality in medical travel. The paper makes a strong case for promoting
normative analyses and empirical studies of medical travel.

In particular, the paper argues that empirically informed ethical analysis
of ‘medical tourism’ will benefit from rigorous studies tracking global
flows of medical travelers and the clinical outcomes they experience. The
paper contains practical recommendations intended to promote debate
concerning how to promote patient safety and quality of care in medical
travel.

© 2012 Blackwell Publishing Ltd.
__________________________________________________________________
________________________________*_________________________________

19 through illegal blood selling
__________________________________________________________________

http://www.ncbi.nlm.nih.gov/pubmed/22403266.1

BMJ. 2012 Mar 8;344:e1740.

China is urged to compensate people infected with HIV through illegal blood
selling.

Parry J.

Source: Hong Kong.
__________________________________________________________________
________________________________*_________________________________

20. Announcement: 19th WHO Expert Committee on Selection and Use of
Essential Medicines

Crossposted from E-DRUG with thanks.
__________________________________________________________________
Date: Fri, 16 Mar 2012
From: “Kris Weerasuriya” <weerasuriyak@who.int>

19th WHO Expert Committee on Selection and Use of Essential Medicines

The 19th meeting of the WHO Expert Committee on Selection and Use of
Essential Medicines will be held in the first half of 2013.

The announcement and background files are available at
http://www.who.int/selection_medicines/committees/en/

The deadline for applications for additions or deletions is 1st December
2012.

An application form will become available at
http://www.who.int/selection_medicines/committees/AppForm.pdf
Information for applicants is available at
http://www.who.int/selection_medicines/committees/expert/18/Add_info.pdf

The main output of the meeting will be the 18th WHO Model List of Essential
Medicines.

Regards,

Dr K Weerasuriya,
Secretary, Expert Committee on Selection and Use of Essential Medicines
Medical Officer, Medicines Access and Rational Use (MAR)
Essential Medicines and Health Products (EMP)
World Health Organization
CH-1211 Geneva 27
Switzerland
Tel – +41 22 791 2357
Fax – +41 22 791 4167
email: weerasuriyak@who.int
__________________________________________________________________
________________________________*_________________________________

21. WHO Publication: Safety Monitoring of Medicinal Products

Crossposted from E-DRUG with thanks.
__________________________________________________________________
Date: Fri, 16 Mar 2012
From: “Pal, Shanthi Narayan” <pals@who.int>

E-DRUG: WHO Publication: Safety Monitoring of Medicinal Products –
Reporting system for the general public

Dear Colleagues,

A new WHO publication by the title: Safety Monitoring of Medicinal
Products – Reporting system for the general public is now available on the
WHO website:
http://www.who.int/medicines/areas/quality_safety/safety_efficacy/EMP_Consu
merReporting_web_v2.pdf [repair link if broken]
http://tinyurl.com/ESSentialDrug-HandbookConsumer

This document aims to provide practical guidelines on how to set up
national systems for consumers to report adverse reactions to medicines.
(Throughout this document, the phrase “consumer reporting” is used to
refer to reporting of adverse drug reactions (ADRs) by the general
public.)

The creation of a handbook for consumer reporting of ADRs was discussed
and requested at the thirty-first meeting of the National
Pharmacovigilance Centres held in Uppsala, Sweden from 20-23 October
2008, and the development of this publication has been incorporated into
the aims of the Seventh Framework Programme of the Research Directorate
of the European Commission and its project Monitoring Medicines
(http://www.monitoringmedicines.org/).

Dr Shanthi Pal
Pharmacovigilance Programme Manager
Quality Assurance and Safety: Medicines
Department of Essential Medicines and Health Products
World Health Organization
Geneva, Switzerland
Tel: + 41 22 791 1318
E-mail: pals@who.int
Website: http://www.who.int/medicines
__________________________________________________________________
________________________________*_________________________________

22. Regional Procurement and Supply Management Expert, Latin America

If you are interested, please address your application in English with CV
in English (maximum 3 pages) and names of 3 referees by 26 March 2012 to
Nicole Haenggi (Human Resources) and Magali Babaley (Project Leader) by e-
mail at: nicole.haenggi@unibas.ch and magali.babaley@unibas.ch with copy to
Odile Pham-Tan at odile.phamtan@unibas.ch

Crossposted from E-DRUG with thanks.
__________________________________________________________________
Regional Procurement and Supply Management Expert, Latin America

The Swiss Centre for International Health (SCIH) of the Swiss Tropical and
Public Health Institute (Swiss TPH) conducts consultancy, project
management, training and applied research work in international health. We
are contracted by the Global Fund to provide Local Fund Agent (LFA)
services and are seeking applications for the following position based in
Nicaraguaor El Salvador:

Regional Procurement and Supply Management Expert Latin America

Tasks:

Review of quantification and specifications of pharmaceuticals and health
and non-health products and equipment to be procured;

Assess systems for the management of health and non-health products
(storage, distribution and information systems);

Review a sample of tenders for the procurement health and non-health
products for consistency with Global Fund procurement policies and
principles;

Review information entered in The Global Fund’s online reporting system;

Review consistency of procurement plan, workplan and budget and performance
targets

Conduct site visits to cross check information reported by Principal
Recipients

To best fit into our active, interdisciplinary team we are looking for
candidates with the following qualifications:

A minimum of 7 years experience in managing or advising on the
procurement, distribution and supply of health products, particularly in
developing countries with:

University Degree in pharmacy preferably or related discipline is required
((Master degree level minimum).

Professional training in procurement and supply management (PSM) of health
products, logistics and/or public health is desirable

Significant experience in most, if not all, of the below six areas:

(i)Experience/expertise in assessing policies, systems and structures in
the public and/or private health sector relevant for managing effective and
efficient access to pharmaceuticals and other health products, particularly
for AIDS, TB and malaria;

(ii)Experience/expertise in the procurement of health products including
regulations and tendering process;

(iii) Experience/expertise in supply chain/logistics management systems;

(iv) Experience in quantification and forecasting of health product needs
in public health programs;

(v) strong understanding of AIDS TB, malaria market dynamics and existing
global supply challenges as well as international health products
procurement and supply management processes, applicable national and
international laws and recognised standards; and

(vi) Good writing and analytical skills.

Minimum of two years working experience in the health sector in low- and
middle income countries

Knowledge of Global Fund procedures and requirements is an asset

Excellent command of English and Spanish required.

Good communication skills, strong team spirit, ability to work under
minimal supervision and in multi- cultural context

An initial contract of two years will be offered with possibility of
renewal based on performance.

We are looking to have the successful candidate in place as soon as
possible

If you are interested, please address your application in English with CV
in English (maximum 3 pages) and names of 3 referees by 26 March 2012 to
Nicole Haenggi (Human Resources) and Magali Babaley (Project Leader) by e-
mail at: nicole.haenggi@unibas.ch and magali.babaley@unibas.ch with copy to
Odile Pham-Tan at odile.phamtan@unibas.ch

Please note that only short listed candidates will be contacted.

For further information please consults our website:
http://www.swisstph.ch/about-us/job-opportunities.html
__________________________________________________________________
________________________________*_________________________________

23. Announcement: 14th International Symposium on Viral Hepatitis and Liver
Disease

http://www.isvhld2012.org/
__________________________________________________________________
14th International Symposium on Viral Hepatitis and Liver Disease

Dates: 22 to 25 June 2012 Shanghai, China

Sponsored by the Chinese Academy of Engineering. Shanghai Municipal
Government.

For more information contact the secretariat, E-mail: info@isvhld2012.org
or access the Web site: http://www.isvhld2012.org/

Early registration deadline: March 30, 2012.

The International Symposium on Viral Hepatitis and Liver Disease (ISVHLD)
represents the continuation of a tradition of outstanding international
symposia on viral hepatitis held every three years.

The ISVHLD is dedicated to bringing together outstanding clinical and basic
researchers in viral hepatitis from around the world to provide summary
updates on advances in the understanding, diagnosis, prevention, control,
and treatment of all five forms of viral hepatitis.

The meeting also provides a venue for reviewing the success of public
health measures taken to control and prevent viral hepatitis.

An important element in the ISVHLD is the inclusion of clinicians,
investigators, and public health experts from all areas of the world,
including developing nations where viral hepatitis contributes considerably
to morbidity and mortality. The purpose is to provide stimulus for future
research and collaborations that promote control of viral hepatitis
worldwide.
__________________________________________________________________
________________________________*_________________________________

24. News

– Viet Nam: More methadone centres to open
– UK: University graduate unveils groundbreaking medical device
– India: BD and NABH’s National Infection Control Programme
– Greece: Cuts to health budget lead to increases in HIV/AIDS, malaria, TB
incidence in Greece
– USA: Hepatitis C Incidence Increasing in Younger People
– Egypt: Egyptians design ‘faster, cheaper’ hepatitis C test?
– Canada: Melting snow revealing cache of dirty needles
– Global: Narcotic Drug Use Should Be Treated As Illness, U.N. Drug Office
Director Says
– Joint U.N. Statement On Closure Of Drug Detention Camps Is ‘Unequivocal’
– Russia: Russia HIV Infections Rise 5 Percent in 2011: Official
– Australia: Needle exchange program is a health care necessity
– Global: Cuts Hamper Bid to Tackle AIDS

Selected news items reprinted under the fair use doctrine of international
copyright law: http://www4.law.cornell.edu/uscode/17/107.html
__________________________________________________________________
Viet Nam: More methadone centres to open
Viet Nam News, Viet Nam (20.03.12)

HA NOI – The Viet Nam Administration of HIV/AIDS Control plans to open 20
more methadone detoxification centres across the country this year, said
director Pham Duc Manh at a conference on HIV/AIDS held recently in Ha Noi.
Once completed, Viet Nam will have 61 methadone centres with the capacity
to treat approximately 15,000 drug addicts th is year.

Methadone medicine is currently imported by the Ministry of Health through
a programme sponsored by the US President’s Emergency Plan for AIDS Relief.
The ministry has imported more than 70,600 litres of the medicine thus far.
Methadone centres are forecast to provide treatment to 80,000 drug addicts
by 2015.

“However, the US programme’s coverage is limited and the ministry has found
it difficult to find an alternate source of methadone since it is
imported,” said Manh.

Relevant bodies should join hands to carry out a methadone manufacture
project and create jobs for patients being treated with methadone, he said.
According to the rector of the Ha Noi Medical University, unsafe drug
injection was the main cause of HIV transmission in the country. – VNS
__________________________________________________________________
__________________________________________________________________
UK: University graduate unveils groundbreaking medical device
Medical Xpress (20.03.12)

An inventor who has won numerous awards for his cutting edge designs has
developed a product he believes could revolutionise hospital treatment.

Oliver Blackwell says his pain-free needle could be used in millions of
procedures every year and lead to a more pleasant experience for patients.
He also says it will reduce the risk of contamination and improve
efficiency for doctors and nurses working on the wards.

Mr. Blackwell, a Plymouth University graduate who is now based in Somerset,
has been working on the design for around 18 months alongside two GPs and
the former president of the Royal College of Anaesthetists.

He said: “Among some doctors, there seems to be a myth that needles don’t
hurt. Most patients, however, will testify that they do and this is about
making their time in hospital more comfortable.”

In appearance, the pain-free cannula is little different than the needles
used on wards up and down the country every day. But attached on the front,
there is a much smaller needle which administers around 0.2ml of local
anaesthetic, to ease discomfort from the larger needle that follows.

Mr. Blackwell said: “We knew that doctors would not want an instrument that
was hugely different to the ones they use now, hence we have kept it
similar to an everyday cannula. But at the moment, if they want to use a
local anaesthetic they have to use two needles, find keys and go to the
medicine cupboard separately and it all takes time and effort.

“Our design cuts down that process but still ensures the patient’s comfort,
meaning they have less pain and the doctor isn’t dealing with a traumatised
patient. It also eradicates the risk of confusion or contamination because
hospital staff will only have one needle instead of two.”

Mr Blackwell, 29, who graduated from Plymouth University in 2005, won the
Daily Mail Designer of the Year Award in 2009 and was one of 10 people
shortlisted for a British Airways Great Britons award in 2010. He has also
worked on projects including the New Zealand Better By Design Programme and
a product for the UK Security Services.

“People often ask how you can go from working on agricultural machinery one
day to developing a medical instrument the next,” he said. “It is all about
gaining an insight. You take simple information on board from the experts
– in this case an anaesthetist and the GPs – and adapt your thinking
based on their skills.

“Based on that, I have so far put thousands of hours into this project and
we are now at the stage where we know the procedure and the technology
work. We are now looking at the next stage of trials and testing before it
can be put into mass production across the world and start making people’s
lives more comfortable.”

Provided by University of Plymouth
__________________________________________________________________
__________________________________________________________________

http://www.expresshealthcare.in/201203/market13.shtml

India: BD and NABH’s National Infection Control Programme
Express Healthcare, India (20.03.12)

Kerala, the first state to implement SAFE-I certification programme in
hospitals to improve its healthcare sector

Becton, Dickinson and Company (BD), and National Accreditation Board for
Hospitals & Healthcare Providers (NABH), a constituent body under the
Quality Council of India (QCI), have come together to launch an infection
control programme. They joined forces with an MOU in a bid to strengthen
the existing health systems in the country and promote constant quality
enhancement with effective infection control practices in place.

Speaking on the occasion, Dr Giridhar J Gyani, Quality Council of India,
Secretary General and CEO, NABH said, “In India, there is an urgent need to
invite all healthcare institutions to be compliant with safety standards.
We are making every effort to address the necessity to introduce quality
assurance mechanisms in the healthcare system in India and NABH
accreditation therefore assumes particular significance. In this programme
of SAFE-I, our partner BD will provide on and off-site technical support to
the hospitals for upgrading their infection control practices. This
programme will be a stepping stone for the hospitals to begin their journey
towards NABH accreditation that will help the SAFE-I hospitals to avail
community insurance schemes.”

NABH recommends a minimum basic requirement with the SAFE-I programme, for
hospitals with regard to infection control. It consists of elements like
injection safety, infusion safety, setting up the infection control
protocols and policies, taking steps towards healthcare workers safety,
biomedical waste management and sterilisation and disinfection procedures.

SAFE-I certification will be considered as the initial step towards
preparing healthcare organisations for NABH accreditation. BD will help
applicant hospitals toward SAFE-ITSM preparation and other pertinent
capacity building workshops.

The infection control programme will be accomplished in three phases. The
first phase will comprise workshops which would be conducted across
hospitals in India to ensure that the SAFE-I programme is implemented in
the hospitals. The second phase would see the development of Centers of
Excellence (CoE) and health economic models to enhance patient safety and
infection control standards in India. The third phase will enhance the
national capability of SAFE-I standards dissemination by extending the CoE
network.

Kerala became the first state in India to roll out the national infection
control programme to attain quality-of-care standards and reduce hospital
associated infections. Present at the occasion of the launch ceremony were
Dr KV Beena, District Programme Manager, Ernakulam; Manoj Gopalakrishna,
Managing Director, BD – India; Dr Matthew, State Coordinator, IAP, Kerala
and many other health officials from the state.

EH News Bureau
__________________________________________________________________
__________________________________________________________________
Greece: Cuts to health budget lead to increases in HIV/AIDS, malaria, TB
incidence in Greece
Kaiser Health News (17.03.12)

“The savage cuts to Greece’s health service budget have led to a sharp rise
in HIV/AIDS and malaria in the beleaguered nation, said a leading aid
organization on Thursday,” the Guardian’s “News Blog” reports. “The
incidence of HIV/AIDS among intravenous drug users in central Athens soared
by 1,250 percent in the first 10 months of 2011 compared with the same
period the previous year, according to” Reveka Papadopoulos, “the head of
Medecins Sans Frontieres [MSF] Greece, while malaria is becoming endemic in
the south for the first time since … the 1970s,” the blog notes.

“Papadopoulos said that following health service cuts, including heavy job
losses and a 40 percent reduction in funding for hospitals, Greek social
services were ‘under very severe strain, if not in a state of breakdown,'”
the blog writes. “MSF Greece said the extraordinary increase in HIV/AIDS
among drug users was largely due to the suspension or cancellation of free
needle-exchange programs,” the blog notes, adding that Papadopoulos said,
“‘There has also been a sharp increase in cases of tuberculosis in the
immigrant population, cases of Nile fever — leading to 35 deaths in 2010
— and the reappearance of endemic malaria in several parts of Greece'”
(Henley, 3/15).
__________________________________________________________________
__________________________________________________________________
http://www.medscape.com/viewarticle/760390

USA: Hepatitis C Incidence Increasing in Younger People
Emma Hitt, PhD, Medscape Medical News (16.03.12)

March 16, 2012 – Pennsylvania is reporting an increased incidence of
hepatitis C infections in people 15 to 34 years of age, according to
results presented at the International Conference on Emerging Infectious
Diseases 2012, held in Atlanta, Georgia.

Sameh Boktor, MD, adult viral hepatitis prevention coordinator at the
Bureau of Epidemiology, Pennsylvania Department of Health, in Harrisburg,
presented the findings.

“This has major consequences for the control of this disease, and has
implications for the long-term treatment of infected individuals,” Dr.
Boktor and colleagues say.

“Our findings are similar to those recently reported from Massachusetts and
elsewhere,” they add.

“Clinicians need to consider hepatitis C in their younger patients,
especially those engaging in behaviors such as IV drug use,” Dr. Boktor
told Medscape Medical News.

To assess the incidence of hepatitis C, the researchers reviewed
Pennsylvania’s hepatitis C surveillance data from 2003 (the first full year
of reportable data) to 2010. They compared age-specific rates of reported
cases over time.

The number of newly confirmed or probable hepatitis C cases in people 15 to
34 years of age increased from 1384 in 2003 to 2393 in 2010 (from 43 to 72
cases per 100,000 people).

In addition, the proportion of cases in males in the that age group rose
from 50% in 2003 to 63% in 2010.

In contrast, rates of newly reported cases in all age groups decreased from
85 to 72 cases per 100,000 from 2003 to 2010. In those 45 to 64 years of
age, cases decreased from 185 to 142 per 100,000 during the same time
period.

“The change in rates between 2003 and 2010 appears largest in some rural
areas of Pennsylvania rather than in the 2 large urban centers,” Dr. Boktor
and colleagues point out.

According to Dr. Boktor, hepatitis C is considered a problem of middle age,
owing to exposures that happened well in the past, particularly among those
45 to 64 years of age (the baby boomers).

“Many in the clinical and public health communities are unaware that there
appears to be a new wave of hepatitis C among adolescents and young adults
emerging, especially in those engaged in high-risk behaviors such as IV
drug use,” he said.

“Since this infection is becoming increasingly treatable, testing for
hepatitis C is a very important step to ensure proper care, avoid long-term
complications, and hopefully reduce the potential for subsequent
transmission of the virus,” he added.

Independent commentator John Bartlett, MD, professor of medicine in the
division of infectious diseases at the Johns Hopkins University School of
Medicine in Baltimore, Maryland, noted that “there really is not a good
explanation for these findings.”

“The greatest risk by far is injection drug use; it is unclear from the
report if this was shown,” Dr. Bartlett told Medscape Medical News. He
added that hepatitis C can be transmitted by sex and tattooing, although
neither transmit the infection very efficiently and probably can not
explain the increase.

According to the Centers for Disease Control and Prevention, approximately
3.2 million people are chronically infected with hepatitis C, making it the
most common blood-borne infection in the United States. Overall, the
incidence of acute hepatitis C has declined from just under 2.50 cases per
100,000 in 1992 to about 0.25 cases per 100,000 in 2003 in the United
States, with the incidence remaining stable after that.

This study was not commercially funded. The researchers and Dr. Bartlett
have disclosed no relevant financial relationships.

International Conference on Emerging Infectious Diseases (ICEID) 2012:
Board 75. Presented March 14, 2012.
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Egypt: Egyptians design ‘faster, cheaper’ hepatitis C test?
New York Daily News (15.03.12)

The American University in Cairo said Wednesday that a team of its
researchers has designed a faster and cheaper test for all types of
hepatitis C, which it says affects about 10 million Egyptians.

The development “reduces the two-step testing process carried out over a
number of days to a one-step process that takes less than an hour… at a
fraction of the cost of traditional diagnostic protocols,” the university
said.

The liquid chemistry test can diagnose hepatitis C using gold
nanoparticles, it said.

“Our test is sensitive and inexpensive, and it does not need sophisticated
equipment,” said Hassan Azzazy, professor of chemistry and head of the
research team.

“Detecting HCV during the first six months raises the recovery rate to 90
percent. Little is done on the national level to combat the alarming
prevalence of hepatitis C in Egypt,” said Azzazy.

The AUC said Egypt has about 10 million people who suffer from the
hepatitis C virus (HCV), with the blood-borne pathogen infecting almost
500,000 in the country each year.

Worldwide, around 170 million people are estimated to be living with the
chronic disease caused by the virus.

Unlike hepatitis A or B, most people infected with HCV cannot shake off the
virus on their own because, when under attack by the immune system, it
morphs into stronger variants.

The World Health Organisation estimates that three to four million people
are newly infected with HCV each year.

The WHO says Egypt has one of the highest rates of hepatitis C prevalence
in the world, putting the rate of infection in the country at 22 percent.

Contamination can occur through blood transfusions, blood products and
organ transplants, and the virus can also be passed on to a child if the
mother is infected.
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Canada: Melting snow revealing cache of dirty needles
By Jeff Labine, tbnewswatch.com, Canada (14.03.12)

The Superior Points Harm Reduction Program is in full spring as melted snow
reveals more discard needles.

Rick Thompson, who works at Superior Points – a needle exchange program
meant to curb blood borne diseases — said the amount of needles found
hasn’t changed much since last year but they seem to be getting more calls.

He said it was probably because the program is getting more recognition.

The program distributes about 70,000 needles a month and there are five
needle disposal bins in the south core of the city, one in the north end
and one in the east end.

But sometimes people don’t dispose of the needles properly and they remain
discarded on the ground.

Thompson said they often go on patrol areas that they receive regular calls
about but with the melting snow, more needles are revealing themselves.

“Unfortunately, with the spring thaw we do tend to see an increase in
discarded needles and it takes two or three weeks to catch up and get the
bulk of them cleaned up,” Thompson said.

“A large part of what we do is respond to people who find needles outside
and we’ll go clean up even if it is only one needle. Or we give
instructions on how to clean up.”

Catching anything from a publicly discarded needle is extremely low, he
said.

Thompson said it is difficult to measure the drug addiction problem in the
city but they have noticed they are distributing more needles out to
people.

Harm reduction programs across the province have also seen this increase,
he added.

“We are aware that this city as well as other cities are having
challenges,” he said. “From time to time we will see areas increase but
generally it’s transitional. We will see (needles) show up there for a
while and then it will move to an area. It is a city wide issue so we can’t
pick on one neighbourhood and say it all happens here.”

Thompson said needle exchange is only part of an overall solution to the
needle problem. Other programs such as Alcoholics Anonymous and traditional
treatment programs are all essentially as well.

Thunder Bay Police Chief J.P. Levesque said there’s been a large increase
of needles that police have been running into.

He said he’s concerned that someone may accidently step on a needle and
hurt themselves.

Levesque said it’s pretty clear that needles end up on the street and added
Superior Points isn’t a true needle exchange.

“It’s a huge concern of ours and it is something we need to take better
control over,” Levesque said.

“I understand the issue with addictions and I’m not opposed to harm
reduction by any means but I’d certainly like to see this become more of an
exchange program because I don’t really think it is. I think they are
giving out needles with no expectation of getting them back.”

The Thunder Bay Regional Health Unit wanted to remind the public be careful
when handling discarded or used needles.

The health unit advised people use tongs or pliers when picking up a
needle, store it in a hard plastic container like a peanut butter jar and
then drop it off at any yellow disposal bin.
__________________________________________________________________
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Global: Narcotic Drug Use Should Be Treated As Illness, U.N. Drug Office
Director Says
Kaiser Daily Global Health Policy Report (13.03.12)

“Prevention, treatment, rehabilitation, reintegration and health have to be
recognized as key elements in our strategy” to fight drug demand, supply
and trafficking, U.N. Office on Drugs and Crime Executive Director Yuri
Fedotov said Monday at the opening session of the U.N. Commission on
Narcotic Drugs in Vienna, United Press International reports. Fedotov
added, “Overall, our work on the treatment side must be considered as part
of the normal clinical work undertaken when responding to any other disease
in the health system,” according to UPI (3/12). “He called on countries to
recognize that drug dependence, which claims some 250,000 lives annually,
is an illness,” the U.N. News Centre writes (3/12).

Last week, “12 United Nations entities … issued a joint statement [.pdf]
calling for the closure of compulsory drug detention and rehabilitation
centers,” a UNAIDS feature story reports. “The existence of such centers —
which have been operating in many countries for the last 20 years — raises
human rights issues and threatens the health of detainees, including
through increased vulnerability to HIV and tuberculosis (TB) infection,”

UNAIDS writes, adding, “The joint statement will enable coordinated and
concerted efforts by the U.N. system at country, regional and global levels
to support governments to close compulsory drug detention and
rehabilitation centers and replace them with voluntary, rights-based,
evidence-informed programs in the community” (3/8).

In addition, a new report (.pdf) by Harm Reduction International (HRI)
shows that more than one quarter of women incarcerated in European and
Central Asian prisons are imprisoned because of non-violent drug offenses,
which “routinely ruins lives, breaks families apart and puts children at
serious risk,” according to HRI Deputy Executive Director Damon Barrett, an
HRI press release states (3/12). http://www.ihra.net/contents/1179
__________________________________________________________________
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Joint U.N. Statement On Closure Of Drug Detention Camps Is ‘Unequivocal’
Kaiser Daily Global Health Policy Report (13.03.12)

Daniel Wolfe, director of the International Harm Reduction Development
Program, part of the Open Society Public Health Program, writes in the Open
Society Foundations’ blog about “a recent joint U.N. statement calling for
the immediate closure of the hundreds of centers in which drug users are
detained in the name of treatment,” saying the statement “came not a moment
too soon.”

He continues, “This call for closure of drug detention camps comes after
years of horrifying reports of abuses in these facilities.” According to
Wolfe, “The message, endorsed by agencies such as UNAIDS, the U.N. Office
on Drugs and Crime, and the International Labor Organization, is
unequivocal. Locking people up and abusing them in the name of drug
rehabilitation is ineffective. It violates human rights. And countries
shouldn’t do it” (3/13).
__________________________________________________________________
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Russia: Russia HIV Infections Rise 5 Percent in 2011: Official
Agence France Presse (12.03.12)

Russia’s top doctor said on Monday that new HIV infections rose 5 percent
in 2011, with 62,000 cases recorded. According to Gennady Onishchenko, the
country has logged more than 600,000 cases since 1987, a figure much lower
than the UN’s estimate of 980,000.

Onishchenko said heterosexual HIV transmission continues to increase and
now accounts for 39.9 percent of cases, though most new cases are linked to
injecting drug use. He worries that women are increasingly affected:
Females now represent more than half of new infections in 13 Russian
regions.

According to activists, ongoing social stigma against the groups at highest
risk – homosexuals and drug users – impedes Russia’s response to HIV/AIDS.
International groups have long criticized Russia for failing to take a
comprehensive approach.

Andrei Zlobin, who leads Russia’s HIV patients association, said the
official response to AIDS is marked by inefficiency, inaccurate data, and a
lack of a plan. “The big question is why a country which spends so much
materially lacks such efficiency,” he said.
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Australia: Needle exchange program is a health care necessity
The Canberra Times, Canberra Australia (09.03.12)

Australia has more than 1000 new HIV infections a year. For the sake of
future generations of Australians we should be doing everything we can to
reduce the number of new HIV infections. In several countries, HIV
epidemics starting among prison inmates sharing injecting equipment have
sparked severe epidemics in the general community. Australia also has about
10,000 new hepatitis C infections a year. The overwhelming majority of old
and new hepatitis C infections occur among people who inject drugs.

Many new hepatitis C infections occur inside prisons. Hepatitis C is a time
bomb ticking for the Australian health care system. A good measure of a
country’s fairness is how it respects the human rights of its most
disadvantaged populations. Prisoners are among our most disadvantaged.
Professor Jon Stanhope (”Rights exist behind the wire”, March 13, p15) is
right to emphasise the need to respect the human rights of prisoners.
Australian governments have a responsibility to minimise the number of new
HIV and hepatitis C infections. Who runs the Alexander Maconochie Centre?
The government or the CPSU?

Mr Alistair Waters and Mr Michael Doyle (Letters, March 15) have not
brought up any cogent reasons for denying a health protection readily
available for the past 25 years to citizens in the community to citizens
behind bars. Does the CPSU deny the effectiveness of needle syringe
programs in the community or in prisons to reduce HIV and hepatitis C
infections?

– Dr Alex Wodak, , Alcohol and Drug Service, St Vincent’s Hospital,
Darlinghurst, NSW

Finally the CPSU is showing signs of removing its head from the sand in the
prison needle exchange trial debate. Alistair Waters (Letters, March 15)
rightly points to ”a duty of care”. He is right, and according to the
considered advice we have, this means that provision of sterile injecting
equipment needs to go ahead. Mr Waters correctly states that members have a
right to make a valuable contribution to the debate. That therefore
requires members to be fully informed of the evidence-base from abroad,
which shows that where controlled programs have been established there have
been no recorded instances of syringes being used as weapons against prison
staff. We have developed the world’s first set of protocols that can guide
establishment of a safe controlled needle exchange model (see
www.anex.org.au/prisons). It factors in his concerns and the need to design
an intervention for situation-specific environments that Mr Waters alluded
to.

If the CPSU, with support from Government and public health agencies, was
prepared to enable an informed discussion with its membership, then I am
sure the workable solution Mr Waters hinted at could be found.

– John Ryan, CEO, Anex

The ACT Hepatitis Resource Centre sees some hope in CPSU spokesperson
Alistair Waters’ call for ”a workable outcome among myriad competing
issues” (”Disagreeing with Stanhope on the needle exchange program”,
March 15, p16); though we do not agree with his characterisation of this as
a ”workplace matter”. Far beyond workplace politics the spread of blood-
borne viruses such as hepatitis C within prison, and then from prison to
the general community, has our prisons as incubators for these preventable,
serious, expensive-to-treat, and for some life-threatening conditions.

The very worst model of a needle and syringe program is operating at the
AMC right now. It is unregulated, circulates a limited supply of unsterile
equipment, and fails to connect its ”clients” with health professionals.
Sadly there are other gaps in the current approach to BBV prevention. For
the sake of detainees, prison staff and community health, the ACT Hepatitis
Resource Centre calls for the development and implementation of a
comprehensive, evidence-based blood-borne virus management strategy.

– John Didlick, executive officer, ACT Hepatitis Resource Centre
__________________________________________________________________
__________________________________________________________________
Global: Cuts Hamper Bid to Tackle AIDS
Erika Check Hayden, Nature Vol. 483; No. 7388: P. 131-132 (08.03.12)

At the recently concluded 19th Conference on Retroviruses and Opportunistic
Infections in Seattle, scientists and advocates expressed concern that
austerity budgets are eroding the funding needed to prevent HIV globally.

Last month, Obama’s 2013 budget proposal requested a 10.8 percent cut to
direct international HIV program aid under the President’s Emergency Plan
for AIDS Relief. Combined with previous cuts, that would represent a PEPFAR
funding decline of more than $1 billion from the 2010 level. And in
November, the Global Fund to Fight AIDS, TB and Malaria announced that a
shortfall in donations would leave it unable to support new programs until
2014.

At the conference, data continued to bolster evidence that early
antiretroviral treatment is a powerful HIV prevention tool. Last May, the
HIV Prevention Trials Network’s HPTN 052 study found early treatment
greatly helped to cut HIV transmission among serodiscordant couples. Final
data on the Partners PrEP (pre-exposure prophylaxis) trial found that HIV
infection risk could be reduced by as much as 90 percent if the regimen is
taken as prescribed.

However, developing countries may be unable to reap such benefits, given
cuts to support existing treatment programs. Myanmar scaled back a plan to
expand treatment access by 46,500 more patients after the Global Fund
cancelled the funding round. The Democratic Republic of Congo is lowering
its 2014 treatment target from 82,000 people to 54,000, and it has told
some non-governmental organizations to stop HIV testing.

PEPFAR’s budget for next year is months from a decision. However, Doctors
Without Borders is calling for an emergency Global Fund meeting to lobby
for donations that would enable HIV grants to be issued before 2014.
Gabriel Jaramillo, the fund’s general manager, supports the proposal.
__________________________________________________________________
________________________________*_________________________________
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