AP Medical
LONDON – The number of women dying in childbirth worldwide has dropped dramatically, a British medical journal reports, adding that it was pressured to delay its findings until after U.N. meetings this week on public health funding.
A new, separate report by a group headed by the United Nations reached a very different conclusion on maternal mortality, saying the figure remains as high as 500,000 deaths a year.
The disagreement reveals the politics behind public health, where progress made in tackling a health problem can jeopardize funding. Public health officials are gearing up to ask for billions of dollars at U.N. meetings.
U.N. Secretary-General Ban Ki-moon is holding a press conference later Wednesday in New York to kick off a new global initiative on reproductive, maternal and newborn health.
The British medical journal Lancet rushed out a paper on Sunday that found the number of women who die in pregnancy or childbirth has dropped by more than 35 percent over 28 years.
Richard Horton, editor of the Lancet, said he was disappointed when maternal health advocates pressured him to delay publishing the report until September, after several critical fundraising meetings. He also wrote a commentary in Lancet on the pressure.
"Activists perceive a lower maternal mortality figure as actually diluting their message," he told The Associated Press on Wednesday. "Advocacy can sometimes get in the way of science."
He did not name any group or individual who tried to pressure him.
In their paper, Christopher Murray and colleagues at the Institute for Health Metrics at the University of Washington found that maternal deaths have fallen from about 500,000 deaths in 1980 to about 343,000 in 2008. The study in the Lancet was based on more data than was previously available in addition to statistical modeling and was paid for by the Bill & Melinda Gates Foundation.
It was a surprising finding for experts who have long assumed that little progress has been made in maternal health.
But on Tuesday, another report by the Partnership for Maternal, Newborn and Child Health, a global alliance hosted by the World Health Organization, claimed progress in maternal health has "lagged." According to their "detailed analysis," from 350,000 to 500,000 women still die in childbirth every year. The authors did not explain where their data came from or what kind of analysis was used to obtain that wide range of figures.
In that report, U.N. officials also claimed they need $20 billion every year between 2011 and 2015 to save women and children in developing countries.
Dr. Flavia Bustreo, director of the Partnership for Maternal, Newborn and Child Health, denied there was any conflict between her group's study and the Lancet study. She said her group was not involved in pressuring the journal not to publish Murray's study.
"The debate on numbers may continue," Bustreo told the AP on Wednesday. "But we welcome this as good news. There is hope at last for maternal health."
In the world of public health, good news can paradoxically be bad news. The more people who are dying, the more money U.N. officials can raise, making some experts less keen to acknowledge that a problem is not as bad as they once thought.
The U.N. is hosting a meeting of public health experts and heads of state on maternal and child health this week in New York, followed by another one in Washington in June.
For years, U.N. AIDS officials threatened that the epidemic would spread among general populations in countries worldwide, and claimed more than 40 million people were infected. Money for projects fighting AIDS, meanwhile, grew exponentially.
When U.N. officials finally admitted they had been overestimating the numbers for years and dramatically revised their figures — down to 33 million — donors began to rethink their financial commitments.
Experts say public health figures need to be taken with a huge grain of salt, particularly when they come from people who are also soliciting funds for the campaign.
"The U.N. has a track record of inflating disease figures to keep the aid money flowing, so I'd probably place more faith in the figures which show a lower disease burden," said Philip Stevens, of International Policy Network, a London think tank. "This is yet more confirmation that whoever paints the most apocalyptic picture gets the most cash, even if they have to manipulate and spin the data."
Experts say autism bowel disease may not exist
LONDON – A new autism disease identified in a flawed paper linking a common children's vaccine to autism, may not exist, new research says.
A dozen years ago, British surgeon Andrew Wakefield and colleagues published a study in the journal Lancet on a new bowel disease and proposed a connection between autism and the vaccine for measles, mumps and rubella.
The study was widely discredited, 10 of Wakefield's co-authors renounced its conclusions and the Lancet retracted the paper in February. The research set off a health scare, and vaccination rates in Britain dropped so low measles outbreaks returned.
In research published Friday in the medical journal BMJ, reporter Brian Deer examines if the illness described by Wakefield and colleagues — autistic enterocolitis, a bowel disease found in autistic people — actually exists.
In 1996, Wakefield was hired by a lawyer to find a new syndrome of bowel and brain disease to help launch a lawsuit against drug companies that made the measles, mumps and rubella vaccine, according to BMJ article.
According to reports from London's Royal Free Hospital, eight of the 11 children included in Wakefield's original study had normal bowels. But in the Lancet study, 11 of the 12 were said to have a swollen bowel, which was said to be proof of a new gastrointestinal disease affecting autistic children.
In 2005, Wakefield started a clinic in Texas to research and treat the syndrome.
The original biopsy slides from the children in the Lancet study are no longer available. Deer asked independent experts to examine hospital reports on the biopsies, who failed to find any distinctive inflammation that would qualify as a new disease.
In an accompanying editorial, Sir Nicholas Wright from the Barts and the London School of Medicine and Dentistry, said "any firm conclusion would be inadvisable." He said several studies have shown a link between inflamed bowels and autism, but too little evidence exists to prove there is a new illness.
In January, Britain's General Medical Council ruled Wakefield had acted unethically. He and the two colleagues who have not renounced the study face being stripped of their right to practice medicine in Britain.
A dozen years ago, British surgeon Andrew Wakefield and colleagues published a study in the journal Lancet on a new bowel disease and proposed a connection between autism and the vaccine for measles, mumps and rubella.
The study was widely discredited, 10 of Wakefield's co-authors renounced its conclusions and the Lancet retracted the paper in February. The research set off a health scare, and vaccination rates in Britain dropped so low measles outbreaks returned.
In research published Friday in the medical journal BMJ, reporter Brian Deer examines if the illness described by Wakefield and colleagues — autistic enterocolitis, a bowel disease found in autistic people — actually exists.
In 1996, Wakefield was hired by a lawyer to find a new syndrome of bowel and brain disease to help launch a lawsuit against drug companies that made the measles, mumps and rubella vaccine, according to BMJ article.
According to reports from London's Royal Free Hospital, eight of the 11 children included in Wakefield's original study had normal bowels. But in the Lancet study, 11 of the 12 were said to have a swollen bowel, which was said to be proof of a new gastrointestinal disease affecting autistic children.
In 2005, Wakefield started a clinic in Texas to research and treat the syndrome.
The original biopsy slides from the children in the Lancet study are no longer available. Deer asked independent experts to examine hospital reports on the biopsies, who failed to find any distinctive inflammation that would qualify as a new disease.
In an accompanying editorial, Sir Nicholas Wright from the Barts and the London School of Medicine and Dentistry, said "any firm conclusion would be inadvisable." He said several studies have shown a link between inflamed bowels and autism, but too little evidence exists to prove there is a new illness.
In January, Britain's General Medical Council ruled Wakefield had acted unethically. He and the two colleagues who have not renounced the study face being stripped of their right to practice medicine in Britain.
Experts differ on health risk of volcanic ash
GENEVA – Europeans should try to stay indoors if ash from Iceland's volcano starts settling, the World Health Organization warned Friday as small amounts fell in Iceland, Scotland and Norway.
WHO spokesman Daniel Epstein said the microscopic ash is potentially dangerous for people when it starts to reach the Earth because inhaled particles can enter the lungs and cause respiratory problems.
"We're very concerned about it," Epstein said. "These particles when inhaled can reach the peripheral regions of ... the lungs and can cause problems — especially for people with asthma or respiratory problems." He also said Europeans who go outside might want to consider wearing a mask.
Other experts, however, weren't convinced the volcanic ash would have a major effect on peoples' health and said WHO's warnings were "hysterical." They said volcanic ash was much less dangerous than cigarette smoke or pollution.
Volcanic ash is made of fine particles of fragmented volcanic rock. It is light gray to black and can be as fine as talcum powder. During a volcanic eruption, the ash can be breathed deep into the lungs and cause irritation even in healthy people. But once it falls from a greater distance — like from the cloud currently hovering above Europe — its health effects are often minimal, experts say.
The Icelandic volcano that erupted Wednesday has sent an enormous cloud of microscopic basalt ash particles across northern Europe, grounding aircraft across continent. It is drifting above 20,000 feet (6,000 meters), high and invisible from the ground.
"Not all particles are created equal," said Ken Donaldson, a professor of respiratory toxicology at the University of Edinburgh, who has studied the impact of volcanic ash in people. "In the great scheme of things, volcanic ash is not all that harmful."
Donaldson said most Europeans' exposure to volcanic ash would be negligible and that only those in the near vicinity of the Icelandic volcano would likely be at risk.
"Once the volcanic particles are in the stratosphere, they're getting massively diluted because there's a lot of air and other particles blowing around," he said.
He said after previous volcanic eruptions, little impact has been seen in people's health, except for those with lung problems who were close to the volcano.
Dr. Stephen Spiro, a professor of respiratory medicine and deputy chair of the British Lung Foundation, said the further the particles travel, they more diluted and less dangerous they will be. "The cloud has already passed over northern Scotland and we haven't heard of any ill effects there," he said. Spiro said to wear masks or stay indoors to avoid volcanic ash was "over the top" and "a bit hysterical."
"If this was really coming down, you'd see a yellow (tinge) in the air from the sulphur," he said. "But we've seen no sign of that."
Britain's Health Protection Agency said the concentration of volcanic particles that might settle on the ground was likely to be low and should not cause serious harm. The agency said people with respiratory problems like bronchitis and asthma might experience more symptoms like itchy eyes, a sore throat and dry cough. It advised those people to carry their inhalers or medicines with them and said any health effects were likely to be short-term.
Experts said the irritants in volcanic ash were likely to be very diluted by the winds by the time they hit continental Europe, and that any rainfall would also lessen their effects.
"People with health problems shouldn't sit around outside looking up at this cloud because there could be microscopic particles falling down," said Dr. Pascal Imperato, dean of the public health school at the State University of New York Downstate Medical Center, who worked on the response to the eruption of Mount St. Helens in 1980. "But for most people, they will not experience any major breathing or other difficulties."
By Associated Press
WHO spokesman Daniel Epstein said the microscopic ash is potentially dangerous for people when it starts to reach the Earth because inhaled particles can enter the lungs and cause respiratory problems.
"We're very concerned about it," Epstein said. "These particles when inhaled can reach the peripheral regions of ... the lungs and can cause problems — especially for people with asthma or respiratory problems." He also said Europeans who go outside might want to consider wearing a mask.
Other experts, however, weren't convinced the volcanic ash would have a major effect on peoples' health and said WHO's warnings were "hysterical." They said volcanic ash was much less dangerous than cigarette smoke or pollution.
Volcanic ash is made of fine particles of fragmented volcanic rock. It is light gray to black and can be as fine as talcum powder. During a volcanic eruption, the ash can be breathed deep into the lungs and cause irritation even in healthy people. But once it falls from a greater distance — like from the cloud currently hovering above Europe — its health effects are often minimal, experts say.
The Icelandic volcano that erupted Wednesday has sent an enormous cloud of microscopic basalt ash particles across northern Europe, grounding aircraft across continent. It is drifting above 20,000 feet (6,000 meters), high and invisible from the ground.
"Not all particles are created equal," said Ken Donaldson, a professor of respiratory toxicology at the University of Edinburgh, who has studied the impact of volcanic ash in people. "In the great scheme of things, volcanic ash is not all that harmful."
Donaldson said most Europeans' exposure to volcanic ash would be negligible and that only those in the near vicinity of the Icelandic volcano would likely be at risk.
"Once the volcanic particles are in the stratosphere, they're getting massively diluted because there's a lot of air and other particles blowing around," he said.
He said after previous volcanic eruptions, little impact has been seen in people's health, except for those with lung problems who were close to the volcano.
Dr. Stephen Spiro, a professor of respiratory medicine and deputy chair of the British Lung Foundation, said the further the particles travel, they more diluted and less dangerous they will be. "The cloud has already passed over northern Scotland and we haven't heard of any ill effects there," he said. Spiro said to wear masks or stay indoors to avoid volcanic ash was "over the top" and "a bit hysterical."
"If this was really coming down, you'd see a yellow (tinge) in the air from the sulphur," he said. "But we've seen no sign of that."
Britain's Health Protection Agency said the concentration of volcanic particles that might settle on the ground was likely to be low and should not cause serious harm. The agency said people with respiratory problems like bronchitis and asthma might experience more symptoms like itchy eyes, a sore throat and dry cough. It advised those people to carry their inhalers or medicines with them and said any health effects were likely to be short-term.
Experts said the irritants in volcanic ash were likely to be very diluted by the winds by the time they hit continental Europe, and that any rainfall would also lessen their effects.
"People with health problems shouldn't sit around outside looking up at this cloud because there could be microscopic particles falling down," said Dr. Pascal Imperato, dean of the public health school at the State University of New York Downstate Medical Center, who worked on the response to the eruption of Mount St. Helens in 1980. "But for most people, they will not experience any major breathing or other difficulties."
By Associated Press
