In this month's Bulletin



Rare essentials

In his editorial, Marcus M Reidenburg (p. 686) defines the term "essential drugs" and explains why this concept was introduced in 1977. He discusses the possibility of expanding the definition of an essential medicine to include treatments for rare diseases. In a Policy and Practice article, Pieter Stolk et al. (p. 745-751) call for the creation of an Orphan Medicines Model List which would consist of drugs for rare diseases, to complement the WHO List of Essential Medicines.



Health and foreign policy (p. 687)

In their editorial, Nick Drager & David Fidler introduce an upcoming Bulletin theme issue on health and foreign policy, discussing the historically unprecedented effect that health concerns now have on political relationships between countries. They cite the HIV/AIDS pandemic, threats from emerging and re-emerging infectious diseases, fears of bioterrorism, and controversies involving trade and health as reasons for this change.



Tuberculosis control

Rasmus Malmborg et al. (p. 752) review the evidence for the contribution of public-private partnerships to tuberculosis case-finding in poor and vulnerable populations. In an editorial, (p. 688) Léopold Blanc & Lindsay Martinez introduce a call for papers for a Bulletin theme issue on reaching the targets for tuberculosis control.



In the News (pp. 689-698)

Tom Osanjo reports from Kenya on how the Health InterNetwork Access to Research Initiative (HINARI) has transformed patient care at a university hospital in Nairobi. Abiodun Raufu reports on Nigeria's progress in the fight against counterfeit drugs, and Anita Elash discusses the importance of obtaining accurate statistics for HIV/AIDS. In an interview, Dr Mirta Roses Periago, Director of PAHO/AMRO, describes her efforts to tackle inequality in the region.



Neonatal mortality in developing countries

In a research article, AH Baqui et al. (p. 706-713) used verbal autopsy to assess the timing and causes of 1048 neonatal deaths in rural Uttar Pradesh, India. Of these deaths, 41% were stillbirths. Of the liveborn, 32% of deaths occurred on the day of birth, 50% during the first 3 days of life and 71% during the first week. Nhu Thi Nguyen Ngoc et al. (pp. 699-705) investigated the causes of perinatal and neonatal mortality in Argentina, Egypt, India, Peru, South Africa and Viet Nam. Their findings highlight preterm delivery and hypertensive disorders as the most common causes of death. Both studies concluded that there is an urgent need for improvements in neonatal care.



Echinococcosis in China (714-721)

Yu Rong Yang et al. measured the prevalence of human cystic and alveolar echinococcosis in Ningxia, China. They analysed hospital records and did community surveys, covering 4773 individuals from 26 villages in 2002 and 2003. They found that Xiji county has the highest prevalence for both human cystic and alveolar echinococcosis. The authors conclude that echinococcosis is a severe public health problem in this part of China due to unhygienic practices and lack of knowledge about the disease.



Australian trends in heart failure mortality (pp. 722-728)

Farid Najafi et al. analysed official data on mortality for 1997-2003 to assess the changes in deaths due to heart failure in Australia. The total number of deaths for which heart failure was listed on the death certificate as the underlying cause decreased by 21.6%. The authors conclude that the decline in mortality from heart failure reflects a real change in the epidemiology of the condition.



Treatment of vaginal discharge in West Africa (pp. 729-738)

In a research article, Jacques Pépin et al. compared the effectiveness of single-dose treatments with standard therapy for the management of vaginal discharge. The two treatment regimens had a similar effectiveness, with complete resolution in 66% of cases treated with a single dose of tinidazole and fluconazole, and in 64% of those given multiple doses of metronidazole and clotrimazole.



Violence and women's health in Victoria, Australia (pp. 739-744)

T Vos et al. estimated the health risks of intimate partner violence among women in Victoria, Australia, based on data from the year 2001. Such violence represents a significant risk to women's health, and accounts for 2.9% of the total disease and injury burden. More research is needed to evaluate interventions aimed at preventing such violence.



Public Health Classic: Water fluoridation (pp. 759-764)

Michael A Lennon comments on the first community trial of water fluoridation, started in 1945 in Grand Rapids, Michigan, by Francis A Arnold et al. This trial established the benefits of fluoridation in preventing tooth decay to the extent that, years ahead of the planned endpoint, the control community of Muskegon also decided to fluoridate its water supply.

World Health Organization Genebra - Genebra - Switzerland