Bum shuffles as ex-conjoined twins try out independence

MELBOURNE: It took six hours for doctors to separate conjoined Bhutanese twins Nima and Dawa last week, but nurses said Thursday the recovering girls are still not ready to go their own ways.

“We try and have them a little bit apart, but they manage to sort of bum shuffle back together and have their legs intertwined always,” nurse Kellie Smith told reporters, six days after their operation.

“We did initially try and have them in two beds, but they didn’t like that at all, so they’re in the one bed together and just happy playing with one another, and it’s actually beautiful to see,” she said.

Chief Surgeon Joe Crameri of the Royal Children’s Hospital in Melbourne said the 15-month-olds, who had been joined at the torso and shared a liver, were “making good progress” despite “a few bumps we’re still smoothing out”.

Nurse Megan Collins said the twins — whose names mean “Sun” and “Moon” — particularly liked watching videos of The Wiggles children’s music group.

“They’ll do little dance moves with their hands and what not, so it’s really nice to see them separated but they’re still really happy and wanting to be close to one another.”

The girls’ mother, Bhumchu Zangmo, was initially disoriented to see her daughters in separate beds following the operation, Melbourne’s The Age newspaper reported Thursday.

“She was confused. They had their position earlier,” Tshewang Choden, a Bhutanese nurse travelling with the family, told the newspaper.

“We had to ask the nurses and doctors out there which twin was which”.

The family arrived in Australia a month ago with the help of an Australian charity, but doctors had delayed the surgery to ensure the twins were well-enough nourished to survive the operation.

Bhutan is a poor Himalayan kingdom where doctors did not have the expertise to separate the girls, who were joined from the chest to the waist. — AFP

Sierra Leone’s chimpanzees pay price of human expansion

FREETOWN:They have their hands full at the Tacugama Chimpanzee Sanctuary, where record numbers of orphaned chimps are being delivered to their care, victims of the relentless expansion of human activity.

Poachers hunt them for their meat, farmers shoot them to protect their crops and a lack of political will means more and more of their habitat is being surrendered to urban development and forestry.

Founder of the sanctuary Bala Amarasekaran does not mince his words.

“Over the past 10 years, the environment has suffered much depletion as a result of widespread construction of houses, logging and mining with the approval of corrupt politicians and lands ministry officials,” he said.

Several species of wildlife around the forest, he added, had been wiped out.

The chimps’ plight echoes the core message of the WWF’s new Living Planet report, released Tuesday: that the devastation of the planet’s wildlife is mostly down to “runaway human consumption”.

Over the past three months, the Sierra Leone sanctuary has received seven orphaned chimps, a record number. But those figures only hint at the true scale of the slaughter, said Amarasekaran.

They calculated that for every chimp they received, up to 10 others could have been killed. Over the past three or four months then, between 70 and 100 chimpanzees could have perished.

‘Sometimes they even cry for me’

“Most chimps that arrive at the sanctuary are less than five years old and would still be suckling milk from their mothers,” said Mama Posseh Kamara, who acts as surrogate mother to the new arrivals at the sanctuary.

“Many have lost their mothers to bush meat hunters, abandoned or illegally sold as pets,” she explained.

As she spoke, she fed milk to one of her new charges, a four-month-old baby chimp, as several others climbed over her back and head.

“I have been doing this job for the past 14 years,” she said. “They usually see me as their mother because I feed and clean them daily. Sometimes they even cry for me”.

While they do what they can to protect the animals’ habitat, their efforts are often frustrated by the actions of local officials, said Amarasekaran.

“We planted over 4,000 trees around the National Park area in Freetown,” he said.

“But city planners gave it away for the construction of dwelling houses, due to lawlessness, greed and corruption.

“Government should stop all human activities around our forests to protect biodiversity. If we continue to deplete our environment there will be nothing left for the future”.

‘Obsolete’ laws

Western chimpanzees are the only critically endangered chimp subspecies. They have already been wiped out in Burkina Faso, Benin, Gambia — and possibly Togo too.

According to The American Journal of Primatology, their population plunged more than 80% between 1990 and 2014. And Sierra Leone is home to about 10% of an estimated 55,000 still living wild.

And the loss of their natural habitat is only making the situation worse.

“Sierra Leone is losing a lot of forest cover, due to human activities,” the Food and Agriculture Organization’s (FAO) local representative Nyabenyi Tito Tipo told AFP during her visit to the sanctuary.

“Our forests need to be protected, regenerated and not depleted,” she added.

But for Papanie Bai Sesay, biodiversity officer at the Conservation Society of Sierra Leone, there are two problems with Sierra Leone’s current conservation laws.

“We have obsolete wildlife laws, which date as far back as 1978,” he explained.

But the other problem was more fundamental, he added.

“Our current forest conservation laws and policies are also not enforced by authorities”.

Battling deforestation

Beran Forster, an assistant director at Sierra Leone’s Environmental Protection Agency, acknowledges the scale of the problem.

“The major impact on the environment in Sierra Leone is human expansion into wildlife areas, bush fire to clear lands and hunting wild animals for bush meat,” he said.

“Deforestation through unsustainable logging practices for exporting of logs is the worst situation the environment is faced with,” he added.

In response, they were trying to educate local people on the effects of deforestation and replant across the country.

International partners, such as the US Embassy in Freetown are also helping.

They are financing an agricultural project to improve crop diversity in a sustainable manner, engaging the local villages near the Tacugama Sanctuary.

But change needs to come soon, warned Amarasekaran.

The Freetown National Park boasts a high level of biodiversity: large numbers of species of both plant and animal life, including snakes, birds, butterflies, chimps and other monkeys, he said.

But, he added: “If we continue to deplete our environment there will be nothing left for the future”. — AFP

So Sad: Ntozake Shange, Award-Winning Playwright Of “For Colored Girls”, Passes Away At Age 70

Award-Winning Playwright Ntozake Shange Passed Away At 70

Ntozake Shange,70, the poet, novelist and pioneering playwright responsible for the choreopoem, “For Colored Girls Who Have Considered Suicide/When the Rainbow is Enuf,” died on Saturday (October 27). She reportedly died in

‘Himalayan Viagra’ under threat from climate change

WASHINGTON: A prized caterpillar fungus that is more valuable than gold and is nicknamed “Himalayan Viagra” in Asia, where it is seen as a wonder drug, is becoming harder to find due to climate change, researchers said Monday.

People in China and Nepal have been killed in clashes over the years over the elusive fungus “yarchagumba,” known formally as Ophiocordyceps sinensis.

Although it has no scientifically proven benefits, people who boil yarchagumba in water to make tea or add it to soups and stews believe it cures everything from impotence to cancer.

It is “one of the world’s most valuable biological commodities, providing a crucial source of income for hundreds of thousands of collectors,” said the report in the Proceedings of the National Academy of Sciences, a peer-reviewed US journal.

In recent decades, the fungus has skyrocketed in popularity and prices have soared — it can fetch up to three times the price of gold in Beijing, researchers say.

While many have suspected overharvesting was the reason for its scarcity, researchers wanted to find out more.

So they interviewed around four dozen harvesters, collectors and traders of the prized fungus.

They also examined previously published scientific literature, including interviews with more than 800 people in Nepal, Bhutan, India and China, in order to understand its apparent decline.

Weather patterns, geographic factors and environmental conditions were also analyzed to create a map of yarchagumba production in the region.

“Using data spanning nearly two decades and four countries, (we) revealed that caterpillar fungus production is declining throughout much of its range,” said the report.

The finding “is important because it calls attention to how highly valuable species, like caterpillar fungus, are susceptible not only to overharvesting, as is often the focus, but also to climate change,” lead study author Kelly Hopping told AFP.

“This means that even if people start reducing the amount that they harvest, production will likely continue to dwindle as a result of ongoing climate change,” said Hopping, who conducted the work while a postdoctoral research fellow at Stanford University and is currently assistant professor in Human-Environment Systems at Boise State University.

Researchers were unable to tell which factor — overharvesting or climate change — had a larger impact on the fungus.

“To do so would require access to better harvest records, but monitoring of it is very limited throughout most of the areas where it grows,” Hopping said.

Particular temperatures

The cone-shaped fungus is only found above an elevation of 3,000m, and forms when the parasitic fungus lodges itself in a caterpillar, slowly killing it.

To grow, it needs a specific climate with winter temperatures below freezing but where the soil is not permanently frozen.

“Such conditions are typically present at the margin of permafrost areas,” said the PNAS report.

“Given that winter temperatures have warmed significantly from 1979 to 2013 across much of its range, and especially in Bhutan, its populations are likely to have been negatively affected”.

The warming trend has particularly affected Bhutan, with average winter temperatures “increasing by 3.5-4°C across most of its predicted habitat (+1.1°C per decade, on average),” added the study.

Researchers have previously found that vegetation on the Tibetan plateau “did not shift upward in response to climate warming from 2000 to 2014,” suggesting that the caterpillar fungus will be unable to simply move up the mountain to colder habitats as the climate warms.

This spells trouble for harvesters who sell the fungus in order to survive, according to Hopping.

“Communities throughout the Himalayan region have become very financially dependent on collecting and selling caterpillar fungus, and so this study could serve as a warming of what many harvesters already realize,” she said.

“That decreasing availability of this fungus will be devastating to local economies, and that these communities need other viable livelihood options”. — AFP

NKF is out to create awareness on Kidney disease

IN CONJUNCTION with Minggu Kesedaran Pendermaan Organ (MKPO) Peringkat Kebangsaan 2018, the National Kidney Foundation (NKF) of Malaysia had initiated a unique approach to promote organ donation with mobile cruisers.

The NKF team distributed flyers containing organ donation statistics and information about organ donation along with green pens to drive awareness and commitment for organ donation, This exercise began on Oct 17 and will go on until Oct 21.

“Almost 25,000 patients are currently on the waiting list for organ transplant in Malaysia; however only 1.3% per million population of Malaysian has registered as organ donor pledgers.

“Through this effort, we strive to create awareness of the struggle of those with kidney disease that are hoping for transplants as well as to encourage the public to recognize the life-saving significance of organ donation,” said Chua Hong Wee, Chief Executive Officer of NKF.

The mobile cruiser team went around Klang Valley areas including Subang Jaya, Petaling Jaya, Shah Alam, Kelana Jaya, Damansara and Kuala Lumpur, targeting public places such as universities and shopping malls in order to spread the message to members of the public of all ages.

There were also fun and informative activities such as live interviews with the public so as to understand Malaysians’ perspectives and knowledge towards organ donation in the country.

Interactive games with free gifts, as well as special appearance of the movie character mascots brought cheers to the visitors.

The campaign hashtag is #ambilserius.

“NKF continuously strives to create awareness on kidney disease – from preventive measures to providing assistance to the underprivileged suffering from the disease.

“On 27 and 28 October 2018, NKF Malaysia will also be hosting the 15th Annual Dialysis Meeting 2018 which is a patient-centred approach to dialysis care towards a better quality of life for dialysis patients in Malaysia,” Chua added.

To find out more about National Kidney Foundation log on to the organisation’s website at www.nkf.org.my

Targeted nutrition

FOR PEOPLE diagnosed with diabetes, arguably the most difficult aspect of managing the life-long illness is, of course, changing the way they approach diet and nutrition.

This rings especially true for a nation that is famous for its rich and carb-laden cuisines, including deep-fried flour-based snacks and sugary sambals.

And while there is no real harm in the occasional indulgence of sugar, it is best to consider a specialised nutrition diet based on a diabetes-specific formula (DSF), or Glycemia Targeted Specialised Nutrition (GTSN).

Through GTSN, which is a structured calorie-controlled meal plan, diabetics can decrease the risk of overfeeding their body during meals or while snacking.

When combined with regular exercise, GTSN offers a diet with less sugar, comprising different types of carbohydrates that will help to stabilise blood sugar glucose after meals.

It also assists in the intake of necessary nutrients, as diabetics can consider GTSN as a calorie replacement or supplementation formulated to manage their disease.

The emphasis is on better nutrition because a poor diet can lead to further serious diabetes-related health complications such as heart disease, strokes and retinopathy.

People living with diabetes are not only two to four times at risk of developing heart disease and five times more likely to suffer a stroke, but are also at risk of developing retinopathy, or blindness, within the first five years of diagnosis.

Diabetes also affects kidney function, where some 10% of diabetics are likely to develop kidney disease, according to Persatuan Diabetes Malaysia.

Perhaps the most visibly noticeable complication resulting from diabetes is nerve disease and amputation, as an alarming 50% of diabetics is likely to develop nerve damage.

Diabetics can help manage their condition through a combination of regular exercise, proper medication, as well as a GTSN-based diet.

One such meal replacement or oral supplement formulated specifically for diabetics is Glucerna Triple Care powder, which is designed with a low GI, meaning it helps the body release energy from carbs at a steadier pace.

Backed by 28 years of clinical research by Abbott Laboratories, Glucerna Triple Care can be easily incorporated into a diet as recommended by healthcare professionals.

In an investigator-initiated study, Malaysian patients recorded a significant reduction in weight and better sugar control through medical nutrition therapy.

Joslin Diabetes Centre’s Obesity Clinical Programme medical director Assoc Prof Dr Osama Hamdy, while commenting on that study, said that a personalised care plan can help patients “manage their diabetes better”.

He added: “Effective implementation of a personalised care plan incorporating medical nutrition therapy through a structured low-calorie meal plan and diabetes-specific meal replacements, increased physical activity, and motivation from dieticians, have demonstrated clinical benefits for patients that, in turn, helps them to manage their diabetes better.

“Medical nutrition therapy utilising a diabetes-specific formula has been shown to improve sugar control and the risk of Type-2 diabetes complications.”

Overweight or obese patients with either controlled or uncontrolled diabetes can benefit from adding Glucerna Triple Care to their diet.

Patients can also replace between 250 to 500 calories from meals a day with one or two servings of GTSN.

A typical 1,500 calorie-a-day meal plan for overweight or obese patients may include a 225-calorie serving of Glucerna Triple Care for breakfast, along with three pieces of wholemeal crackers (75 calories) and a slice of cheese (90 calories).

For dinner, they can have a tuna sandwich with wholemeal bread (180 calories), and one medium apple (60 calories). They can then supplement that with a glass of Glucerna Triple Care (225 calories).

Add in the fitness element, and they are all set on managing their diabetes and weight.

A simple 30 minutes of walking can be worked into the most hectic of schedules, such as taking the stairs instead of the lift, or parking the car further away.

Glucerna Triple Care is available in two flavours – chocolate (400g tin) and vanilla (400g and 850g tin) – and can be purchased from retail and hospital pharmacies, as well as selected hypermarkets.

For more, visit the Abbott Malaysia website.

Children’s eyesight falling far short of perfect

MYOPIA, or nearsightedness, among young children occurs not so much due to genetics, but more because of lifestyles and behaviour, according to Vista Eye Specialist’s consultant ophthalmologist, cataract and refractive surgeon Dr Vienne Tai Pih Yih.

Tai was speaking at the launch of the Kid’s Myopia Control Programme organised by the specialist eyecare company recently.

She explained that too many young children are now using mobile devices, and often for long stretches at a time.

“They do not realise that this is detrimental to their vision, as their eyes will grow tired with extended close proximity focus,” she said, adding that poor reading posture and a lack of sleep also contribute to a deteriorating eyesight.

Myopia is an eye condition that occurs when the eyeball is elongated, and the image is formed in front of the retina in the eye, instead of on the retina, which then results in poor vision of distant objects.

This may deteriorate to high myopes (short-sightedness) if left unchecked.

Tai also pointed out that many children do not play outside enough, which is a pity, as outdoor activities under the sun for two hours daily, or 10 hours a week, will help stimulate the release of the neurotransmitter dopamine in the retina which prevents elongation of the eyeball.

This is an important measure to reduce the progression of myopia in children.

Other measures include limiting the usage of mobile devices or the computer as this will prevent eye strain (and elongation of the eyeball), maintaining good posture when using mobile devices or reading (at a distance of 25cm to 30cm), and sitting upright when doing so.

Tai also advised parents to ensure their children avoid rubbing their eyes as this may induce astigmatism.They should also get enough sleep and proper nutrition.

While having a poor diet is not directly linked to myopia, a diet-influencing medical condition like diabetes is, and hence, maintaining good dietary habits is essential.

Parents are also advised to observe their child’s eye behaviour from as early as six months, and arrange for regular eye examinations from the time the child turns three, to see if there are any underlying eye problems or refractive issues.

If myopia is detected, this is when the Kid’s Myopia Control Programme comes in.

Vista Eye Specialist’s consultant ophthalmic surgeon Dr Calvin Lim Chung Yee said this programme is designed to help control the rapid progression of myopia.

It starts off with a comprehensive eye check, followed by controlled usage of Atropine eye drops that must be applied every night before sleep.

The eye drops help to prevent the rapid progression of myopia, with minimal effect on the child’s vision or focusing abilities.

Lim added: “Our ophthalmologists may also prescribe either Myopia Control Glasses or Ortho-K contact lenses that are designed to be worn during sleep to flatten and reshape the cornea which may reduce myopia progression of up to 40%.”

Tai pointed out that if the problem of myopia is detected early, they can actually do something about it.

Nooses in cells, poor medical care at US immigration detention site

LOS ANGELES: Inadequate medical care, improper segregation and even nooses found in cells are among “serious issues” found in a surprise inspection at the largest detention site for immigrants in California.

The US Department of Homeland Security released Tuesday the results of a visit by the Office of the Inspector General to the detention site in Adelanto, California.

The site, located some 150km northeast of Los Angeles, holds 1,940 male and female adult immigrants. It is managed by The Geo Group, a government contractor that runs privately run prisons and detention sites.

“We identified a number of serious issues” that violate Immigration and Customs Enforcement (ICE) standards that “pose significant health and safety risks at the facility,” said the report, dated Sept 27.

Inspectors found nooses made from braided bed sheets hanging from air vents in 15 of 20 cells for male detainees.

The report said that in March 2017, a 32-year-old man choked himself to death with sheets in his cell, and that seven suicide attempts were reported between December 2016 and July 2017.

“ICE’s lack of response to address this matter at the Adelanto Center shows a disregard for detainee health and safety,” the report said.

And the pervasive suicide attempts are not always successful.

“I’ve seen a few attempted suicides using the braided sheets by the vents and then the guards laugh at them and call them ‘suicide failures’ once they are back from medical,” an unidentified detainee was quoted as telling the investigators.

The report warned that “ICE must prioritize addressing the issue of sheets hanging in detainee cells, as they represent the potential to assist suicide acts”.

Nine days in a wheelchair

The report also noted mistakes in segregating detainees for disciplinary or administrative reasons.

In one case, a disabled detainee was mistakenly held in disciplinary segregation for nine days, during which time he “never left his wheelchair to sleep in a bed or brush his teeth.”

Such violations of segregation standards “pose a significant threat to maintaining detainee rights and ensuring their mental and physical well-being”.

The inspectors also saw contract guards move detainees in handcuffs and shackles, contravening ICE regulations.

The physical restraints gives “the appearance of criminal, rather than civil, custody”.

The report also noted the lack of proper medical and dental care.

Detainees frequently wait for weeks and even months to see a doctor or a dentist, and often the appointments are canceled with no explanation.

One detainee reported waiting eight months to have a tooth pulled, while another said the dentist pulled the wrong tooth.

Attached to the report was a letter from ICE saying that it will inspect the Adelanto site starting Oct 18 “to ensure corrective actions are completed”.

“Any compliance issues found during such reviews must be promptly addressed,” said ICE spokeswoman Lori Haley.

“ICE takes seriously the OIG’s findings, and has agreed to conduct a full and immediate review of the center to ensure compliance with detention standards and expedite necessary corrective actions”. — AFP

Child abuse leaves ‘molecular scars’ on victims

PARIS: Children subjected to abuse may carry the physical hallmark of that trauma in their cells, scientists said Tuesday, in research that could help criminal investigations probing historic mistreatment.

The imprints may also shed light on whether or not trauma can be passed on between generations as has long been hypothesised.

A team of researchers at the University of British Columbia examined the sperm cells of 34 adult men, some of whom had been victims of child abuse years earlier.

They found that the effects of the trauma were indelibly printed in 12 regions of the DNA of those men who had experienced varying levels of emotional, physical or sexual abuse.

Scientists believe these alterations, known as methylation, could one day be used by investigators or courts to weigh allegations of child abuse.

“If you think of genes as being like lightbulbs, DNA methylation is like a dimmer switch that controls how strong each light is — which in turn can influence how cells function,” Nicole Gladish, a PhD candidate in the university’s Department of Medical Genetics, told AFP.

“This information can potentially provide additional information about how childhood abuse affects long-term physical and mental health”.

The experiment is one of a growing number of trials looking into what turns genes “on and off” at different periods of human development, a field of study known as epigenetics.

Once thought as entirely pre-programmed from conception, some genes are now known to be activated or deactivated by environmental factors or an individual’s life experience.

‘Small piece of the puzzle’

Scientists involved in the study, published in the journal Translational Psychiatry, said they still did not know how methylation affects a person’s long-term health.

In addition, due to the difficulty in extracting egg cells, the team don’t plan to replicate the experiment on women — statistically far likelier to have been victims of child abuse than men.

Scientists said the degree of “dimming” in the DNA regions were surprising — one part of the genome of the men who were abused as children was 29% different to those who were not.

And, because the degree of methylation changes over time, they were able to tell by looking at the men’s cells roughly when the abuse occurred.

“This might help the development of tests that could be used by healthcare workers or potentially even as forensic evidence,” Gladish said.

Although researchers still have little idea whether or not the imprints of abuse contained within sperm cells would survive fertilisation intact, lead author Andrea Roberts said the study “brings us at least one step closer” towards working out if trauma can be transmitted across generations.

“We can look at our study as one small piece in the huge overall puzzle of how intergenerational trauma works,” said Gladish.

She pointed out there are several other teams working on the conundrum, including experiments on mice and other animals.

“It is certainly possible that epigenetic changes in sperm cells play a role in the physical and mental health of the next generation, but we don’t know for sure”. — AFP

Most nations to miss UN target on chronic diseases: Study

MORE than half of all countries will likely fail to hit the UN target of reducing premature deaths from a quartet of chronic diseases by a third before 2030, researchers said Friday.

Cancers, heart and blood vessel disease, diabetes, and chronic respiratory disease combined to kill 12.5 million people aged 30 to 70 worldwide in 2016, they reported in a major study.

“The bottom line is this: A set of commitments were made, and most countries are not going to meet them,” lead author Majid Ezzati, a professor at Imperial School London’s School of Public Health, told AFP.

Only 35 nations are on track to meet UN Sustainable Development Goal 3.4 – launched in 2015 – for women, and even less for men, the study revealed.

“International donors and national governments are doing too little to reduce deaths from non-communicable diseases,” Ezzati said.

The good news, he added, is that most countries are at least moving in the right direction.

But around 20 states – 15 for women, 24 for men – are either stagnating or backsliding.

That select group of failure includes only one wealthy nation: the United States.

A much-noted study last year in the American Journal of Public Health showed that the rise in premature deaths was especially sharp among white, rural Americans, described by the authors as gripped by an “epidemic of despair”.

“It comes down to weak public health, weak health care system, high levels of inequality,” Ezzati said.

Weak public health

Across all age groups, non-communicable diseases kill more than 40 million people a year worldwide, accounting for seven in ten deaths.

Of these, 17 million are classified as “premature”, or before the age of 70.

“We are sleepwalking into a sick future because of severely inadequate progress on non-communicable diseases,” said Katie Dain from the NCD Alliance.

The “NCD Countdown 2030” report, published in The Lancet ahead of next week’s UN High-Level Meeting on NCDs in New York, “will assist in holding governments and donors accountable”, she added.

Ezzati rejected the notion that the UN goal may have been set too high.

“The fact that 30-odd countries are very much on track, and another 40 or 50 – depending on the gender – are close, means that it is very doable,” he said by phone.

Declining tobacco and alcohol use, low blood pressure, a good public health care system, low levels of inequality – countries not doing so well in meeting the UN target are likely to fail in a couple of these things, Ezzati said.

Only four countries – South Korea, Japan, Switzerland and Australia – ranked among the top ten for lowest NCD mortality rates for both men and women.

China not on track

Spain, Singapore, Portugal, Italy, Finland and France rounded out the good health podium for women.

For men, the other countries were Iceland, Sweden, Norway, Bahrain, Canada and New Zealand.

The United States ranked 53rd for men, and 44th for women, with Chinese men and women placed 80th and 76th, respectively.

China is not on track to meet the goal but its NCD rates are declining, even as levels of obesity and high blood pressure are on the rise, the study revealed.

Smoking rates have stabilised but remain high, especially for men. Tobacco use claims one million lives in China every year.

“China has the ability to do a lot when it comes to managing tobacco and alcohol, with both largely state-owned industries,” Ezzati noted.

“They are also wealthy enough so that hypertension treatment should be trivial.”

In sub-Saharan Africa, non-communicable diseases account for a smaller share of deaths than infectious diseases such as AIDS and tuberculosis.

But their NCD mortality rates are still much higher than in most middle-income and rich countries, and should not be neglected, the authors said.

“By any standard, it would be inappropriate and non-strategic to not incorporate NCDs in the strengthening of the overall health care system,” Ezzati said.

“We should say to the donor and aid agencies: ‘Focus on the overall health system rather than disease by disease’.” — AFP