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Indian Journal of Medical Sciences
Medknow Publications on behalf of Indian Journal of Medical Sciences Trust
ISSN: 0019-5359 EISSN: 1998-3654
Vol. 58, Num. 3, 2004, pp. 138-140
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Indian Journal of Medical Science Vol. 58 No. 3, March 2004 , pp. 138-140
News
Code Number: ms04023
Global Strategy: Breastfeeding critical for child survival
UNICEF and WHO call for increased commitment to appropriate
feeding practices for all infants and young children
23 MARCH 2004 | NEW YORK Calling on governments to
promote and protect breastfeeding, UNICEF and WHO today jointly launched the Global
Strategy for Infant and Young Child Feeding. The document, developed over
two years of global consultation, pinpoints the main problems affecting infant
and young child feeding and identifies approaches to their solution.
"There is no better way than breastfeeding to make sure
that a child gets the best start in life," said UNICEF Executive Director
Carol Bellamy. "The strategy is an invaluable roadmap for governments
to create supportive environments where women can make informed choices about
feeding their children."
Breastfeeding alone provides the ideal nourishment for infants
for the first six months of life as it provides all the nutrients, antibodies,
hormones, immune factors and antioxidants an infant needs to thrive. It protects
babies from diarrhoea and acute respiratory infections and stimulates their
immune systems.
"Virtually all mothers can breastfeed provided they have
accurate information, and support within their families and communities and
from the health care system," said LEE Jong-wook, Director-General of
WHO. "Governments should move swiftly and effectively to implement this
important strategy."
Lack of breastfeeding - and especially lack of exclusive breastfeeding
during the first half-year of life - are important risk factors for infant
and childhood morbidity and mortality. These risk
factors are compounded by
inappropriate complementary feeding as infants grow.
"Exclusive breastfeeding in the first half-year of life
and continued breastfeeding coupled with appropriate foods reduce the number
of children under five who die from malnutrition," said Dr Lee. Malnutrition
is associated with more than 50% of deaths among children under five.
The strategy calls for a dramatic increase in the number of
infants who are exclusively breastfed. Currently, no more than 35% of infants
worldwide are exclusively breastfed during even the first four months of life.
Complementary feeding frequently begins too early or too late, and foods are
often nutritionally inadequate and unsafe. Malnourished children who survive
are more frequently sick and suffer the life-long consequences of impaired
development.
"The long-term impact of poor feeding practices in infancy
and early childhood include poor school performance, reduced productivity and
impaired intellectual and social development," Bellamy said.
In addition to stressing the link between the health and nutritional
status of mothers and children, the strategy addresses the challenges of feeding
in exceptionally difficult circumstances, such as natural or man-made emergencies.
The strategy also highlights the issue of optimal feeding
of the roughly 2.6 million children who are born to HIV-infected women each
year. The absolute risk of HIV transmission through breastfeeding - globally
between 5% and 20% - needs to be balanced against the increased risk of morbidity
and mortality when infants are not breastfed. All HIV-infected mothers should
receive information about the risks and benefits of various options and guidance
in choosing the most
suitable option.
The Global Strategy for Infant and Young Child Feeding, available
in six languages, was presented by UN Under Secretary-General for Management
Catherine Bertini on 23 March to the Standing Committee on Nutrition session
at the UN. It was distributed 24 March during a session on Breastfeeding and
Complementary Feeding and their contribution to achieving the UN Millennium
Development Goals.
Source: http://www.who.int/mediacentre/releases/2004/pr19/en/
Substance dependence
treatable, says neuroscience expert report
Psychosocial, environmental, biological and genetic factors
all play significant roles in dependence, says new report published by WHO
18 MARCH 2004 | GENEVA/BRASILIA The World Health Organization
(WHO) today launched Neuroscience of Psychoactive Substance Use and Dependence, an
authoritative report summarizing the latest scientific knowledge on the role
of the brain in substance dependence. The report* is the first of its kind
produced by WHO, and cites an explosion of advances in neuroscience to conclude
that substance dependence is as much a disorder of the brain as any other neurological
or psychiatric disorder.
Substance dependence is multifactorial, determined by biological
and genetic factors, in which heritable traits can play a strong part, as well
as psychosocial, cultural and environmental factors, says the report. It has
been known for a long time that the brain contains dozens of different types
of receptors and chemical messengers or neurotransmitters. The report summarizes
new knowledge on how psychoactive substances are able to mimic the effects
of the
naturally occurring or endogenous neurotransmitters, and interfere with normal
brain functioning by altering the storage, release
and removal of neurotransmitters.
The report discusses new developments in neuroscience research
with respect to craving, compulsive use, tolerance and the concept of dependence.
The report shows that psychoactive substances have different ways of acting
on the brain, though they share similarities in the way they affect important
regions of the brain involved in motivation and emotions. The report discusses
how genes interact with environmental factors to sustain psychoactive substance-using
behaviours. This knowledge is the basis of novel diagnostic tools and behavioural
and pharmacological treatments.
The report urges increasing awareness of the complex nature
of these problems and the biological processes underlying drug dependence.
It also supports effective policies, prevention and treatment approaches and
the development of interventions that do not stigmatize patients, are community
based and cost-effective.
"The health and social problems associated with use of
and dependence on tobacco, alcohol and illicit substances require greater attention
by the public health community and appropriate policy responses are needed
to address these problems in different societies," says WHO Director-General
Dr LEE Jong-wook. "Many gaps remain to be filled, but this important report
shows that we already know a great deal about the nature of these problems."
United Nations Office on Drugs and Crime (UNODC) data estimates
about 205 million people make use of one type of illicit substance or another.
The most common is cannabis, followed by amphetamines, cocaine and the opioids.
Illicit substance use is more prevalent among males
than females, much more so than
cigarette smoking and alcohol consumption. Substance
use is also more prevalent among young people than in older age groups. UNODC
data shows that 2.5% of the total global population and 3.5%
of people 15 years and above had used cannabis at least once in one year between
1998 and 2001.
"Substance dependence is a chronic and often relapsing
disorder, often co-occurring with other physical and mental conditions," said
Dr Catherine Le Galès-Camus, WHO's Assistant-Director General, Noncommunicable
Diseases and Mental Health. "While we still do not know to what extent
it is curable given the long-term alterations in brain functioning that result
from substance abuse we do know that recovery from dependence is possible through
a number of effective interventions."
The Global Burden of Disease (GBD) from the use of
all psychoactive substances, including alcohol and tobacco, is substantial:
8.9% in terms of DALYs (Disability Adjusted Life Years). However, GBD findings
re-emphasize that the main global health burden is due to licit rather than
illicit substances. Among the 10 leading risk factors in terms of avoidable
disease burden cited in The World Health Report 2002, tobacco was fourth and
alcohol fifth for 2000, and remains high on the
list in the 2010 and 2020 projections. Tobacco and alcohol contributed 4.1% and
4.0%, respectively, to the burden of ill health in 2000, while
illicit substances contributed 0.8%. The burdens attributable to tobacco and
alcohol are particularly acute among males in the developed
countries (mainly Europe and North America). Measures
to reduce the harm from tobacco, alcohol and other psychoactive substances are
thus an
important part of the public health response, says WHO.
"The explosive growth in knowledge in neuroscience in
recent decades has contributed new insights into why many people use psychoactive
substances even though it causes them harm," says Dr Benedetto Saraceno,
Director of WHO's Department of Mental Health and Substance Abuse. "The
need for this report comes from these advances, which have shown that psychoactive
substances, regardless of their legal status, share similar mechanisms of action
in the brain, can be harmful to health and can lead to dependence. The public
health impact is enormous and requires a comprehensive approach to policy and
programme development."
Source: http://www.who.int/mediacentre/releases/2004/pr18/en/
Copyright by The Indian Journal of Medical Sciences
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