This Week in Medicine

www.thelancet.com Vol 381 April 27, 2013 i

US infant mortality A CDC report shows that US infant mortality fell by 12% between 2005 and 2011, with the greatest decreases in non-Hispanic black women (16%) and in some southern states. Mortality decreased for four of the fi ve leading causes of infant death. The results might be attributable to a decline in premature births during this period.

Famine response Aid needs to be delivered more eff ectively during famines in the Sahel, according to an Oxfam report, Learning the Lessons. Focusing on responses to the 2012 food crisis, the report emphasises that communities need to be better prepared, and that international organ-isations and national authorities need to ensure that they can provide timely and suffi cient assistance.

Oz health slip A national survey has shown that the overall health of Australians has deteriorated slightly in the past 5 years. Australians are smoking and drinking less than they were in 2007, but 736 000 more adults are obese and the prevalence of anxiety has increased substantially. The best results were for major cities, with the worst results in rural areas.

Hunger strike 84 of 166 detainees at the US detention facility at Guantanamo Bay are now on hunger strike, according to US military offi cials. 16 inmates are being force-fed. The present protest, against indefi nite confi nement and conditions, began in February. About 100 inmates remain at the facility despite being cleared for release.

World Malaria Day April 25 marks World Malaria Day 2013. Major progress has been made in the fi ght against malaria during the past decade because of investments in malaria control. Malaria deaths have been cut by a third in Africa. Outside Africa, 35 of 53 countries aff ected by malaria have reduced cases by 50%. However, a recent shortage in fi nancial support has slowed progress.

PIP trial Five executives from the former French breast implant manu-facturing fi rm PIP are being tried for allegedly knowingly using substandard silicone in their prostheses. The silicone used made implants more prone to rupture. Sold in 65 countries, an estimated 300 000 women have been aff ected, many undergoing implant removal surgery.

Vaccine cost cut Indian supplier Biological E and GAVI have reached an agreement to cut the cost of a fi ve-in-one vaccine for diphtheria, tetanus, pertussis, hepatitis B, and Haemophilus infl uenzae type b. Biological E will sell the vaccine, the most widely used by GAVI, for US$1·19 per dose, compared with a 2012 weighted average price of $2·17, saving GAVI up to $150 million in the next 4 years.

Gene patents US Supreme Court justices have heard arguments about the validity of gene patents. Debate centres on whether isolated genes are products of human ingenuity, which can be patented, or products of nature, which cannot. A fi nal decision is not expected until later this year, but early indications are that the justicies will not allow patents on DNA, but will allow them for cDNA.

Free delivery The Ugandan Government has begun to off er free training in nursing and midwifery to combat the shortage of more than 2000 midwives in health units across the country. The Ministry of Health is partnering with organisations such as the African Medical and Research Foundation and Baylor-Uganda to fund the courses, and aims to give 300 women free training this year.

Social confl ict Countries with wide social inequalities and governments with restricted capacity to manage unrest have most confl icts in Latin America, according to a report by UNDP. Understanding Social Confl ict in Latin America details many tensions. Argentina, Bolivia, and Peru had most confl icts, whereas Chile, Costa Rica, and El Salvador had fewest.

Healthy change More women from the Pacifi c Islands than ever before are undergoing health checks in New Zealand, as a result of health promotional programmes. BreastScreen Aotearoa showed that more women are taking part in breast screening, with the biggest rise in the Pasifi ka group. Breast cancer is the leading cause of death not related to smoking in New Zealand women.

Safe rooms The Independent Drugs Commission for Brighton and Hove has recommended ways to reduce illegal drug use in Brighton. Suggestions include consumption rooms, where users could inject drugs with medical supervision. Brighton would be the fi rst city in the UK to have such facilities. However, a change to the law might be needed before these rooms could be introduced.

For The Lancet News podcast see http://www.thelancet.com/lancet-news-audio/

For the US CDC report see http://www.cdc.gov/nchs/data/databriefs/db120.htm

For Oxfam’s report see http://policy-practice.oxfam.org.uk/publications/learning-the-lessons-assessing-the-response-to-the-2012-food-crisis-in-the-sahe-281076

For more on World Malaria Day see http://www.worldmalariaday.org/home_en.cfm

For UNDP’s report see http://www.undp.org/content/undp/en/home/librarypage/crisis-prevention-and-recovery/Understanding-Social-Confl ict-in-Latin-America/

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