Health

The Ministry of Public Health announced, in a report published today, Sunday, on Corona cases, that “198 new infections were recorded, which raised the cumulative number of confirmed cases to 1,228,399, and one death was recorded.”

The Ministry of Public Health also published a report on cholera cases in Lebanon, as “no new infection was recorded, and accordingly the cumulative number of confirmed cases settled at 671, and no deaths were recorded, and the cumulative number of deaths was 23.”

Tribune written by Philippe Leduc, doctor and health journalist, initially published on the Les Echos-Le Parisien website.

The President of the Republic should soon speak. It is important for a President who decides to speak on the subject of health. It sets the course, it defines the objectives and it describes the method. Will he announce, once more, the acceleration of the reform of the health system “My Health 2022” unveiled by himself on September 18, 2018 at the Elysée but whose results, in 2023, are awaited? Or will he change course?

In fact, it may seem simple. It would suffice to apply the most corporatist measures proposed here and there by health professionals and actors to transform the health system “out of breath”.

“Who can do more, can do less! The hour is serious, it is not any more with procrastination. It takes a shock of trust with caregivers.

A shock of trust with caregivers

Increase the number of beds in hospitals? While we are not short of beds but of caregivers around these beds. At the Assistance Publique-Hôpitaux de Paris, 16% of beds are closed due to lack of staff. In some cancer centers: 20%.

Double the basic price of the consultation, from 25€ to 50€, of city doctors? While in Quebec such an increase has worsened access to care. Some exhausted practitioners took the opportunity to reduce their activity.

Broadly authorize nurses to prescribe drugs and complementary examinations independently of any collaboration with doctors? Whereas precisely it is not necessary to increase the work in silos of the carers but to facilitate the coordination and the cooperation between them.

Completely regionalize the health system by entrusting it to the Regions? While the local authorities are not ready for it. It would add clutter to inefficiency.

Demonstrate originality and determination

So what can the President of the Republic announce? He will have to show originality and determination while creating a break to get out, at all levels, of the habits that maintain this deleterious situation. It is mobilize (really) all caregivers towards the same well-defined direction.

The key words are: working conditions and attractiveness of professions, public health missions, administrative revolution, territory, cooperation, relevance, financing, prevention, training.

Malaria is still endemic in more than 90 countries around the world and causes around 630,000 deaths each year. If vaccines are the intervention that might eliminate the disease, despite advances in research, there is currently no effective one. Transmitted by the bite of Anopheles mosquitoes, P. falciparum and P. vivax are responsible for more than 90% of all cases and 95% of malaria-related deaths worldwide. Most cases and deaths occur in sub-Saharan Africa, but half the world’s population is at risk of contracting the disease.

“Physical” means of prevention such as mosquito nets and insecticides are the best tools once morest the disease.

The mosquito net with 2 or more insecticides should have been generalized a long time ago

This is indeed the position of these Irish experts who demonstrate here that thousands of people have needlessly contracted malaria due to a “failure of public health policy”. Mosquitoes are also evolving, and have evolved to tolerate pyrethroids, the first-line class of insecticides in the prevention of malaria. This is why Professor Gerry Killeen, an expert in pathogen ecology, today reveals the results of a large-scale trial of mosquito nets treated with two insecticides.

The test reveals that a net treated with 2 insecticides rather than 1, clearly demonstrates the effectiveness of the combination on the disease burden caused by malaria in rural Africa. Because mosquitoes have evolved to tolerate pyrethroids, children sleeping under mosquito nets treated only with this insecticide are still at very high risk of malaria.

• The incidence of the disease is estimated at once a year on average, ie twice as much as in children protected by a mosquito net treated with 2 insecticides;

“Such nets with 2 or more insecticides should have been approved long ago. Because by using 2 or more insecticides, these nets can decisively eliminate insecticide-resistant variants of mosquitoes before they have a chance to multiply, thus preventing resistance from becoming established in entire populations of mosquitoes. mosquitoes”.

While pyrethroids should remain the standard treatment for nets, as they are the only class of insecticides that can be safely dispersed into the air as a repellent vapor, resistance to pyrethroids must be combated through the combination of other repellent agents.

The team is currently focusing on the wild areas of southern Tanzania, looking for malaria-carrying mosquitoes that have escaped the pressure of insecticides…