Public Health SPOT #1

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Diabetes Picture Contest

It’s raining Public Health Campaigns

Since establishment in 1949, IPSF now represents more than 350,000 pharmacy students and recent graduates in 84 countries worldwide.

IPSF is the leading international advocacy organisation of pharmacy students promoting improved public health through provision of information, education, networking, and a range of publication and professional activities.

Follow us on

www.ipsf.org

International Pharmaceutical Students’ Federation

‘‘

IPSF Public Health Chairperson says

Hello IPSFers!

Welcome to the new PH Spot! We are introducing a new magazine that covers all of the public heath campaigns to replace the previous individual campaign newsletters. This change will help keep all campaigns up-to-date on their available information and to keep ideas for upcoming campaign days flowing.

Publication team Issue 1 April 2012 Design and layout Ines Harzallah

Chairperson of Media and Publications 2011-2012

Cover photo Ines Harzallah Proofread by Yuqian Liu Ranveer Bassey Justin Tenney Sadia Naeem Asma Ismail Dayl Eccles Michelle Garner Contact publications@ipsf.org editor@ipsf.org

In addition to the new magazine, the campaigns themselves have been redesigned and updated. The new logos are visible on the cover page of PH Spot and at the beginning of each campaign’s section.

Please use these new logos when developing your campaign days.

The campaign coordinators have been hard at work putting together information for this magazine, including compiling campaign reports submitted

by YOU! There are some wonderful stories and experiences shared along with up-to-date news.

Check out what your fellow IPSFers have been up to!

Your campaign reports are truly the heart of this magazine, so please take an extra moment or two to submit those for publication. Also, don’t forget to check out each of the campaign websites for those stories we could not fit into the magazine.

As always, do not hesitate to contact me with questions or comments at publichealth@ipsf.org. I hope you enjoy the new magazine!

Warm regards, Christine Cooper IPSF Chairperson of Public Health 2011-12

‘‘

Public Health Spot

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Diabetes and Healthy Living Campaign Greetings from the 2011-12 IPSF Diabetes and Healthy living Coordinator Dearest IPSF friends, The first IPSF public health campaign of the year took place on the 14th of November. This was the 20th time that this day has been celebrated, after it was introduced in 1991 by the World Health Organization in cooperation with the International Diabetes Federation.

This year we aimed to raise a circle of encouragement and support. We wanted to get all pharmacy students worldwide to become proactively involved in increasing awareness among health care professionals, as well as the general public, about the importance of a healthy lifestyle in the prevention and care of this chronic disease.

h t l a e H c i l b u P H h c t i l l a b e u H P c h i t l l b a u a e e P H H c i c l i l b b u u P P e h t l H a c e i l H b u c i l P t Pub c Health l a e H i c l i l b b u Pu P h h t t l l a a e e H H c c i i l l b u P Pub c i l th b

The blue circle (of encouragement) was also the theme of this years’ Diabetes picture contest. People were supposed to take a picture of whatever they wanted. The only rule was that the blue circle had to be included in the picture. Please find the winning picture as well as the campaign of the winning association included in this newsletter.

Many reports showing what student associations around the globe had been organizing for this year’s World Diabetes Day had been handed in. Some of them are now included in this newsletter, but by far not all of them. If you are interested in all the reports (and I hope you are), please check out the diabetes database (diabetes.ipsf.org)!

Finally I would like to thank Christine Cooper, this year’s Chairperson of Public Health. She has been a great support throughout the preparation of the campaign. Being involved in IPSF as a public health coordinator has been a great chance that I am more than happy to have taken.

Viva la pharmacie!

Cheers,

Johanna Walz IPSF Diabetes and Healthy Living Coordinator, 2011-12 diabetes@ipsf.org | http://diabetes.ipsf.org

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Diabetes 2011 best picture Dear all pharmacist candidates, do you remember when the World Diabetes Day is celebrated? What are you usually doing that day? Why does this day exist?

I am Andreyanus and I am happy that I can use this opportunity to share with other pharmacy students around the world our World Diabetes Day campaign. We got this opportunity since we won the diabetes picture contest that took place for the first time this year.

A little bit information about WDD: it is the primary global awareness campaign on diabetes. It was introduced in 1991 by the International Diabetes Federation (IDF) and the World Health Organization (WHO) to response to the alarmingly rising numbers of diabetics all around the world.

WDD takes place on the 14th of November every year. So, diabetes is the first noncontagious disease which was declared by United Nation as a disease that requires special attention in the world.

We as pharmacist candidates in our lovely college, Widya Mandala Catholic University have a campaign on diabetes day together with other students at the 4

Public Health Spot

university Surabaya in ISMAFARSI, as well as other students from Unair (or in English, Airlangga University). We had exciting sessions where we learned how we could share information about diabetes with other people. We started with introduction of diabetes, how to prevent this disease, and how to heal it. About those topics we talked to everyone we met.

Agatha, a friend of mine along with two others offered to walk together and to give precious information to pedicab drivers, waiters, food stalls, etc. They gave away brochures and communicated to give some important information. Some people shared their own experiences with this disease. In our team one person lost his brother, who had just died one week before from diabetes. That was awful.

We believe that this campaign is important for the whole society to raise awareness about diabetes.

I think we all have values in our

lives and so do we as future pharmacists.

The pharmacist has nine stars in their profession. We are caregiver, decision maker, communicator, manager, life-long learner, teacher, leader, researcher and entrepreneur.

We as pharmacist candidates need to be aware about this disease. We need to grow the essence of humanity in our study process. We must care about each other.

We start to care from now, try to be different people who are happy to help others. In this simple example, we can participate in an activity like diabetes d a y .

We could share what we have got from our knowledge to society. Don’t afraid. They will welcome you instead.

Blue circle became a symbol of strength for World Diabetes Day. The circle symbolizes life and health. The blue color reflects the sky that unites all nations and the United Nation flag colors. The blue circle signifies the unity of the global diabetes community in response the diabetes pandemic.

Let’s start campaigning!

Salam ISMAFARSI to you all.. ^^

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Algeria Association Scientifique des Etudiants en Pharmacie de la faculté d’Alger (ASEPA) This year was marked by the second participation of ASEPA Algeria to the IPSF World Diabetes Day Awareness campaign, under the local theme of “Live well, live healthy with your Diabetes”.

Diabetes is one of the most common chronic diseases in Algeria, so our association gives a particular importance to this campaign which keeps the attention of the whole population.

The organizing committee, with the help of about 80 volunteers including pharmacy students and young pharmacists, organized a campaign that could serve the population as well as possible. We have planned some global actions to reach our target: 6

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To touch the most of the population, we have chosen strategic places: 3 famous public hospitals of Algiers.

To keep people attention, we have worn blue t-shirts and used banners and posters.

To inform people, we have used leaflets and flyers about Diabetes.

total of 819 glycaemia; it represents 8.79 % of the whole population.

To test people knowledge’s and correct some wrong ideas they have, we have made some quizzes about diabetes

According to the data of the Algerian Health Ministry; there are about 2, 5 millions diabetics in Algeria among a total population of 35, 5 millions, it represents

To make people care about their health and orient them to specialized structures if necessary, we have made glucose blood tests.

Through these actions, more than 1000 people, all ages and levels combined have been informed about Diabetes, 400 quizzes and 819 blood glucose tests have been realized.

Here are some results we have obtained from the Campaign: - From these people, 158 were diabetics: 28 persons with Diabetes Type1

about 7% of the population.

125 persons with Diabetes Type2

Our results correspond with these national statistics.

60 persons with not defined diabetes - 661 of them were not known diabetic.

The results of the blood glucose tests were as follows: 7 persons had a glycaemia ≥ 1, 10 g/l 5persons had a glycaemia ≥ 1, 26 g/l 44 persons had a glycaemia ≥ 1, 40 g/l 67 persons had a glycaemia ≥ 2,00g/l As the results show it, we have discovered many suspected cases of diabetes and orient them to the adequate structures for more investigation.

To help people was our main objective as pharmacists and public health actors.

This experience has allowed us to communicate with people from all ages or levels. It allowed us to improve our knowledge about Diabetes, to work as a team to concretize one objective and the same goal.

It was so a great experience for us as students and future pharmacists because it has an importance that goes over than a simple public health activity it has an importance on the human and the professional side as well, we strongly advice all organizations to plan this public health campaign in the next future.

Toufik OUKID ASEPA Diabetes Coordinator 2011

72 suspected diabetics were screened, on a Public Health Spot

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HIV / AIDS Awareness Campaign

Greetings from the 2011-12 IPSF HIV/AIDS Awareness Coordinator Dearest IPSF friends, December 1st, 2011 marked the 23rd World AIDS Day. Since its first celebration in 1988, the World AIDS Day has brought together people around the world to raise awareness about the HIV and AIDS pandemic.

The goal of IPSF HIV/AIDS Awareness for the World AIDS Day 2011 was to raise awareness from three different levels: as an individual, as a group, and as an organization. We invited every individual to participate in the “See Red Day” by wearing red outfit for the World AIDS Day. As a group, we invited you to participate in this year IPSF HIV/AIDS Awareness project, the “Human Red Ribbon Project.” Together with the chairperson of public health, the chairperson of publication, and the public health sub-committee, we were able to present the 2011 HIV/AIDS Awareness Kit with a theme “Fighting AIDS, everybody’s responsibility.” We hope that this kit has been a valuable resource for IPSF member organizations in creating your own HIV/AIDS Awareness campaign.

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What IPSFers have done to inspire their communities for the World AIDS Day were very remarkable. The reports that we received truly showed the creativity and the spirit of pharmacy students in making a difference for a greater cause. We would like to introduce some of the exceptional HIV/AIDS Awareness Campaigns that we received in this magazine.

However, there are many more outstanding stories than what the space allowed. Therefore, make sure to see the complete reports at aids.ipsf.org!

Lastly, being involved as an IPSF HIV/AIDS Awareness Coordinator had given me the opportunity to collaborate with wonderful people around the world and to make a difference together. Thank you!

Viva la pharmacie!

Cheers,

Juliane Christina IPSF HIV/AIDS Awareness Coordinator, 2011-12 hivaids@ipsf.org | http://aids.ipsf.org

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Global 10 Public Health Spot

HIV/AIDS Awareness

December 1, 2011 marked the 23rd World AIDS Day. Pharmacy students around the world had done amazing work to raise awareness for this disease. Awareness activities such as education, health screening, seminar, fundraising, and quiz competition were organized by pharmacy students.

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World AIDS Day Festival

Egypt Egyptian Pharmaceutical Students’ Federation (EPSF)

As we are excited for the upcoming IPSF world congress in Egypt, let’s take a look at what pharmacy students in Egyptian Pharmaceutical Students’ Federation (EPSF) did to raise awareness for HIV/AIDS. Here is their story: Chairperson of the activity: Ms. Rana Mohamed Introduction More than anything, people battling with AIDS suffer from the social stigma associated with the disease. On Sunday, 29th of January 2012, we gathered in El Shams Club in Cairo to convey a message of tolerance and hope.

Our beloved EPSF in cooperation with the Egyptian AIDS Society, World Bank, Professor Dr. Ibrahim El Kerdany, WHO 12 Public Health Spot

Consultant, and Dr. Zeinab Heada, Project Manager at CARE International in Egypt, and joined efforts to celebrate World AIDS Day by extending an accepting hand to all those living with the disease everyday and more importantly raise the number of extended hands by raising awareness.

Supporting our words with actions A 120 EPSFers from 25 local associations headed to El Shams Club on that Sunday.

At the club, EPSFers completed the registration then took their red ribbons, t-shirts and high spirits, then started the day with a march around the place. Our guest speakers who spent a considerable time of their lives fighting AIDS, gave a couple of important talks. Dr. Ibrahim and Dr. Zeinab, both talked about the facts of AIDS, its myths, and how vital it was to reintegrate AIDS patients into society.

Awareness is our weapon Whether it is to stop the spreading of the disease, or just to embrace AIDS patients and improve their quality of life, awareness is a vital tool. EPSFers were all over the place; talking to people and handing out flyers containing the basic simple facts of AIDS. During kids’ time, teams of EPSFers and kids competed in drawing pictures of different issues related to transmission and prevention of AIDS. A lot of kids were able to learn about the disease while drawing and having red ribbons colored on their faces and hands. The day was concluded with a talent show and finally with forming a human ribbon. A young singer has performed music tracks that suited the overall atmosphere of the festival and shows a full support to AIDS patients.

How we got involved With the efforts of 20 organizing students, various promotional materials, such as posters, flyers and ribbons, and over the course of 20 days preparing, we were able to go through the day with success and ease. We used our main EPSF Website and Facebook page and its affiliated pages to promote for the World AIDS Day Festival online.

Famous numerous national newspapers and magazines wrote about the Festival few days before it, then 4 national and regional TV stations sent their cameras to have interviews with EPSF Executive Board and the partners, and have some shots for the activities.

How we got out “An AIDS patient is not a bad person” were the simple words of a little girl who participated with us, and the simplest expression of our goal; a world where an HIV/AIDS patient is not deprived from a normal life, instead supported and embraced by family and friends. We believe

that the day was a complete success.

We were able to successfully grab the attention of almost 2500 people, and deliver our message. Our society now has 2500 more advocates for the social wellbeing of AIDS patients, all of which we are very proud of.

Human Ribbon formed by EPSF

The use of promotional materials and the opening talk of World AIDS Day Festival

Amazing work from IPSF friends in Egypt, wasn’t it?

Let’s take a look at another campaign story from our IPSF friends in Bangladesh.

This event truly showed what a small group of dedicated people could plan in only 17 days and made their first campaign a huge success, targeting over 250 people in their community!

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Bangladesh

BRAC University Pharma Society(BUPS)

Chairperson of Activity: Prof Dr. Ashik Mosaddik Introduction HIV/AIDS awareness campaign on World AIDS Day was the first program hosted by the BRAC University Pharma Society (BUPS), the pharmacy students’ organization of BRAC University, Bangladesh. As a new organization formed at the end of September 2011, BUPS, in collaboration with James P Grant School of Public Health, had successfully organized this event in a short period of time. The campaign was financially aided by Square Pharmaceutical Limited, BRAC Health Program, and BRAC & the student affairs forum of BRAC University. Around 200 students from different universities, colleges and other educational institution of the country took part in this campaign.

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The Campaign The campaign included the human red ribbon formation, a walk for HIV/AIDS awareness, seminar on different aspects on HIV/AIDS, quiz competition on HIV/AIDS, poster exhibition, and poster competition on HIV/AIDS. The awareness started with the formation of human red ribbon, followed by the HIV/ AIDS Awareness walk. After the welcome speech by Mrs. Shahana Sharmin, the co- Advisor of BRAC University Pharma Society, the seminar session began. This session included different documentaries on HIV/AIDS, global scenario, Bangladesh context, social stigma on HIV/AIDS positive patients, HIV/AIDS awareness, and method of diagnosis and prevention of HIV/AIDS. Quiz competition involving the participating institutions took place on HIV/AIDS. About 15 teams each comprising of 3 members

participated in this competition. During this process, the selection of the winners of the posters received also took place. Prizes were given for the winners of the quiz and

the posters. Refreshments were served to the participants of the campaign at the completion of the program.

The Human Red Ribbon Formation by BUPS

The seminar (left) | The speakers and the organizers of the activity (right)

TO WANT E? OR SEE M

Curious about what other countries have done for HIV/ AIDS Awareness? Creative activities including health screening, bike riding, penny wars, and many more can be an inspiration for you to raise awareness for this disease! See the complete stories from Bangladesh, Croatia, Egypt, Germany, Indonesia, Lithuania, Nepal, Poland, Portugal, Tunisia, United States, and more at the IPSF HIV/ AIDS website: http://aids.ipsf.org

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The Human 2011 Red Ribbon Project The Human Red Ribbon Project is the IPSF HIV/AIDS Awareness Project of 2011. This project is a continuation of HIV/AIDS Awareness project from last year. Pharmacy students and the general public worldwide welcomed this idea and formed the human red ribbons to increase awareness for HIV/AIDS day on December 1, 2011. Groups from as few as 8 people to as many as 200 people gathered for the same purpose: increasing awareness. Here are some of their stories.

“On November 30th, 2011, there was a soccer game at the Stadium of Monastir between two of the most competitive Tunisian clubs. In the morning, we gathered at the stadium and started blowing red balloons with Helium. Just before the starting of the game, and in front of all the audience, we made the Human Red Ribbon with over

Tunisia

Association Tunisienne des Etudiants en Pharmacie (ATEP)

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200 students (from pharmacy, medical and dental faculties); all dressed in red and each of the held a red balloon. On the count of three, all the students flew their balloons shouting out loud: ‘ALL AGAINST AIDS.’ This activity was shown on the national television and the soccer players took part in it.”

Indonesia Association of Indonesian Pharmaceutical Students (ISMAFARSI)

“ISMAFARSI celebrated the 2011 World AIDS Day (WAD) during the Health Professional Education Quality (HPEQ) 2nd Summit in Bali, Indonesia. The students’ event was held in Sanur Paradise Plaza Hotel, Bali and we made the Human Red Ribbon project with other students from eight different national healthcare organizations on the first day of the event. ISMAFARSI was the initiator of this project and we can see the spirit of healthcare students in fighting AIDS. There are a total of 200 students from all healthcare organizations took a part in this project. “

There are many more human red ribbons formed all over the world, including Bangladesh, Egypt, Tunisia, multiple places in the O T United States, and more. See the rest of the WANT E? human red ribbon project stories at http:// OR SEE M aids.ipsf.org.

Increase awareness, participate.

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Anti Tuberculosis Campaign

Greetings from the 2011-12 IPSF Tuberculosis Awareness Coordinator Dear IPSFers around the world, It’s with a great honor that I introduce myself as the IPSF Tubercuosis coordinator 2011-2012.

Tuberculosis is a focus of the public health care, effectively, more than 1,4 million people have been affected by tuberculosis in 2010 all around the world despite tuberculosis is a curable disease.

As future pharmacists and healthcare providers we have to play our role to stop the spread of tuberculosis by empowering the knowledge about the disease, we can and we have to work together as partners in a positive and open relationship, to improve standards of tuberculosis care and enhance the effectiveness of the health-care process.

In this concept, we have the pleasure to invite you to join us by organizing your own tuberculosis Campaign under the theme “Highlight to stop Tuberculosis”, the running of the Campaign and the projects are detailed in the magazine.

The tuberculosis Kit will be available on the tuberculosis database tuberculosis.ipsf.org or by contacting us on tuberculosis@ipsf.org, don’t’ hesitate to contact us for any help or advices.

We count on you to make the highlight to stop Tuberculosis, happy campaigning!

Viva la pharmacie!

Amal Abad IPSF Tuberculosis Awareness Coordinator, 2011-12 tuberculosis@ipsf.org | http://tuberculosis.ipsf.org

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Tuberculosis in brief What is Tuberculosis?

Tuberculosis is a bacterial disease caused by Mycobacterium tuberculosis. Tuberculosis disease

How is Tuberculosis spread?

Usually attacks the lungs; however it can also affect almost any part of the body. Mycobacterium tuberculosis is also known as tubercle bacilli.

Tuberculosis is spread through aerosolized droplets after infected people cough, sneeze or even speak. People nearby, if exposed Is Tuberculosis long enough, may breathe in bacteria in the treatable? droplets and become infected. From the lungs, bacteria can move through the Yes. Tuberculosis can be cured, blood to other parts of the body, such including in people living with HIV. as the kidney, spine and brain.

The treatment uses a combination of powerful antibiotics over a long period (at least six months) to attack the bacteria and ensure How common their eradication.

is Tuberculosis, and who gets it?

What’s in the future for Tuberculosis?

Over 8 million new cases of Tuberculosis occur each year worldwide. Anyone can get Tuberculosis, but certain people Conceivably, Tuberculosis could have are at higher risk such as people been eliminated by effective treatment, with a deficient immune vaccinations, and public-health measures. system.

However, the emergence of HIV changed the whole picture. Because of HIV, a tremendous increase in the frequency of Tuberculosis occurred in the ‘80s and throughout the ‘90s.

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Tuberculosis in numbers What can be done to combat the spread of Tuberculosis?

The most important way to control Tuberculosis is to find all cases of active Tuberculosis disease and make sure that these are treated properly.

Five basic elements are needed: political commitment to increased and sustained Tuberculosis control; access to high quality laboratory testing for Tuberculosis; easy access to standard Tuberculosis treatment, with support to patients to stay on their treatment; an uninterrupted supply of drugs; and standardized recording and reporting systems that allow monitoring of treatment of all patients.

What is the status of Tuberculosis transmission in the world?

Estimates of Tuberculosis infection rates continue to decline in everywhere, except Africa, where they are rising steadily. This is explained by the insufficient capacity of health systems to deal with the detection and treatment of tuberculosis.

It is also explained by the spread of HIV. As people with HIV infection get ill, they become particularly susceptible to Tuberculosis. Since 1990, therefore, Tuberculosis infection rates have increased by a factor of four in countries that are heavily affected by HIV

8.8 million New tuberculosis cases in 2010 1.4 million Deaths from tuberculosis in 2010, including 0.35 million people with HIV 5.7 million New and recurrent tuberculosis cases treated in 2010 65% of reporting countries lacked sufficient laboratory capacity to diagnose tuberculosis in 2010 87% of new smearpositive tuberculosis patients registered in 2009 were successfully treated *Statistics of the World Health Organization Sources : http://www.who.int

Public Health Spot 21

Tuberculosis in your corner In practice what can we do to say no to Tuberculosis?

Here are some ideas and suggestion for organizing your anti Tuberculosis Campaign: • Date: The World Tuberculosis day “24th of March” or at anytime • Place: everywhere you can reach your objective • Target population: Men, women, children, old people, rich and poor “ Tuberculosis does not make the difference” • Objective: Reach more people with Tuberculosis care

HOW???

22 Public Health Spot

1.

Develop locally key messages such as our Tuberculosis theme “Spotlight to stop Tuberculosis”

2.

Collect photos and stories that bring the messages to the audience target

3.

Distribute flyers, fact sheets and all what can be relevant to Tuberculosis care

4.

Keep the attention of peoples by making a quiz about Tuberculosis

5.

Organize a charity run

6.

Organize Workshops or an interactive discussion with professionals

7.

Organize a donation or an auction to provide Tuberculosis drugs to people in need

8.

Participate to IPSF Tuberculosis Project 20112012.

Tuberculosis theme 2011-2012 This year, the theme of the anti Tuberculosis campaign is “Highlight to stop Tuberculosis “ As future or young pharmacists, we have the role to say STOP to this curable disease that makes every day, every minute and every second victims in each place at anytime and without making the difference.

This year we invite you everywhere at anytime to participate to the anti Tuberculosis Campaign.

You can participate to the campaign in a multiple way: By participating to the “STOP Tuberculosis Project”: The purpose of the project is to inform people about the Tuberculosis Spread and make them conscious with the simple prevention measures that can save their lives and stop the spread such as: ∑ Wearing and distributing surgical masks. ∑ Distributing Handkerchiefs. ∑ Observing one minute of silence in a human posture that represents Tuberculosis for you such as putting your hands on your mouth or coughing.

By participating to “the green lungs picture competition”: Show that you care with Tuberculosis, be creative and participate to the Tuberculosis picture competition: ∑ Gather the participants with everyone wearing green T-shirts. ∑ Form human green lungs or make green lungs appear on the picture. ∑ Take a picture so that we can see the lungs and send it to us!

The best picture will be published on the Tuberculosis website and the public health magazine.

Help us to say STOP to Tuberculosis: S: Recognize the Symptoms T: Respect the Treatment O: Protect the Others P: Make Prevention Happy campaigning!

Public Health Spot 23

Tuberculosis News Electronic nose to detect Tuberculosis Tuberculosis kills close to 1.7 million people globally every year, and researchers estimate the “E-Nose” could save 400,000 lives a year in developing countries through early diagnosis, treatment and reduced transmission.

Tuberculosis is currently detected through sputum tests that are costly and take several days. With the E-nose, the patient blows into the device and sensors pick up Tuberculosis biomarkers in the breath droplets, resulting in an almost instantaneous and highly accurate diagnosis.

Each “E-Nose” would be accessible to rural communities in countries such as India with poor or nonexistent power supplies.

http://www.medicalnewstoday.com http://www.medindia.net http://www.sciencedaily.com http://www.vitamindcouncil.org/

Vitamin D to fight Tuberculosis Researchers found that, in the presence of even minimally adequate levels of vitamin D, the body’s own immune system will naturally trigger an immune response against the disease and many others without the need for drug or chemical interventions.

They discovered that the vitamin D hormone is crucial for T-cells, which are the first responders to immune invaders, to produce a protein called interferon. And interferon has been shown to directly attack tuberculosis bacteria and prevent it from taking hold, moreover, vitamin D is necessary for the immune system to produce cathelicidin, an antimicrobial peptide that, like interferons, provides humans and other mammals with protection against bacterial infections.

In other terms, vitamin D equips the body with the tools it needs to prevent infection without the need for drug-based antibiotics.

New vaccine against Tuberculosis Tuberculosis kills some 1.7 million people each year, with one in three people around the globe infected, according to the World Health Organisation (WHO). The only vaccine currently in use is notoriously inconsistent.

Researchers led by William Jacobs *, have the idea to use a closely related species of the bacterium responsible for Tuberculosis called Mycobacterium smegmatis lacking a set of genes that allows the bug to evade host immunity and they have injected mice with large doses of the altered bacteria, as expected, the mice did not get sick , after that they thought to create a hybrid of the two bacteria Mycobacterium smegmatis and Mycobacterium tuberculosis by inserting the immune-system beating genes from M. tuberculosis into the version of M. smegmatis from which the equivalent genes has been removed, it let’s oversee a promising way to prevent tuberculosis. *Professor at Albert Einstein College of Medicine in New York 24 Public Health Spot

TB/HIV, a fatal synergy

http://www.cdc.gov http://www.who.int http://cid.oxfordjournals.org

Tuberculosis is the leading infectious killer of people with HIV/AIDS, especially in sub-Saharan Africa, where it causes up to half of all AIDS deaths. Tuberculosis-HIV co-infections are also on the rise in other areas of the world, particularly Western Asia, including China, and Eastern Europe. As long as HIV/AIDS continues to spread, Tuberculosis will remain a constant and deadly threat.

Because of their weakened immune system, people living with HIV are less able to fight Tuberculosis infection and are more likely to develop active Tuberculosis which can be deadly and can spread to others.

Tuberculosis and HIV/AIDS are fatally synergistic. In high-burden countries, people with HIV/AIDS are 20 times more likely to contract Tuberculosis than those not suffering from HIV/AIDS, and reciprocally, Tuberculosis bacteria can hasten the progression of an HIV infection, causing patients to become sicker more rapidly.

Tuberculosis and HIV statistics: ∑

∑

∑

∑

∑

∑

Of the 1.4 million people who died from Tuberculosis in 2010, 350,000 were living with HIV. the two diseases are a deadly combination; they are far more destructive together than either disease alone in developing countries many people infected with HIV contract Tuberculosis as the first sign of AIDS At least one-third of the 38.6 million HIV-positive people in the world is also infected with Tuberculosis and is at greatly increased risk of developing Tuberculosis disease.

Tuberculosis is the leading cause of illness and death among people living with HIV in Africa and a major cause of death in HIV-positive people living elsewhere. In some settings, Tuberculosis kills up to half of all AIDS patients A further complication for Tuberculosis/HIV integration is that inadequate treatment has meant that multiple drug-resistant tuberculosis (MDRTuberculosis) or tuberculosis that is resistant to second-line therapy (XDR-Tuberculosis) is also on the rise.

In conclusion, Tuberculosis prevention in the context of HIV infection is a necessity that demands a comprehensive approach that effectively marshals evidence-based interventions for prevention of HIV infection and Tuberculosis, including earlier diagnosis of HIV infection.

Public Health Spot 25

1 February to 15 April 2012 16 April to 15 May 2012 16 May to 31 May 2012

90 US $ 160 US $ 250 US $

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Anti Counterfeit Drugs Campaign

Greetings from the 2011-12 IPSF Anti Counterfeit Campaign Coordinator Hello everyone, Welcome back to the ACDC Newsletter that keeps you updated with the recent news in counterfeit medicines’ world.

Firstly, we’ll introduce the New ACDC Team Members; 8 members from 5 different countries!

You will find in this NL the latest advances in the medicines authentification’s technology as well as a review of IMPACT’s latest seizures of counterfeit medications within the Pangea actions.

While Europe strengthens the laws concerning falsified medicines and China urges awareness via health promotion campaigns, counterfeit medicines continue to be of concern in Kampala…

This year, the IPSF has scheduled the very first World ACDC Day: The 13th of April! So keep it in mind; the time to Act has come. The full campaign kits will be available soon on our website.

As usual, we will have an ACDC workshop at the 58th IPSF World Congress in Hurgada, Egypt, so remember to stop by to learn more how we can combat counterfeit medicines and keep our patients safe.

If you have any questions concerning ACDC, please contact me.

Together, we can show the world what students can do!

Yosra Boubaker IPSF Anti-Counterfeit Drugs Campaign Coordinator, 2011-12 counterfeit@ipsf.org | http://counterfeit.ipsf.org

Public Health Spot 27

28 Public Health Spot

Pangea IV nets illegal medicines worth around $6.3m

Phil Taylor 29-Sep-2011

The latest Interpol-backed operation to fight the trade in counterfeit and otherwise illegal medicines has led to dozens of arrests and the seizure of some 2.4m potentially harmful drugs with a value of $6.3m.

Meanwhile, some 55 individuals are currently under investigation or arrest as a result of the operation for a range of offences, including illegally manufacturing, selling and supplying unlicensed or prescription-only medicines.

Operation Pangea IV targeted the online supply of illegal medicines and was carried out between September 20 and 27 by Interpol, the International Medical Products Anti-Counterfeiting Taskforce (IMPACT) and police, customs and national medicines regulatory agencies.

“We cannot halt the illicit online supply of medicines without a consistent, constant and collective international effort involving all sectors,”commented Aline Plancon, the manager of Interpol’s Medical Products Counterfeiting and Pharmaceutical Crime (MPCPC) unit.

Once again the scale of the operation was increased, with 81 countries taking part in the operation with the help of Internet Service Providers (ISPs), payment systems providers and delivery services. Last year’s offensive netted around 1m suspect medicines worth $2.6m.

The aim of Pangea IV was to “disrupt the online criminal networks and activities connected with the selling of fake medicines online, such as credit card fraud, and to raise public awareness of the health risks linked to purchasing medicines online,” said Interpol in a statement.

“Ultimately, we hope that by raising public awareness about the dangers of illegal Internet pharmacies, people will exercise greater care when purchasing medicines on the Internet,” she added.

Nimmo Ahmed, acting head of enforcement at the UK Medicines and Healthcare products Regulatory Agency (MHRA), said that the UK regulator alone was involved in seizures of illegal medicines worth £2m ($3.1m), including 52,000 doses of counterfeit pills, and 13 arrests.

“This week we have recovered a range of medicines The operatives launched a three-pronged attack being supplied without prescriptions and stored on the trade, zeroing in on ISPs, electronic payment in unacceptable conditions by people who are systems and delivery services in order to trace not qualified to dispense medicines,” he said. online medicine purchases back through the supply channels to those offering the medicines for sale “When you buy medicines from an unregulated source you don’t know what you’re getting, and supplying the fakes. where it came from or if it’s safe to take.”

All told, 13,500 websites engaged in illegal activity were shut down, 45,500 packages were inspected by regulators and customs authorities, 8,000 © 2011 SecuringPharma.com packages were seized and 2.4m individual doses were confiscated. 48 different countries were identified as the source of the haul, which included http://www.securingpharma.com/pangea-iv-netsantibiotics, steroids, anti-cancer, anti-depression illegal-medicines-worth-around-6-3m/s40/a1053/ and anti-epileptic pills, as well as slimming or food supplements.

Public Health Spot 29

ACDC QUIZ

What do you know about counterfeit medicines?

1.

what percentage of the worlds medicines are counterfeit? a. About 5% b. From 5 to 10% c. About 10%

2.

A counterfeit medicine may include medicines which have: a. no active substances b. a high level of contaminants c. the wrong active substance d. a crumpled package e. All of the above

3.

4.

According to the IMPACT reports of 2007, the most targeted drugs by counterfeiting are: a. Anti-infective agents b. Central Nervous System drugs c. Genito-urinary drugs d. Cardiovascular drugs The use of counterfeit antimalarial agents may leads to: a. treatment failure b. resistance to genuine drugs c. both

30 Public Health Spot

5.

Counterfeit antiretrovirals are only found in the poorly controlled markets such as subSaharan Africa and are never found in the US market: a. True b. False (April 2007: the United States FDA issued an alert on counterfeit antiretroviral medicines)

6.

Medicines purchased over the internet from illegal websites concealing their physical addresses are counterfeit in over: a. 30% of cases. b. 80% of cases c. 50% of cases

7.

The proportion of counterfeit medicines in industrialized countries (USA, Australia‌) is less than: a. 10% of the market value; b. 5% of the market value; c. 1% of the market value.

8.

The WHO created the International Medical Products Anti-counterfeiting Taskforce in: a. 2004; b. 2006; c. 2008

What was IMPACT?

9.

In developing countries, the most disturbing issue is the common availability of counterfeit medicines which are: a. For the treatment of lifethreatening conditions (malaria, HIV…) b. Blood glucose test strips; c. Antibiotics.

10.

Counterfeit medicines rates within countries are higher in cities than in rural areas: a. True b. False

The international Medical Products Anti-Counterfeiting Taskforce (IMPACT), launched by the WHO in 2006, was the first global initiative to mobilize against fake medicines. IMPACT was comprised of all 193 WHO Member states on a voluntary basis and included international organizations, enforcement agencies, national medicine regulatory authorities, customs and police organizations, associations representing pharmaceutical manufacturers and wholesalers, health professionals and patients’ groups.

Scores: 1 per right answer: 0 to 3 4 to 6 7 to 9 10

l l l l

Question

Answer

Reference: IMPACT updated brochure 2008.

1 2 3

c e c

4 c 5 b 6 c 7 c 8 b 9 a 10 b

Poorly aware future pharmacist :( Average...need to knoww more.

Well done!

Hmm...maybe you should take the Coordinator’s place ;) Public Health Spot 31

Label combines holograms, 2D datamatrix and thermal monitoring

Scriba Nanotecnologie has launched a miniaturised 2D datamatrix technology that can be combined with holograms and other reflective surfaces to provide authentication, cold-chain and traceability features.

Phil Taylor 14-Dec-2011

datamatrix - roughly one-tenth the size of a typical code but able to hold 20-30 times the volume of data - that can be printed directly within the body of any security hologram using a standard lasermarking process.

The labels are barely visible to the human eye but can be used to store a wealth of digital data such as company logos, videos, or drug pedigree information, including the name, dosage form and strength, expiration date and lot number of a medicine, according to Scriba. A 1mm² tag can contain around 300 text characters, it said.

Meanwhile, the tags can also help monitor the pharmaceutical cold chain by acting as thermal monitoring devices at the unit dose level, thanks to the integration of a polymer layer that changes the look of the hologram when a specified temperature threshold is breached.

“For temperature-sensitive products in particular, such as biologics, food products, wine, etc., the technology is a first-in-class security feature with a clear-cut value proposition,” said Dr. Claudio Rota, business development advisor at Scriba.

“At the pallet level, drug makers have many options when it comes to ensuring that their temperaturesensitive products are properly delivered to the end user,” added Rota.

“However, none of the existing technologies, “The evolving role of holograms lies in their including dataloggers, RFID or insulated ability to combine authentication with detection, shippers can really be used to monitor the which is the reason why some of the largest thermal history of each package or blister pack.” pharmaceutical companies have recognised the need to make holograms an integral part of their http://www.securingpharma.com/labelanti-counterfeiting strategies,” said Scriba. combines-holograms-2d-datamatrix-and-thermalThe En-Tag technology takes the form of a 2D

32 Public Health Spot

monitoring/s40/a1151/

DNA-based codes are proposed for pharma product authentication Technology could combine anti-counterfeiting measures with serialization for supply chain track and trace.

At the recently held Pharmaceutical/Medical Packaging Leadership Summit (Opal Events; Baltimore, Nov. 7-8), James Hayward, CEO of Applied DNA Sciences updated attendees on several efforts the company is engaged in to address pharmaceutical anti-counterfeiting and track-andtrace issues. Applied DNA Sciences is one of the pioneers of adapting gene-splicing technology to industrial applications; in their case, DNA from plant sources is segmented and then shuffled in a proprietary manner, and mixed into (for example) printing ink. The DNA tag can be sensed in the field with a handheld scanner, then confirmed—to courtevidence levels—in a lab test that takes 1-3 hours.

Hayward claims that the DNA shuffling technique is flexible enough to provide unique tags to individual packages—the same goal as item-level serialization.

In practice, though, the likelihood is that one code would be used for a part or all of a production run.

In recent months, the Stony Brook, NY, company has had extended trials with protecting currency and ensuring the authenticity of microchips used in Defense Dept. equipment. In October, it partnered with a label converter and printer, DISC Packaging (Hauppauge, NY), which is putting one code, unique to DISC, on all products that it sells, at no

charge to clients. John Rebechhi, SVP of marketing there, says that the company also offers other authentication technologies (including fluorescent inks from Honeywell, security foils from Kurz and microprinting from Agfa); using combinations of individualized techniques and the DNA signature multiplies the number of variations that can be produced. In addition, Applied DNA Sciences and DISC have developed a method to encode a product identifier both in the DNA signature and in a 2D barcode or QR code, in a manner that can be compliant with GS1 barcoding standards. “Now, with today’s smartphone technology and the appropriate app, a customer can perform authentication,” notes Hayward. “In addition, provided that permissions are granted, the authentication check can be tied to a location, so a manufacturer can essentially map where counterfeiting might be encountered.”

Applied DNA Sciences has another connection to the pharma industry besides DISC Packaging; last year, it announced a partnership with Bilcare Technologies (Phoenixville, PA), which produces pharma packaging in the US and India. http://www.pharmaceuticalcommerce.com/ f ro n t E n d / 1 7 5 2 - D N A _ H ay w a rd _ D I S C _ a n t i _ counterfeit_barcode.html

Public Health Spot 33

Europe acts against falsified medicines

Tim Sandle

has a clear definition of “falsified medicinal products” which distinguishes those products from other types of illegal drugs or from those that infringe intellectual property rights.

From this a falsified medicinal product is defined as any medicinal product with a false representation of: • its history, including the records, and documents relating to the distribution channels used • its source, including its manufacturer, its country of manufacturing, its country of Fallsified medicines are a major threat to public health and safety and the number are, according to origin, or its marketing authorization holder the European Commission, increasing each year.

• its identity, including its packaging and labelling, Falsified (‘fake’) medicines and drugs are a major its name, or its composition as regards to any of the problem for patients, their families and health care ingredients including excipients and the strength of providers. The main risk with falsified medicines is those ingredients with medicines which are targeted at those who are seriously ill. Such medicine may be contaminated or contain the wrong or no active ingredient. They could have the right active ingredient but at the wrong dose.

The Directive also examines the way in which medicines are distributed. Here the legislation focuses on brokers, who are not considered wholesale distributors and so previously were unaccountable.

To ensure transparency it is recommended that a The main source is from internet sales, marketed database of wholesale distributors, which must have by illegitimate or unethical companies. The big passed member state-inspection, is established at problem is that - globally - legislation has been the European Union (EU) level. relatively weak.

Although the Directive is a step forward, there Within Europe, a strategy to combat falsified are aspects of the final document which leave the medicines has recently been put together. The interpretation ambiguous and some elements open European Medicine Agency (EMA) has worked to debate. Over time, further refinement as to the with the European Comission to put together a scope of the legislation will be required. Certainly new directive published in the Official Journal of the Directive deals with prescription medicines only the European Union addressing the rise in falsified in the first instance. medicines in the European and global supply chain. Similar legislation is in place in the USA and regulated The directive, which was supported by the European by the Food and Drug Administration (FDA).

Parliemant, is being implemented during 2012 and all member states must have applied the measures Read more: http://www.digitaljournal.com/ by the beginning of January 2013. article/315040#ixzz1gnkwKIff The Directive breaks some new ground. The ruling 34 Public Health Spot

DNA System Developed to Identify and Authenticate Plant Species ScienceDaily (Nov. 23, 2011) — A pioneering system which uses a plant’s DNA to identify and authenticate a species has been developed in Leicester. Experts from De Montfort University (DMU) have developed a method which can detect the use of illegal or counterfeit plants in medicine and could also be used to boost conservation by identifying and monitoring the exploitation of endangered plant species.

adulteration of plant medicines is the driving force behind the UK Medicines and Healthcare Products Regulatory Agency’s implementation of the EU Traditional Herbal Medicines Directive.

This requires suppliers to register their products before they sell them -- a very time consuming and expensive process. The use of this DNA system could reduce the timescale and provide a simpler method to demonstrate compliance with the regulators.

Currently, species are identified by measuring levels of chemical compounds in plants but the same Adrian Slater, Professor of Biomolecular Technology level of compounds may be present in a number of at DMU, is leading the research. He said: “The development of this test could revolutionise the different species. way information is collected on different species DNA identification relies upon the genetic and will allow for better accuracy when plants are individuality of the species which is unique and identified and authenticated. therefore is much more accurate. The system, which is also faster and cheaper than the current means of “This could have huge implications for the billion identification, can detect the presence of the plant pound medicinal plant business as until the species expected in a product as well as detect any development of DNA testing you couldn’t be sure that adulterant material, therefore showing if the plant what you were being sold was the genuine product. medicine being tested is what it is supposed to be. It could also greatly improve plant conservation and help to identify and monitor endangered Scientists working on the new method at DMU are plant populations.” The £50,000 research project is currently focused on the authentication of plants being funded by the East Midlands Healthcare and used in complementary and alternative medicines. Bioscience iNet. It is hoped that the system will be These medicines have been increasing in popularity available for use in 2015. in Europe and America in recent years, with 35% of The research is being conducted in DMU’s Faculty of adults in the UK having used them.

Health and Life Sciences. Other research highlights The system has already proved successful with St. within the faculty include the development of an John’s Wort, one of the most highly used medicinal artificial pancreas, a test which can determine the plants in Europe and America, used to treat amount of medication in the blood by a single spot depression, anxiety and sleep disorders. It is also of blood and a tool which can help in the early currently being tested on Black Cohosh, one of the detection of skin cancer. highest selling medicinal plants, used to combat menopausal symptoms, menstrual cramps, arthritis, http://www.sciencedaily.com/ releases/2011/11/111123132933.htm muscle pain and indigestion.

Over the past decade Black Cohosh has been linked to a small number of cases of liver damage and other significant health issues but on inspection it has been suggested that the adverse reactions may have resulted from a substitute plant being used instead of the genuine one.

The potential harm that could result from Public Health Spot 35

China pushes campaign for drug safety

China promised Saturday to impose harsh new penalties on makers of contaminated drugs, the latest in a series of recent high-profile government efforts to improve drug safety.

medical waste. Last Friday, new regulations issued by the health department of the northeastern city of Mudanjiang required hospitals to incinerate all medical packaging after use.

The country’s State Food and Drug administration announced that it would withdraw operating licenses from pharmaceutical companies whose products failed to meet safety standards.

Meanwhile, health authorities are reminding consumers to properly dispose of expired medicines and are warning against “drug recyclers” who buy expired drugs and sell them on the black market.

The announcement came just days after the State Council, China’s highest administrative body, approved a plan to strengthen the regulation of the country’s pharmaceutical market over the next five years.

Local branches of China’s food and drug administration have organized events in several cities across the country encouraging residents to return unused drugs to designated pharmacies, often in exchange for store credit or other rewards.

The plan, which focuses on increased monitoring At one such event held last week in Zaozhuang, of manufacturers and distributors, also calls for a Shandong province, health officials claimed to have “severe crackdown” on counterfeit drugs. received over 4,000 boxes and bottles of expired medicines worth an estimated 35,000 yuan.

In recent weeks, Chinese media have reported numerous large-scale police raids on drug But counterfeit drugs are likely to remain a thorn in counterfeiting operations. On Nov. 17, the Ministry the side of Chinese officials and consumers for quite of Public Security announced that a three-month some time. A 2010 report by the United Nations nationwide investigation had resulted in over Office on Drugs and Crime estimated China’s market 1,770 arrests and netted an estimated 2 billion for fake medicines to be worth over 20 billion yuan, yuan (US$314m) in fake medicines and packaging or $3,1bn. materials.

While about 40 percent of counterfeits are exported, Local authorities have also joined in the campaign domestic sales of fake drugs have grown at about to clamp down on counterfeits. Last Wednesday, 15 percent annually, the UN reported. police in the northern city of Taiyuan reported that they had seized over 23,000 yuan in fake drugs http://asiancorrespondent.com/71918/chinaduring a raid on an illegal market across the street pushes-campaign-for-drug-safety/ from a local hospital.

The current dragnet was sparked in late July when traffic police in Zhejiang province stopped a taxi with a passenger carrying over 700 empty medicine packages. Police later discovered that the packages had been secretly bought from hospital cleaning staff with the intent of reusing them to disguise counterfeit drugs.

In response, the government has called upon hospitals to step up oversight on the disposal of 36 Public Health Spot

Residents of Hangzhou return expired medicines.

Source: Xinhua Public Health Spot 37

Pharma Secure: Fighting fake drugs in India (SMS based Drug Authentication Technology)

The world of counterfeit drug trade is a devastating one. According to the World Health Organization (WHO), up to 30% of drugs sold in developing nations are branded drugs which are counterfeited.

The fake drug market is estimated at $200 billion by the World Customs Organization (WCO). The number of deaths and drug resistance levels continue to rise due to consumption of fake drugs, which is creating a healthcare nightmare, and more so in developing countries.

Closer home, estimates place the fake drug industry at 15-20% of the 40,000 crore Indian pharmaceutical industry. What was once confined to exotic and costly pills like Viagra has now proliferated to cough syrups, vitamin supplements, painkillers and the like.

India, being the world’s largest supplier of generic drugs, has become an epicenter for counterfeit and Each Pharma Secure-’d’ drug has a unique code that can be SMSed to the manufacturer to find out if your fake drugs. drug is authentic. Pic: Wayan Vota via a CC license.

Pharma Secure is a US company that started off in 2007 in an effort to check counterfeit drugs by using appropriate technology. The company uses a track and trace system deployed through an SMS authentication of unique codes on mobile phones http://thealternative.in/articles/pharma-secureused by consumers. Consumers send the unique fighting-fake-drugs-in-india code available on their medicine to the drug manufacturer, who then confirms if it is authentic or not.

Pharma Secure’s India pilot began in 2010 with a pharmaceutical firm based in Hyderabad. Following the launch, Pharma Secure conducted an impact assessment study on ground with doctors, chemists and consumers. From the total number of codes launched, the SMS response was that 10% of the product was declared fake.

Website: thealternative.in

38 Public Health Spot

Fake drugs infiltrate Kampala

THE National Drug Authority (DNA) has described Kampala and surrounding cities also included the influx of counterfeit and unregistered medicines Bioquin (chloroquine) 250mg tablets claimed to be in the country as “very worrying”. manufactured by Biodeal laboratories in Kenya and Methomine tablets made by Universal Corporation The counterfeits currently circulating in the market in Kenya and Emoquin tablets made by Elys are mainly from Kenyan manufacturers.

Chemical Industries in Kenya.

The NDA Chief executive Gordon Sematiko Katende “The medicines are not manufactured by the said that the fake medicines intercepted include purported manufacturers on the label but by Quinine Bisulphate 300mg tablets claimed to be unscrupulous individuals intending to cheat the manufactured by Laboratory and Allied Limited of public at the expense of their health. The medicines Kenya. are dangerous and are likely to cause harm to “Others are Quinine Sulphate 300mg tablets claimed anyone who consumes them,” Sematiko warned. to be from Macleods Pharmaceuticals Limited in He appealed to the general public to be vigilant India. and report anyone involved in sale of the above Metakelfin 500mg tablets from Pharmacia Italy medicines by calling the NDA hotline 0776110008. and the outlawed Maxaquin 4% injection 30ml He pointed out that three persons had been manufactured by Mac’s Pharmaceuticals in Kenya,” arrested in Kampala in connection with counterfeits said Sematiko. recovered worth Shs15m.

Sematiko who addressed the press at the NDA http://www.newvision.co.ug/news/314930-fakeoffices on Friday urged the public to be vigilant and drugs-infiltrate-kampala.html observant.

He urged Ugandans to only purchase medicine from registered and licensed drug shops. He said other drugs recovered in the operation held in

Public Health Spot 39

FDA finalises guidance for on-dose anti-counterfeit technologies

The US Food and Drug Administration has published its final guidance on the use of on-dose anti-counterfeiting technologies - referred to as physicochemical identifiers or PCIDs - for use in solid oral dosage forms such as tablets and capsules.

Phil Taylor 20-Oct-2011

For example, product developers might consider not incorporating the PCID within the core of a The new document extends and finalises earlier dosage form which draft guidance released in the middle of 2009 (see contains the active FDA publishes guidance on anti-counterfeiting p h a r m a c e u t i c a l markers), and provides advice on the supporting ingredient (API) in information that drugmakers need to provide in order to minimise the risk of interactions which order to secure approval for using PCIDs in their could result in degradation. products, either during initial development or as a The new document also confirms that PCIDs which post-approval change. stand up to scrutiny will not need to be identified As in that earlier document, the agency defines a on the labelling unless they change the identifying PCID as “a substance or combination of substances characteristics of a product, such as its colour. possessing a unique physical or chemical property that unequivocally identifies and authenticates a Drugmakers have already started to look at incorporating PCIDs into their pharmaceutical drug product or dosage form.” products, and last year one technology supplier The latest version notes that examples of suitable - NanoInk subsidiary NanoGuardian - said it was PCIDs include inks, pigments, flavours, and within months of its first pharmaceutical customer molecular taggants, while stressing that these bringing product to market using its on-dose ingredients should not be pharmacologically active authentication technology which combines overt, so they can be treated from a regulatory perspective covert and forensic markers. as inactive excipients. The smallest possible amount of a PCID to allow identification and authentication Other key players include excipient specialist of a product should be employed in order to reduce Colorcon and its partner ARmark, which last year agreed to work together on an authentication the risk of side effects. technology that can be incorporated into the film To that end, the FDA also recommends the use coatings of solid oral dosage forms. of food additives that have already been cleared under its Generally Recognised as Safe (GRAS) The On-Dose ID technology (pictured) consist classification. The amount of information provided of covert micro-tags that can be integrated for a PCID would depend on its pharmacological and into existing film coating processes and carry toxicological characteristics, as well as the design information such as lot and batch numbers, of the oral dosage form, so use of well-established logos and other text, patterns, shapes and symbols, in a particle just 75-110 microns across. ingredients will reduce the data requirement.

The guidance also uses the concept of sections meaning a discrete, contained solid or a layer in a © 2011 SecuringPharma.com solid oral dosage form - as a means of reducing risk http://www.securingpharma.com/fda-finaliseswhen incorporating a PCID within a drug product. guidance-for-on-dose-anti-counterfeittechnologies/s40/a1069/ 40 Public Health Spot

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Tobacco Awareness Campaign

Greetings from the 2011-12 IPSF Tobacco Awareness Coordinator Dear Fellow IPSFers, World No Tobacco Day is observed around the world every year on May 31st, highlighting the health risk associated with tobacco use and advocating for effective policies to reduce consumption.

“Tobacco Industry Interference” marks the theme of this year, 2012.

Hope that you all will have a great campaign at your place and don’t forget to share it with us!

Yours in IPSF, Mohan Schresta IPSF Tobacco Awareness Coordinator, 2011-12 tobacco@ipsf.org | http://tobacco.ipsf.org

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Pharmacists role in the Tobacco control Scenario about Tobacco Tobacco use is one of the leading preventable causes of death in the world. Currently, nearly six million people die each year from tobacco-related diseases. The death toll from the worldwide epidemic of tobacco use could rise to eight million annually by 2030, the greater chunk of which will be from developing countries.

It is estimated that, at the current rate of mortality, tobacco use could kill one billion people during the 21st century. Thus, tobacco use is an important public health issue.

Tobacco is a major risk to health and the single largest cause of preventable death globally. Tobacco use kills about 5.4 million people annually and causes another 600000 deaths every year due to exposure to secondhand smoke. Three quarters of these deaths take place in the developing world. Tobacco is the only legally available substance that kills one third to half the number of people who use it. Moreover, tobacco use not only increases the burden of health-care costs for countries but also leads to a colossal degree of lost productivity due to premature deaths and chronic illnesses.

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Why Pharmacist?

Pharmacist should play a vital role by supporting the smokers in any that they think is appropriate, Miriam Armstrong, Chief executive of Pharmacy Health Link says, “Whether it is to refer the smoker to their local National Health Service stop smoking service or to provide them with nicotine replacement therapy over the counter, they are ideally placed to provide support.”

The community pharmacist is a highly trained health professional who can be seen without appointment, in an informal setting which is often considered to be part of an everyday shopping experience. Pharmacists are, therefore, among the most highly accessible members of the primary health care team, visited both by people who are sick and by people in good health.

This provides them with the opportunity to promote smoking cessation to a wide spectrum of the community.

Many people who want to give up smoking will not necessarily feel ill and will therefore feel comfortable in the pharmacy environment.

Tobacco control efforts should be focused on several fronts: • Preventing people consumption

from

taking

up

tobacco

• Promoting cessation • Protecting non-smokers from the exposure to tobacco smoke • Regulating tobacco products The World Health Organization (WHO) selects “Tobacco Industry Interference” as the theme of the upcoming World No Tobacco Day, 31st May 2012. The campaign will focus on the need to expose and counter the tobacco industry’s brazen and increasingly aggressive attempts to undermine the WHO Framework Convention on Tobacco Control (WHO FCTC) because of the serious danger they pose to public health. Though the topic is mainly focused on the tobacco industry where the production is done, pharmacist and organizations related to pharmacy must refrain from accepting any kind of tobacco industry support financially and from investing in the tobacco industry and encourage the members to do the same.

How pharmacist move forward within comprehensive tobacco control program?

• Pharmacist can be a role model of the society and community by playing various role as a scientist, educator, leader, clinicians and opinion builder • Public health is no one’s domain but everyone’s arena. So, pharmacist have an enormous potential to play a key role in battling the tobacco epidemic • At the individual level, they can educate the population of the harms of tobacco use and exposure to 2nd hand smoke; also help tobacco users overcome their addition.

• At the society level, pharmacist can add their voice and their weight to national and global tobacco control efforts like tax increase campaigns and become involved at the national level in promoting the WHO FCTC • At the community level, pharmacists can be initiators or supporters of the policy measures

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Major roles pharmacists can play Quitting Tobacco Use: “Quitting is difficult but not quitting is even more difficult and dangerous.” Pharmacist can play a much bigger part in helping smokers quit than received wisdom has previously suggested, since recent research has found that smokers quit attempts are much more impulsive than has been thought.

We used to think that people would set a date, plan and then try to quit but quitting without planning is the norm- people are much more responsive to the immediate triggers than we had previously thought.

But that’s not necessarily a bad thing from a pharmacist point of view, since it means that pharmacists can help smokers by just offering advice and information about new treatments, without necessarily entering into an in-depth debate about smoking.

If the pharmacist comes across as knowledgeable and professional, smokers will be attracted to that and willing to listen. So, in that situation, the best way that pharmacists can help smokers is by being ready to sell the best ways of quitting and that means the National Health Service stop smoking services and nicotine product. If a smoker says, ‘I’ve tried this or that nicotine products before and it didn’t work for me’, the pharmacist can offer new flavors or formulations.

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Recent developments: Advances in the licensing of Nicotine Replacement Therapy (NRT) products are also expanding the box of tools pharmacists can offer smokers. Reducing the reliance of smoker on cigarette for nicotine intake appears to help many smokers to stop smoking completely.

Sadly about half of smokers still remain convinced that NRT is dangerous to use and are unwilling to try it.

So, pharmacist has a major role in informing the public that NRT is relatively safe.

Professor West adds: “The key misconceptions people have about NRT are that nicotine causes cancer- which it doesn’t – and that nicotine products are as addictive as cigarettes, which they aren’t.

“A knowledgeable pharmacist should be able to explain that and help smokers understand that nicotine products release nicotine much more slowly than cigarettes and so are far less addictive.”

Legislative: Smokers planning to quit may also be helped by plans to reduce the number of places where they are legally allowed to smoke.

The government needs to focus on the real and process ways of reducing tobacco use, such as smoke-free public places.

Pharmacist should involve in the policy measures and those pharmacists who are on the policy level must take responsibility about the control measures.

Future advances: Progress continues to be made in the development of nicotine vaccines and a drug designed to block nicotine’s action. When such products come to market they may be able to provide that little bit more help that those who are ready to give up smoking need to quit for good.

In the meantime, pharmacists can offer advice and information about treatments and be enthusiastic about selling the concept of quitting and how pharmacist themselves can help smokers who are serious about giving up.

Role of National Pharmaceutical Association National pharmaceutical Association is extremely important in encouraging pharmacists to stop smoking themselves, changing the attitudes of the profession towards smoking, taking action to develop non smoking policies in the country and supporting pharmacists in organizing their own smoking cessation services.

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IPSF, World No Tobacco Day and Tobacco Alert Campaign The Tobacco Alert Campaign has grown up to be one of the most popular initiatives of the Federation.

Tobacco use is the 2nd cause of death globally and one person dies every six seconds.

Tobacco use is the number one preventable epidemic that the health community faces.

The campaign is mainly focused on the community and to the high school students. Though the younger generations are most attracted towards the use, it is focused on the school students. It also aims to educate IPSF members on how to effectively communicate public health messages to the target group.

To control the Global Tobacco Epidemic, six MPOWER strategies are useful: 1. Monitor tobacco use and preventive policies 2. Protect people from tobacco smoke 3. Offer help to quit tobacco use 4. Warn about the dangers of tobacco 5. Enforce bans on tobacco advertising, promotion and sponsorship 6. Raise taxes on tobacco 46 Public Health Spot

IPSF and WHO joint statement on Tobacco Control Apart from our local tobacco awareness campaign held by members around the world, IPSF also strives to be a strong advocate on the international front. Among our various initiatives, the IPSF and WHO joint statement on Tobacco Control is an example of how we are constantly trying to bring increased awareness to the global community.

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How to start a Campaign and continue it?

- Discuss with different group of people and services and start brainstorming as a team - Make a street campaign and tell the people about the day by showing some campaigning materials - Make poster, pamphlets, flyers and banners related to the campaign and post them within the community circle - Collaborate with the anti-tobacco organization or other community organization in your country - Describe and remind people to stop smoking by means of songs and poems during the campaign - Choose a targeted group on the community, school, supermarket, malls or public stations and make them alert about the tobacco use and their consequence - Organize an interactive program by exchanging tobacco products with fruits. Compare fruits to tobacco use and the benefits - Video presentation with the harmful impact of tobacco use may also be effective to make the uneducated people aware - Inform the campaign program to the media so that it get published and is beneficial - Sport festival with anti-tobacco theme, signal and slogan - Approach pharmacies and use them for campaigns - Short rally or short marathon with tobacco slogan printed white T-shirt People who have quitted smoking successfully would be worth inviting to any of your program for sharing his experience

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Useful Links: http://www.who.int/tobacco/resources/publications/en/ http://tobacco.ipsf.org/ http://www.who.int/tobacco/publications/youth/en/index.html http://www.who.int/tobacco/wntd/en/ http://www.tobaccobook.com/Tobacco-blog.html http://www.tobaccolabels.ca http://www.roswelltturc.org/ http://www.cdc.gov/ http://www.ecademy.com/node.php?id=159471 http://www.facebook.com/pages/WHO-Tobacco-Free-Initiative/100643340596

For Further Information: Whenever you need more information, do not hesitate to contact: Christine Cooper (Chairperson of Public Health) at publichealth@ipsf.org Mohan Shrestha (Tobacco Alert Coordinator) at tobacco@ipsf.org Also, don’t forget to fill in your activity report and share it with us!

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World No Tobacco Day

Indonesia BEM KMFA UGM

Activity Chairperson: Dayah Trianas Putri Tobacco use is the second cause of death globally and is currently responsible for killing one in every ten adults worldwide.

Every year, there is increasing number of young smokers. This cause an increase number of passive smokers as well.

The organizing committee set the aim of the campaign as: • Increase awareness of smoking to the young people especially students • To provide opportunity to students for taking part in the campaign and together create healthier environment • Circulate knowledge about the danger of smoking, second hand smoke and announce for smoking cessation Students began preparation of the campaign one month before the day of the 50 Public Health Spot

campaign. They had done preparation by coordination with Quit Tobacco Indonesia and Health Department of Yogyakarta.

They made collaboration with other organization as well: IBSF (International Biotechnology Students’ Federation) region Pharmacy UGM and Organization of Faculty Pharmacy.

The publicity of the campaign was done through facebook, post in some groups and by mouth-to-mouth advertisement.

They had organized the campaign in Malioboro St. crossroad, Yogyakarta. The students of Pharmacy faculty UGM and all people on campaign spot were made known about the campaign. They set the target population to be 100 and for that 30 students were actively participated to make the campaign a grand success.

In the campaigning day, coordinators distribute brochures, use posters, replica of cigarette and headband to make students and general public aware of the harmful aspects of the tobacco and the importance of the day celebration.

Though the campaign was on the crossroad, coordinators make aware to the smokers on the way to turn off the cigarette and replace them with candy.

They found the response to be positive as many of the people accept and support the event by turning off the cigarette and exchange for candy. Also, some reject the existence of this celebration.

Finally, they found the event was big and successful due to coordination with Quit Tobacco Indonesia and Health Department of Yogyakarta.

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World No Tobacco Day

Nepal Nepal Pharmacy Students’ Society (NPSS) Chairperson of Activity: Bidur Neupane The students organized the campaign to spread awareness about the harmful effects of the tobacco use. The program was run within the hospital premises, one of the renowned hospitals where there is mass flow of patients and their relatives. Students set the target population to be 350 and they appoint 30 volunteers for the campaign.

During the campaign, brochure, pamphlets, posters were distributed to make people aware of the tobacco use. The program was made effective by video presentation and fruit exchange program with tobacco products for healthier living. Printed T-shirts were used for the pictorial warning 52 Public Health Spot

Mass of public watching Video presentation shown during the awareness campaign which depicts harmful effects of tobacco use

Anti-Tobacco Course and Campaign

Portugal AEFFUL

Students realize that de-motivating message written on tobacco package was not enough and need course and campaign. They found that a large number of young people smokes or starts smoking when entering the Faculty.

So, the course and campaign was organized to motivate people to give up the cigarette smoking. A day program was run to spread awareness about the harmful effects of tobacco. The number of students participated in the course were 60. Students invited Professor Maria Augusta Soares, from FFUL in the course and campaign program.

In the campaign, students invite people to fill in a questionnaire and the options for stop smoking were presented and

discussed with the person. Also, people were invited to break a cigarette and made them involve in the cigarette to fruit exchange program.

Before the program, they were involved in advertisement and promotion was made via channels of the entities where the campaign was set. Also, they had done advertisements via posters, pharmaceutical magazines and websites.

Since it’s the first time of the program, students found out that the program was effective. They found that the course provide knowledge to the participating students and the knowledge will be transmitted to other students, namely the ones who aren’t taking health degrees and are less aware for the ravage consequence of smoking.

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Signing in the commitment book after quitting tobacco in exchange with fruits.

This was a major attraction of the campaign.

During the campaign, they also provide counselling services (one to one and group counselling). The tobacco quitting tips and help-line contacts were provided.

Health worker signing in the commitment book after visiting the stall

Students collect fund from campus through Students welfare fund and from the non-governmental organization (HERD International).

Finally, students found that the comments in the commitment sheet and impressive and encouraging. Responses from visitors were indeed commendable. This event certainly helped every volunteer in enriching their communication skills and using their knowledge for betterment of the society they live in. They had used trick during the campaign. As it is said “if you teach a woman you teach the whole family�, females were made aware about the hazards of direct and passive smoking, especially relating to the growing foetus or children.

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Tobacco products in Nepalese market

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Let’s celebrate to stop tobacco industry interference. The campaign should be such that it will spread knowledge to the general public about the tobacco industry and their strategies of marketing which ultimately have a great effect on smokers as well as non-smokers health system.

Let’s make the day special by forming a human blue ribbon. A small effort may give a great knowledgeable effect to the society around us. Let’s do it!

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Greetings from the 2011-12 IPSF Humanitarian Coordinator Dear IPSFers, Welcome to IPSF Humanitarian subcommittee’s corner!

In our SC we don’t have a specific world day to celebrate neither an awareness to conduct.

The Humanitarian Subcommittee is a 365 days’ campaign to remind us about the most important aspect of our future job: humanitarian work. Because a pharmacist is always ready to help others and to assist the less fortunate.

In this magazine we will present some of IPSF’s humanitarian’s projects: The vampire cup campaign, the 3rd IPSF EMPS humanitarian campaign and we will get a glance at this year’s world congress host, EPSF’s humanitarian campaign.

If you are interested in getting involved within our subcommittee, you are very welcome to join our Sub-committee e-group.

I wish you a happy reading, and Viva La Humanitarian pharmacie, Viva La Pharmacie, Hager Ben Mosbah IPSF Humanitarian Coordinator, 2011-12 humanitarian@ipsf.org | http://humanitarian.ipsf.org

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Vampire Cup Campaign

Bring home the Vampire Cup Dear IPSF friends, I have been asked to write something about the Vampire Cup Projects for this magazine.

You might have heard about the project, and wonder how the project came to life in IPSF. I wish I could tell you that I felt bad for Edward for not being able to drink human blood without killing them, and therefore wanted to launch this project to help them. Luckily, it is less noble than that.

I participated in IPSF congresses before, but I was more involved in the European Pharmaceutical Students’ Association. My BFF tricked me into going to the IPSF congress in Bali before heading to Sydney for my research. At this congress I learned about the Vampire Cup from NAPSA and I liked the idea. In Sydney, I did not participate myself when the event was on-going, however, during their congress I saw the students’ enthusiasm when the cup was awarded. For those who are not familiar with the Vampire Cup Project: In Australia pharmacy students, their friends and family of each local association are able to donate their blood over a period of six weeks. At their national congress a prize is awarded to the local association with the highest donation in proportion. Since the launch in 2006 it became a notable event in NAPSA. IPSF campaigns mostly are focused on raising awareness, but less about taking initiative yourself to help the public. This project is ideal in these two goals: awareness towards yourself, fellow students, friends and family; and providing your blood to the ones who need it.

The threshold of donating blood is low because you can go whenever you want during the period, or go with a group of friends/family. One of its appeal is that it can be organised in several ways, for example in collaboration with blood banks; followed by an event afterwards or with lectures; between various faculties within your city and whatever you can think of.

Also it has a competition element in it, so students are willing raise more awareness actively, just to bring home the Vampire Cup, which makes it more enjoyable.

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When I learned about the project, I had a vision: each country will have a Vampire Cup just like in Australia, and during the IPSF congress THE VAMPIRE CUP AWARD will be given to the national association with the highest donation in proportion. Starting with a few countries so members can see the enthusiasm of the VC participants, start their own VC, and compete in the global competition. An ever growing event. IPSF is now launching VC Live parallel to original VC, which is a sign that the project is growing.

To be fair, I am not a blood donor. Just because I have never thought about it, like some of you. This project might trigger you or your friends to become a donator. The initial plan was that I would start donating blood to launch the first IPSF Vampire Cup. Unfortunately, I was not able to launch it during my mandate, nor am I able to witness the event in each country, and be the one who awards the first IPSF Vampire Cup to the winning nation. It triggered me to donate blood, so my task now is become a donator to support “my” event, you as participants and most of all: the people who are in need.

I’m looking forward to see the project in the future, and hopefully it will be a notable project within IPSF with all nations competing. If that is the case, my vision is fulfilled.

Yours, Thanh Huynh

2012 LIVE VAMPIRE CUP All pharmacy students within IPSF member associations are entitled to enter the vampire cup competition.

If you are interested in this project you can ask for the campaign kit by email (humanitarian@ipsf. org or publichealth@ipsf.org )or download it from humanitarian.ipsf.org This year our humanitarian sub-committee is launching a real-time worldwide vampire cup contest from June 14th to 18th All participating associations will be competing at the same time during 4 days and the scores will recorded on vcup.ipsf.org Each competition regular and live will have a winner who will be awarded at IPSF’s world congress in HURGHADA, EGYPT.

SOMEONE NEEDS BLOOD EVERY TWO SECONDS 96% of us rely on the other 4% to give blood More than 1 million people are newly diagnosed with cancer each year. Many of them will need blood.

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EPSFers Exploring Humanity Humans, by nature, are not inclined towards isolation; we are an inter-dependable species that needs communication to survive. That is why to be humane is to interact with people’s needs; it is to empathize. Humanitarian events are a time for EPSFers to slow their pace, take the time to appreciate their good fortune, and give back. It’s a time where EPSFers strive to alleviate suffering by launching campaigns for awareness and aid projects.

EPSFers across the country directed their efforts to both saving lives and improving their quality. Starting with “Blood Donation” campaigns in almost every university’s campus in the country, almost 100 EPSFers were able to collect over 1340 bags of donated blood; to us that’s over 1340 possibly saved lives. Through the path of “First Aid” awareness campaigns, EPSFers made sure that the supervising staff of 60 orphanages will be able to save the lives of over 3000 children in case of any emergency; those are another 3000 possibly saved lives.

And because existing is not the equivalent of living, EPSFers launched “Healthy Living” awareness campaigns. In every one of the 60 orphanages they went to, EPSFers used short acts, games, and story-telling to demonstrate leading healthy life styles to resident children. Last but not least, “Orphan’s Day” celebrations. Across the country, EPSFers went to local orphanages, took orphaned children out, threw them parties and even organized musical concerts especially for them. These celebrations were meant to be days out of time, to alleviate the stress of their everyday lives and to share with them the hope of living in a world still filled with humane humans. We believe that our lives are not ours alone, they are this world’s, and it is our duty to better it; it’s a duty we have fulfilled and strive to continue fulfilling.

Khaled Mostafa EPSF Contact Person 60 Public Health Spot

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Join the Humanitarian Campaign rd during the 3 IPSF Eastern Mediterranean Pharmaceutical Symposium 2012 in Sudan 62 Public Health Spot

Photo: El Nuba Village, one of the visted villages during the campaign This year the 3rd IPSF Eastern Mediterranean Pharmaceutical Symposium (3rd IPSF EMPS), will be hosted by the Faculty of Pharmacy Students’ Association (FPSA) in Sudan.

A great opportunity of humanitarian work is waiting for all IPSFers: If you’ve always dreamt about going on a humanitarianmedical mission, don’t miss this opportunity and go register for EMPS!!

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A letter from the EMPS 2012 coordinator Hello IPSFers, The Faculty of Pharmacy Students’ Association (FPSA) has always been a pioneer in humanitarian missions since the Faculty of Pharmacy was established.

Preparing for and organizing such missions reveals itself as a result of honest, sincere intention to help and develop the local community whenever and wherever this help is required.

The main goal of our medical mission is to provide health education and free health examination and counseling for the local community in ELNOBAH* and ELGDEED*, including primary health care, dental clinic and ophthalmic clinic. Moreover, there will be a laboratory to conduct free routine tests and the pharmacy to provide free medicine including antibiotics, antimalarials, analgesics, antihistamines…

The health education groups conduct the educational workshops to raise awareness amongst the local community using appropriate educational tools. These workshops usually take place in the schools or in the local health care centers. The topics that are usually covered range from communicable to non-communicable diseases such as Tuberculosis, AIDS, Malnutrition, Hypertension and Diabetes, Breast cancer, Tobacco Awareness, childhood Illnesses, Malaria, Diarrhea and self-hygiene…

The Humanitarian campaign is the most popular and awaited event of the year. Its two major roles are helping the less fortunate and providing an unforgettable experience to the students, we are glad to share this amazing experience with all EMPS attendees So, are you ready to join us? It’s a life time opportunity… We guarantee that you won’t regret it!!

See you in Khartoum! ”

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ELNOBAH It’s about 56 km away from Khartoum.

The population is around ten thousands.

The village is near the high way and it’s on the bank of the blue Nile.

The activities will be held the village school. The main fields of action are about sanitary problems, diarrhea, childhood illnesses, vaccination, malaria.

ELGDEED It’s about 40 km away from Khartoum.

The population thousands.

is

around

elven

Elgdeed is near the high way too, the other side of the village is the blue Nile.

The activities will be held in the school too.

The two village are in the same area, having the same health problems.

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Medicine Awareness Campaign Greetings from the 2011-12 IPSF Medicine Awareness Coordinator Hello Everyone!

More than 4% of hospital admissions are due to drug side effects; One in ten teens reports having abused OTC cough medicines to get high; Drug poisoning is the leading cause of home accidents.

These statistics show that medicines could be harmeful , when wrongly used. Drug misuse is a major public health issue, concerning all countries in the world at the same level.

Since pharmacists are drug experts, they can play a key role in fighting drug misuse and increasing public awareness towards medicines. For all those reasons, in 2012, IPSF decided to start a worldwide medicine awareness campaign among other public health campaigns.

Providing free and accurate data about drugs is our main duty. You will find in this magazine articles related to drug addiction, self-medication and how medicine awareness campaigns are ran in some countries.

Check medicineawareness.ipsf.org to get the campaign kit, you will find advice about how to run your campaign and the latest updates about the campaign ambitious projects.

If you have any questions concerning the medicine awareness campaign section in the public health magazine, please contact the MAC coordinator Marouen Ben Guebila IPSF Medicine Awareness Coordinator, 2011-12 medicineawareness@ipsf.org | http://medicineawareness.ipsf.org

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Medication misuse while Studying for final exam It’s final exam season in high schools and colleges and you may have noticed an increased sense of urgency when it comes to academics.

The abuse of prescription medications that are usually prescribed to combat the symptoms of Attention Deficit Hyperactivity Disorder (ADHD), activity that is being undertaken in the name of academic performance.

Serenity through Stimulation?

Because ADHD often manifests as fidgeting and an ability to remain still, many people assume that the prescription medications that treat the disease work by slowing the body down. But prescription ADHD drugs such as Ritalin and Adderall are actually stimulants, which increase brain activity and alertness.

The British website Net Doctor describes how this apparently counterintuitive approach results in a lessening of ADHD symptoms: Methylphenidate [the primary active ingredient in Ritalin] works by affecting some of the natural chemicals that are found in the brain.

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In particular, methylphenidate increases the activity of chemicals called dopamine and noradrenaline in areas of the brain that play a part in controlling attention and behavior.

These areas seem to be underactive in children with ADHD. It is thought that increasing the activity of these chemicals improves the function of these underactive parts of the brain.

In his May 8 article in The Maneater (the student newspaper of the University of MissouriColumbia), Will Guldin reported on national statistics that appear to indicate a pattern of abuse of ADHD medications among college students.

“The National Survey on Drug Use and Health, released in April, stated seven percent of all fulltime college students aged 18-22 use Adderall,” Guldin wrote. “This was almost twice the percentage of reported usage among the same age group not attending college full-time.”

Boosting Brain Power, Risking Health Because ADHD drugs boost brain functioning and increase focus among ADHD-diagnosed students who were once highly distractible, their neuro-enhancing abilities have proved to be an attractive option for students who feel they need an extra boost during study sessions and at testtaking time.

“You just can’t get distracted on it because you’re so focused on what you need to get done,” Sara Buxton, a junior at the University of Vermont, said in a May 7 article on the website of Vermont’s WCAX-TV NEWS. Dr. Jon Porter, director of the University of Vermont’s health and wellness program, told WCAX that the pills do, indeed, work the way students think they will. “It has the ability to make people focus and attend to a task,” Dr. Porter said, though he emphasized that the drugs aren’t riskfree.

“Heart rate increases, blood pressure increases,” he told WCAX. “If you take it awhile and you can’t sleep, your personality is affected.”

Other side effects related to the abuse of prescription ADHD medications include the following: • Stomachache and headache • Dry mouth, loss of appetite, and weight loss

The news service article also reported on a 2005 study by the National Center on Addiction and Substance Abuse at Columbia, in which it was revealed that the abuse of prescription medications by teens had tripled between 1992 and 2003.

The problem of student abuse of prescription ADHD drugs was also addressed in a May 10, 2007 article by Ann Griswold of the University of Florida’s Health Science Center News: Undergraduates, as well as high school SAT-takers, are increasingly turning to prescription stimulants to boost concentration during long study sessions and all-nighters, according to drug abuse experts at the University of Florida, who cite a rise in the number of teen patients they see who openly admit to having conned unnecessary prescriptions from doctors.

Ten percent of college students use stimulants illegally at some point in their college years, a 2005 study by the University of Michigan Substance Abuse Research Center revealed, and many get them from friends who were legally prescribed the drugs. And according to the federal government’s Drug Abuse Warning Network, the number of emergency room visits stemming from illicit use of pharmaceuticals jumped 20 percent between 2004 and 2005.

“Experts fear the trend is only growing worse,” Griswold reported.

• Depression, anxiety, and irritability • Hallucination and other psychotic episodes In addition to health risks, the abuse of ADHD prescription medications can also result in criminal penalties. Using prescription ADHD medications without a prescription, using ADHD drugs for recreational or other unapproved purposes, and selling or otherwise transferring ownership of one’s prescription ADHD medications are all illegal.

References : www.netdoctor.co.uk http://www.teenoverthecounterdrugabuse.com/ Please answer IPSF Survey on: medicineawareness.ipsf.org

Not a New Problem The trend of student abuse of prescription ADHD medications for study purposes is not a new phenomenon. An Aug. 1, 2005 New York Times news service article said that the misuse of prescription ADHD medications on college campuses had become “almost as commonplace as No-Doz, Red Bull and maybe even caffeine.”

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National Medicine Abuse Awareness Month: The American experience

Did you know that more than 6 million people ages 12 or older have abused a prescription drug and one in 10 youth ages 12 through 17, or 2,400,000 children, reports having intentionally abused cough medicine to get high? Help raise awareness about the dangers of prescription (Rx) drug abuse and over-the-counter (OTC) cough medicine abuse by taking part in National Medicine Abuse Awareness Month, observed annually in October.

National Medicine Abuse Awareness Month urges communities to educate parents and youth of the potential dangers associated with prescription and OTC medicine abuse and to hold educational events throughout the month of October to spur discussions in the community.

17 percent, jumping from 2.3 percent of youth in 2008 to 2.7 percent in 2009. In addition, the 2009 Monitoring the Future Survey showed that 5 percent of teens have abused an over-the-counter cough medicine to get high over the past year.

National Medicine Abuse Awareness Month is an ideal launching pad for any medicine abuse prevention efforts. Several prevention and intervention activities and materials are available to help community coalitions address Rx and OTC drug abuse.

How to campaign ?

-Convening town hall meetings: Host educational events, such as town hall meetings, with your local anti-drug abuse advocates, substance abuse treatment experts, healthcare professionals and policy makers to talk about the facts and craft prevention and intervention strategies.

-sport events, music concerts.

References and useful links : -http://www.stopmedicineabuse.org -http://www.cadca.org/ -http://www.drugfree.org/ -http://www.dare.org According to the 2009 National Survey on Drug Use and Health, considered the preeminent -http://www.preventrxabuse.org national study on teen substance abuse, since 2002 -YouTube channel: Stop Medicine Abuse prescription drug abuse has jumped 20 percent among those ages 12 and older. Among those ages 12-17, prescription drug abuse increased

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Self-medication : guidance to physicians and patients An old tunisian proveerb says: ”! ‫“اسأل اجملرّب و ما تسألش الطبيب‬ it means “The patient advices you better than a doctor!”

This Proverb shows how much the self-medication phenomenon is widespread in our cultures. The World Medical Association (WMA) has developed the following statement to provide guidance to physicians and their patients regarding responsible self-medication.

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2.

Distinction between Self-Medication and Prescription Medicine a. Medicinal products can generally be divided into two separate categories: prescription and non-prescription medicines. This classification may differ from country to country. The national authorities must assure that medicines, categorized as non-prescription medicines, are sufficiently safe not to be harmful to health. b. Prescription medicines are those which are only available to individuals on prescription from a physician following a consultation. Prescription medicines are not safe for use except under the supervision of a physician because of toxicity, other potential or harmful effects (e.g. addictiveness), the method of use, or the collateral measures necessary for use. c. Responsible self-medication, as used in this document, is the use of a registered or monographed medicine legally available without a physician’s prescription, either on an individual’s own initiative or following advice of a healthcare professional. The use of prescription medicines without a prior medical prescription is not part of responsible self-medication. d. The safety, efficacy and quality of non-prescription medicines must be proved according to the same principles as prescription medicines.

Use of Self-Medication in conjunction with Prescription Medication A course of treatment may combine self-medication and prescription medication, either concurrently or sequentially. The patient must be informed about possible interactions between prescription medicines and non-prescription medicines. For this reason the patient should be encouraged to inform the physician about his / her self-medication.

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Roles & Responsibilities in Self-Medication a. In self-medication the individual bears primary responsibility for the use of selfmedication products. Special caution must be exercised when vulnerable groups such as children, elderly people or pregnant women use self-medication. b. If individuals choose to use self-medication, they should be able: i. to recognize the symptoms they are treating; ii. to determine that their condition is suitable for self-medication; iii. to choose an appropriate self-medication product; iv. to follow the directions for use of the product as provided in the product labelling. c. In order to limit the potential risks involved in self-medication it is important that all health professionals who look after patients should provide: i.

Education regarding the non-prescription medicine and its appropriate use, and instructions to seek further advice from a physician if they are unsure.

This is particularly important where self-medication is inappropriate for certain conditions the patient may suffer from; ii.

Encouragement to read carefully a product’s label and leaflet (if provided), to seek further advice if necessary, and to recognize circumstances in which self-medication is not, or is no longer, appropriate. d. All parties involved in self-medication should be aware of the benefits and risks of any self-medication product. The benefit-risk balance should be communicated in a fair, rational manner without overemphasizing either the risks or the benefits. e. Manufacturers in particular are obliged to follow the various codes or regulations already in place to ensure that information provided to consumers is appropriate in style and content. This refers in particular to the labelling, advertising and all notices concerning non-prescription medicines. f. The pharmacist has a professional responsibility to recommend, in appropriate circumstances, that medical advice be sought.  Role of Governments in Self-Medication Governments should recognize and enforce the distinction between prescription and non-prescription medicines, and ensure that the users of self-medication are well informed and protected from possible harm or negative long-term effects.

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The Promotion and Marketing of Self-Medication Products a. Advertising and marketing of non-prescription medicines should be responsible, provide clear and accurate information and exhibit a fair balance between benefit and risk information. Promotion and marketing should not encourage irresponsible self-medication, purchase of medicines that are inappropriate, or purchases of larger quantities of medicines than are necessary. b. People must be encouraged to treat medicines (prescription and non-prescription) as special products and that standard precautions should be followed in terms of safe storage and usage, in accordance with professional advice.

Reference: www.wma.net Public Health Spot 73

SMS reminders could improve adherence Kenya: Mobile Phone Technologies Improve Adherence to Antiretroviral Treatment in a Resource-Limited Setting -- A Randomized Controlled Trial of Text Message Reminders Noting the “limited evidence on whether growing mobile phone availability in sub-Saharan Africa can be used to promote high adherence to antiretroviral therapy,” the current study assessed the efficacy of short message service (SMS) ART adherence reminders among patients attending a rural clinic in Kenya.

“These results suggest that SMS reminders may be an important tool to achieve optimal treatment response in resource-limited settings,” the study authors concluded.

Refrence:

Enrollees -- 431 adults who had initiated ART within U.S. Centers for Disease Control and Prevention three months -- were randomly assigned to a control group or one of four SMS reminder interventions. http://www.thebody.com Intervention group participants received SMS reminders that were either short or long and sent daily or weekly. Adherence was measured using the medication event monitoring system. Adherence exceeding 90 percent during each 12-week analysis period and the 48-week study period was the primary outcome; the secondary outcome was treatment interruptions of 48 hours or more.

Intention-to-treat analysis showed 53 percent of participants receiving weekly SMS reminders achieved adherence of at least 90 percent during the 48 weeks, compared with 40 percent of control group participants (p=0.03). In addition, those in the weekly reminder group were significantly less likely to experience treatment interruptions exceeding 48 hours during the study follow-up than participants in the control group (81 percent vs. 90 percent, p=0.03).

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