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Geneva [Switzerland] — The estimated cost of the UN humanitarian response going into 2023 is USD 51.5 billion, a 25 per cent increase compared to the beginning of this year, the United Nations and partner organizations said on Thursday.
Next year will set another record for humanitarian relief requirements, with 339 million people in need of assistance in 69 countries, an increase of 65 million people compared to the same time last year, according to United Nations Office for the Coordination of Humanitarian Affairs (OCHA).
“Humanitarian needs are shockingly high, as this year’s extreme events are spilling into 2023,” said the UN Emergency Relief Coordinator, Martin Griffiths.
“Lethal droughts and floods are wreaking havoc in communities from Pakistan to the Horn of Africa. The war in Ukraine has turned a part of Europe into a battlefield. More than 100 million people are now displaced worldwide. And all of this on top of the devastation left by the pandemic among the world’s poorest.
“For people on the brink, this appeal is a lifeline. For the international community, it is a strategy to make good on the pledge to leave no one behind.”
The 2023 Global Humanitarian Overview (GHO), launched today by the UN in collaboration with nongovernmental organizations and other humanitarian partners, paints a stark picture of what lies ahead.

This gargantuan UN appeal comes as at least 222 million people in 53 countries will face acute food insecurity by the end of 2022. According to OCHA, forty-five million people in 37 countries risk starvation.
Public health is under pressure due to COVID-19, monkeypox, vectorborne diseases, and outbreaks of Ebola and cholera. Climate change is driving up risks and vulnerability. By the end of the century, extreme heat could claim as many lives as cancer. OCHA said it will take four generations – 132 years – to achieve global gender parity. Notably, 388 million women and girls live in extreme poverty around the world.
According to OCHA, the response plans in the GHO detail how aid agencies working together around specific types of aid – including shelter, food, maternal health, child nutrition and protection – can save and support the lives of a combined 230 million people worldwide.
This year, humanitarian organizations have delivered assistance to stave off the most urgent needs of 157 million people. This includes food assistance for 127 million people; sufficient safe water for nearly 26 million people; livelihood assistance for 24 million people; mental health and psychosocial support for 13 million children and caregivers; maternal health consultations for 5.2 million mothers; and health-care services for 5.8 million refugees and asylum-seekers.
According to the UN agency, humanitarians have painstakingly negotiated access to communities in need, most recently in the Haitian capital, Port-au-Prince, to deliver water and food rations. And the Black Sea Grain Initiative has been renewed, ensuring a continuous flow of food commodities from Ukraine to global markets.
National and local organizations are members of 80 per cent of all Humanitarian Country Teams, providing essential guidance and leadership. And from Afghanistan to the Central African Republic, local organizations led by women are engaged in humanitarian planning and programming.
The UN agency said donors have provided a generous USD 24 billion in funding as of mid-November 2022, but needs are rising faster than the financial support. The funding gap has never been greater, currently at 53 per cent. Humanitarian organizations are therefore forced to decide who to target with the funds available. (ANI)

People of South Asian ethnicity may be able to achieve type 2 diabetes remissions by following a structured weight management program, according to a new study which saw one third of participants lose more than 10% of their body weight.

The findings from the STANDby trial—led by the University of Glasgow and published in The Lancet Regional Health—Southeast Asia—used a formula diet as “total diet replacement” for up to 12 weeks in people of South Asian ethnicity, and found sufficient weight loss was achieved by around 40% of all participants to allow for remission of their type 2 diabetes.

Globally, type 2 diabetes (T2D) affects over 400 million people, and almost 4 million, or one in ten adults in the UK.

Around one in four people worldwide are of South Asian origin, with considerably higher risk of T2D than the general UK/European white population, developing the condition at a lower body mass index and at younger ages.

Recent work from the DiRECT study, also led by the University of Glasgow, has shown how weight loss of 10 kg or more, using an evidence-based weight management program called “Counterweight-Plus,” resulted in remission of diabetes after one year, in 70% of people with diagnosed T2D of less than six years’ duration. Almost half (46%) of all participants in the DiRECT study achieved remission. However, in DiRECT, almost all participants were white British, so more research was required to understand its implications in other ethnic groups.

The STANDby now shows similar T2D remission rates in those of South Asian ethnicity as those previously seen in white cohorts with the same weight management program. Without diet treatment none of 12 participants in the control group had remission, but after they had also received the diet program, 10 out of a total of 23 participants (43%) were free from diabetes, without need for medication.

The key to success was weight loss, which reduces the damaging fat accumulation in the liver of people with type 2 diabetes. Overall, 35% of participants lost over 10% bodyweight, and liver fat content nearly halved, from a very high 15.3% at the start of total diet replacement to 8.6%.

Prof Naveed Sattar, from the University of Glasgow’s School of Cardiovascular and Metabolic Health, said, “It was incredibly important to examine whether the same diet intervention could have the same effect on the south Asian population; so while this study is based on a small cohort of participants, the findings should have far-reaching consequences for a large proportion of the world’s diabetes population, to contribute to development of culturally-optimal practical approaches for type 2 diabetes remission. New studies should also aim to find new ways to maximize sustainability of weight loss over the longer period.”

Prof Mike Lean, at the University of Glasgow’s School of Medicine, Dentistry and Nursing, added, “Until recently, people have really not taken type 2 diabetes or its treatment seriously enough. Our study has produced an impressive outcome, reversing an often dreadful disabling chronic disease, and another very strong message that the crucial mechanism underpinning type 2 diabetes remission is weight change with loss of liver fat. We hope our study will offer hope, and increase support, for this ethnic group at particularly high risk, with health care providers prioritizing evidence-based weight management for remission of type 2 diabetes.”

The study recruited 25 adults of South Asian ethnicity within the UK, aged between18–65 years, with type 2 diabetes for four of less years and with a BMI of between 25–45. Participants were randomized to immediately commence either total diet replacement (around 850 kcal/day for three to five months) or delayed intervention as a usual care control arm during this period. Liver fat content was measured by Magnetic Resonance Spectroscopy, which is not a routine clinical investigation.

Intervention effects were tested in an initial randomized comparison powered to detect significant weight loss, and in an expanded observational analysis, after the initial control grouphad also received the intervention, to determine remission effect size in a larger number.

The study is published in Lancet Regional Health Southeast Asia.

More information: Naveed Sattar et al, Dietary weight-management for type 2 diabetes remissions in South Asians: The South Asian diabetes remission randomised trial for proof-of-concept and feasibility (STANDby)

From : Medical express

New York, HRW – Nepali authorities should urgently bolster public health systems that struggled during a dengue fever outbreak in recent months, Human Rights Watch said today. Dengue and other mosquito-borne diseases are projected to becomemore widespread and severe in Nepal as a result of warming temperatures linked to climate change.

As of November 20, 2022, there had been over 52,557 reported dengue cases in Nepal since the beginning of the year, and 60 deaths attributed to the disease, according to government statistics. There have also been large outbreaks in neighboring regions of India. Dengue is a mosquito-borne virus that can cause a range of symptoms. In critical cases, people with dengue can require hospitalization and urgent platelet transfusion. According to the Intergovernmental Panel on Climate Change (IPCC), the world’s leading authority on climate science, “at high elevations in Nepal, there is high confidence that climate change has driven the expansion of vector-borne diseases that infect humans.”

“As temperatures are rising, the federal government and local governments need to work together to protect people from the growing threat posed by outbreaks of disease,” said Meenakshi Ganguly, South Asia director at Human Rights Watch. “The governments of countries that have been most responsible for the emissions that are driving climate change should support Nepali efforts, including with access to vaccines.”

Wealthy countries, whose greenhouse gas emissions are mainly responsible for climate change, should live up to their climate finance commitments and do more to support Nepal in responding to climate-based disasters, Human Rights Watch said.

According to the climate change panel, temperatures in the Himalayan region have increased faster than average global rates, and are projected to continue to rise faster than the global average. The panel also warned that “viruses like dengue, chikungunya, and Japanese encephalitis are emerging in Nepal in hilly and mountainous areas.”

When people who have been infected with dengue are infected a second time with a different variant, severe symptoms can develop, leading specialists to believe that Nepal is vulnerable to even more serious outbreaks in the near future. Doctors also fear that the Zika virus, which can cause infants to be born with microcephaly, could be spread in Nepal in the future by the same mosquitos.

Like dengue, Zika is transmitted predominantly through the bite of an infected Aedes aegypti mosquito. The virus can also be transmitted during pregnancy from a woman to her fetus and through unprotected sexual activity. Infected people are often asymptomatic or experience mild symptoms, such as fever, muscle and joint pain, conjunctivitis, and rash.

Zika is associated with serious neurological complications, particularly when a pregnant person becomes infected and the fetus is exposed in utero. In February 2016, the World Health Organization (WHO) declared a global public health emergency in response to Zika. The virus had been detected in 89 countries and territories around the world.

Nepal has had annual dengue outbreaks since 2006. The previous largest outbreak was in 2019, with almost 18,000 recorded cases. The 2022 outbreak, almost three times as large, also recorded cases over a longer season. Whereas in previous years dengue cases were found at lower altitudes, in 2022 dengue has spread to at least 76 of Nepal’s 77 districts, including high altitude regions.

“This is related to climate change, because the rate of warming is much greater at higher altitudes,” said Dr. Megnath Dhimal, a government public health expert and contributor to the IPCC report. “We need to enhance our infrastructure and capacity for future outbreaks. The most [climate]-vulnerable countries are developing countries like Nepal.”

Doctors Human Rights Watch interviewed said that the true number of infections is likely to be several times higher than the official statistics. Urban environments are particularly susceptible to dengue outbreaks, according to the WHO, because the mosquitoes carrying it breed “mostly in man-made containers including buckets, mud pots, discarded containers and used tyres, [and] storm water drains.” The mosquitos fly only around 500 meters in their lifetime, so are more dangerous in densely populated areas.

While available treatments are limited, the main method of controlling the disease is to eradicate the mosquitos that spread it, especially by targeting larvae in stagnant water. Although there have been public information campaigns and attempts to clean up potential breeding sites, there is criticism that the government’s response has been inadequate. “Basic things are taken very lightly,” said a senior government health official. “It can be done much better than this.”

The Nepal government developed a “National Adaptation Plan 2021-2050,” to respond to climate change, which envisages spending $500 million to strengthen preparedness and response to climate sensitive diseases by 2030. However, experts who spoke to Human Rights Watch said there was a lack of coordination and implementation between central government and local government units, and that international health agencies had not delivered effective support. “Ad hoc activities [to combat dengue] are implemented, but very few effective interventions are implemented,” said Dr. Keshab Deuba, an infectious disease epidemiologist. “Very few activities are happening at the community level that would control these cases.”

Meanwhile, doctors say that Nepal’s weak health infrastructure means there have been preventable deaths due to lack of timely access to healthcare. “The quality of the available health service is very poor, and in remote areas it is almost non-existent,” said Dr. Deuba. “We are not able to manage cases and prevent deaths.” In 2021, a major outbreak of Covid-19 stretched Nepal’s health service beyond breaking point.

In the capital, Kathmandu, where most dengue cases this year are concentrated, Nepal’s sole hospital specializing in tropical diseases has struggled with very high patient numbers.

Nepal’s Constitution guarantees the “right to seek basic health care services from the state” and that no one should “be deprived of emergency health care.” The government has an international legal obligationto respect, protect and fulfil the right to health. In 2021, in cases related to the Covid-19 pandemic, the Supreme Court issued several judgments requiring the government to uphold these rights, although the rulings appear to have had little impact.

Nepal held federal and provincial elections on November 20. The new federal, provincial, and local governments should work together to strengthen and coordinate systems to control and treat outbreaks.

“Without effective measures to remove breeding grounds, reduce transmission, and improve treatment, Nepal is likely to suffer much worse outbreaks of dengue and other mosquito-borne diseases as temperatures rise in the coming years,” Ganguly said. “If the government fails to act to protect people’s right to health, the health of millions of Nepalis may be placed in jeopardy.”

Elections to the House of Representatives (HoR) and seven provincial assemblies were held on Sunday, November 20. The counting of votes started on Monday, November 21.  According to the Election Commission, about 61 percent of polling was recorded across Nepal. More than 17.9 million voters were eligible to cast their votes to elect the House of Representatives and provincial assemblies.  Almost 95% of votes have been counted by today morning.