Expert opinion

India, once referred to as the ‘open defecation capital of the world’, is celebrating the fact that in five short years over 100 million toilets have been built and sanitation coverage has gone from only 40% to almost 100% in rural areas. What are the secrets of this extraordinary sanitary success story?
Although not a new concept in quantitative infectious disease research, outbreak forecasting has yet to be fully integrated into formal policy and decision-making processes in many parts of the globe. One reason for this is the mismatch between the forecasting goals set out by researchers and those considered useful by policy and decision-makers.
Current treatments are able to cure hepatitis C at a relatively low cost to the NHS. This provides a great opportunity to find and treat those currently infected, curing the infection before the onset of liver failure or liver cancer. Testing is currently offered to those who are identified as being at high risk of infection. However, the way in which testing is provided needs to change in order to increase the number of people diagnosed and receiving treatment. Testing needs to be expanded to reach more people that it currently does.
With this short message on March 22, 2014, the missionary doctor in the small hospital where I worked part-time informed the medical team of eight about the outbreak of a strange and deadly disease in a village in Guinea, just across the border from Liberia.
People always ask me when I’m deploying out to Ebola outbreaks, “Aren’t you scared?” and the answer is usually, “No, not really, I’m pretty good at this”. Which I know must sound a bit strange: it’s odd to be good at a viral haemorrhagic fever. But after working for nine months on the big West African outbreak back in 2014 and 2015, and then doing my doctoral study on reproductive health during outbreaks of Ebola, it’s now very much my speciality.
It took time to realise that there was an outbreak happening, and then to work out that it was due to anthrax. We needed to urgently arrange treatment and cattle vaccinations, alert human and animal health authorities, and warn communities and advise them how to deal with cases and prevent more occurring. More recently many of us were part of the international response to the recent Ebola outbreak in west Africa. This was a huge complex operation but brought the same feelings of nervousness, exhilaration, sadness and achievement.
An argument I often hear when I talk about including people with disabilities in health services goes something like this - “Yes, that would be good/nice/worthwhile, but it is too expensive/impractical/unrealistic”. Essentially, there is a widespread belief that providing good healthcare for people with disabilities is a luxury, which we will get to once services are provided for the majority. Let me try to dispel this myth.
With 13% (650 million) adults obese the world is in the grip of an obesity crisis that shows no sign of abating. In response, some governments are implementing policy interventions that use fiscal levers on food and drink with the ultimate aim of reducing obesity and related diseases such as Type 2 diabetes.
Working in the UK Public Health Rapid Support Team Olivier le Polain is the senior epidemiologist and deputy director for operations of the UK Public Health Rapid Support Team (UK-PHRST).
The man spurred his horse towards the centre of the camp: his gun dangled ominously towards women, children and men. They pretended to ignore him and be busy around their miniature cardboard-and-thatch shelters. We traded a long stare: he bore no visible trace of fear or contrition. He rode up and down the camp three times, circled round its borders and was gone.