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1 in 10 medical products in developing countries is substandard or falsified

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An estimated 1 in 10 medical products circulating in low- and middle-income countries is either substandard or falsified, according to new research from WHO.

This means that people are taking medicines that fail to treat or prevent disease. Not only is this a waste of money for individuals and health systems that purchase these products, but substandard or falsified medical products can cause serious illness or even death.

“Substandard and falsified medicines particularly affect the most vulnerable communities,” says Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “Imagine a mother who gives up food or other basic needs to pay for her child’s treatment, unaware that the medicines are substandard or falsified, and then that treatment causes her child to die. This is unacceptable. Countries have agreed on measures at the global level – it is time to translate them into tangible action.”

Since 2013, WHO has received 1500 reports of cases of substandard or falsified products. Of these, antimalarials and antibiotics are the most commonly reported. Most of the reports (42%) come from the WHO African Region, 21% from the WHO Region of the Americas, and 21% from the WHO European Region.

This is likely just a small fraction of the total problem and many cases may be going unreported. For example, only 8% of reports of substandard or falsified products to WHO came from the WHO Western Pacific Region, 6% from the WHO Eastern Mediterranean Region, and just 2% from the WHO South-East Asia Region.

“Many of these products, like antibiotics, are vital for people’s survival and wellbeing,” says Dr Mariângela Simão, Assistant Director-General for Access to Medicines, Vaccines and Pharmaceuticals at WHO. “Substandard or falsified medicines not only have a tragic impact on individual patients and their families, but also are a threat to antimicrobial resistance, adding to the worrying trend of medicines losing their power to treat”.

Prior to 2013, there was no global reporting of this information. Since WHO established the Global Surveillance and Monitoring System for substandard and falsified products, many countries are now active in reporting suspicious medicines, vaccines and medical devices. WHO has trained 550 regulators from 141 countries to detect and respond to this issue. As more people are trained, more cases are reported to WHO.

WHO has received reports of substandard or falsified medical products ranging from cancer treatment to contraception. They are not confined to high-value medicines or well-known brand names and are split almost evenly between generic and patented products.

In conjunction with the first report from the Global Surveillance and Monitoring System published today, WHO is publishing research that estimates a 10.5% failure rate in all medical products used in low- and middle-income countries.

This study was based on more than 100 published research papers on medicine quality surveys done in 88 low- and middle-income countries involving 48 000 samples of medicines. Lack of accurate data means that these estimates are just an indication of the scale of the problem. More research is needed to more accurately estimate the threat posed by substandard and falsified medical products.

Based on 10% estimates of substandard and falsified medicines, a modelling exercise developed by the University of Edinburgh estimates that 72 000 to 169 000 children may be dying each year from pneumonia due to substandard and falsified antibiotics. A second model done by the London School of Hygiene and Tropical Medicine estimates that 116 000 (64 000 – 158 000) additional deaths from malaria could be caused every year by substandard and falsified antimalarials in sub-Saharan Africa, with a cost of US$ 38.5 million (21.4 million – 52.4 million) to patients and health providers for further care due to failure of treatment.

Substandard medical products reach patients when the tools and technical capacity to enforce quality standards in manufacturing, supply and distribution are limited. Falsified products, on the other hand, tend to circulate where inadequate regulation and governance are compounded by unethical practice by wholesalers, distributors, retailers and health care workers. A high proportion of cases reported to WHO occur in countries with constrained access to medical products.

Modern purchasing models such as online pharmacies can easily circumvent regulatory oversight. These are especially popular in high-income countries, but more research is needed to determine the proportion and impact of sales of substandard or falsified medical products.

Globalization is making it harder to regulate medical products. Many falsifiers manufacture and print packaging in different countries, shipping components to a final destination where they are assembled and distributed. Sometimes, offshore companies and bank accounts have been used to facilitate the sale of falsified medicines.

“The bottom line is that this is a global problem,” says Dr Simão. “Countries need to assess the extent of the problem at home and cooperate regionally and globally to prevent the traffic of these products and improve detection and response.”

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DNA to rediscover a forgotten immigration

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The project “Le Vie Aleramiche, Normanno-Sveve”, with the support of the Euro-Mediterranean Federation, after having deepened the linguistic, toponymic and cultural aspects, will make use of the important demo-genetic research, already expressed in a pioneering form in 2016, which has the declared purpose of uncovering traces, more less hidden, of an almost forgotten migration, which started, starting from the 11th century AD, from districts not better circumscribed in northern Italy towards what will later be understood as “Lombard of Sicily”.

This is a survey that involves, on different but strictly interdependent fronts, the three universities of Palermo, Messina, and Bologna, with the coordination of Prof. Luca Sineo, the Professor of Anthropology at the University of Palermo and current President of the ‘AAI (Italian Anthropological Association), and the action on the field by dr. Marco Nania, responsible for the sampling phase. This research, which fascinates the communities involved so much, acts by a comparative analysis of specific DNA segments deriving from biological samples taken from a group of selected subjects from the population currently residing in the Sicilian localities of interest, so qualified as possible receptacles of traces, even significant ones, of the passage and rooting of the “Lombard” colonizers.

With the method of “active” sampling, we will deliberately and hopefully proceed towards a close collaboration and widespread participation of local communities. They will feel as promoters of the survey themselves and, even more, creators of the re-determination, on a genetic basis, of their own history. A fundamental aspect of the pre-sample anthropological analysis is then based on the onomastic study of surnames, first names and nicknames, which say so much about culture and family and social relationships within a given community. The identification of endemic surnames and others of the suspicious and ancient high-Italic matrix, in combination with the reconstruction, up to the third parental generation (that of the great-grandparents), of genealogies purely embodied in the socio-demographic context of reference, will be the guides discriminating factors that will lead to establishing the perimeter within which to include the subjects of greatest interest.

It will be a question of demonstrating, in a definitive way, an indisputable ancestral link between the people of some strips of Sicily, where the progeny of Nordic migrants would be stationed, and the descendants of the sedentary stocks of the Ligurian, Piedmonts, and more generally “Lombard” ancestors. This should consolidate, with real scientific data, the narrative of that “reverse immigration”, now almost forgotten, which saw families and perhaps entire communities of Northern Italy follow the Aleramici, linked to the Norman-Swabian dynasty, in their transfer to the South and, in particular, towards Sicily.

An aspect of the research that before the pandemic had already seen the interest of the University of Bologna and of the Anthropologist Prof. Davide Pettener, interviewed by Fabrizio Di Salvo.

Sampling will take place, in stages and in successive periods, in the localities of San Fratello, Aidone, Piazza Armerina, Corleone, and Fondachelli Fantina. Thanks to the intermediation of Calogero Ridulfo, Filadelfio Crivillaro, Lavinia Garsia, Marco Incalcaterra, Franca Ciantia, Serena Raffiotta, Rosa Maria Restivo and Tiziana Laversa and coordinated by Anna Maria Di Rosa Placa, and Fabrizio Di Salvo of the Euro-Mediterranean Federation on the ancient Medieval Migrations, following the instructions already communicated by the experts in a videoconference.

In the case of Fondachelli-Fantina, however, it was the entire municipal administration, led by the mayor Dr. Marco Pettinato, to have raised awareness and to have promoted and supported, thanks also to the active collaboration of the councillor Gioconda Grasso and the cultural center “Le Miniere”, all the phases that will lead to the imminent sampling.

This is an opportunity to break down, through the science and study of DNA, prejudices and parochialisms that are firmly rooted and that do not allow us to look, with a broad breath, at the numerous pages of the history of mankind that speak of peoples in constant migration and relocation.

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Finance

4 Crucial Factors That Helps in Selecting the Ideal FX Expert Advisor

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The forex market is increasingly expanding at a rapid pace with millions of active traders executing trades daily. The use of advanced technology is also preferred among traders who are involved in active trading. As automation is slowly taking over most industries and businesses, the forex market is also noticing a rise in the use of FX expert advisors to execute a trade on behalf of an investor.

But even with the tons of perks that these FX EAs are capable of, you must consider certain factors before investing in one.

But before we jump into discussing the factors that indicate an EA’s reliability, let us get a clear understanding of what forex EAs are and how they work.

Explaining FX Expert Advisors

An EA is a software program that offers the benefit of automated trading to investors worldwide. A forex EA is responsible for identifying the best possible timings for opening a position with the help of certain in-built algorithms and indicators. As the market is active for 24-hours straight, using an EA will certainly be useful; it is immune to any emotional factors and can facilitate you to make high-profitable trades by identifying the ideal entry points.

Developed in MQL, an EA can operate on MetaTrader 4 or 5 and comes up with complex strategies of trading based on a certain mathematical pattern. The ways expert advisors tend to outperform manual trading practices involve their high-accuracy results along with faster data-processing technology which aids in better analysis.

Although being quite similar and often mistaken as the same, a forex EA slightly differs from a forex robot in terms of its functions. While forex robots can take care of executing a trade on behalf of you, and EA will simply advise you when to initiate a trade allowing you to have full control over initiating a trade.

Points to consider before investing in an EA

Investing in an expert advisor requires certain factors to keep in mind that will help you to maximize your success rate with the benefit of automation.

  1. Performing a thorough background check

The security factor should be on your priority list while opting for an expert advisor. Thorough research along with a complete background assessment is necessary to determine the authenticity of the EA. You can rely on reviews and testimonials of other users as well as checking the credentials of the vendor. Some factors that decide the genuineness of the EA include secure payment options, refund guarantees in case of false claims, transparent business practices, and development by trustworthy programmers.

  1. Conduct satisfactory research

It is common to come across many catchy claims of instant and guaranteed profit while opting for an EA. But these commercials fail to mention that expertise is the most critical asset you will need to succeed in this industry. You can immediately notice risk factors when anyone makes exaggerated and unreasonable statements if you have a good understanding of how the foreign exchange market works. While many appropriate automated trading systems are useful in leveraging your trading career, you may also come across many fraudulent scenarios in this industry. Thus only proper learning will provide you with the information you need to prevent being a target of these frauds.

  1. Get familiar with basic EA stats

Reliable expert advisors are generally introduced to the market after a long process of backtesting performed by the developers. While selecting an EA you will most likely come on certain statistics including the profit factor, drawdown and expected payoff that demonstrate its performanceAs an investor, you need to be knowledgeable about these stats, what they mean and how they can impact your trading style before finalizing an EA.

  1. Perform independent testing

The final step will always be to verify the capabilities of an expert advisor along with checking the backtested results. You can rely on a demo account or a trial version of that EA easily before making the final call.

Selecting the ideal forex EA can be challenging irrespective of the level of experience you have in this. However, following these tips as well as your experience can make this process easier and worthwhile.

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Environment

No pathway to reach the Paris Agreement’s 1.5˚C goal without the G20

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“The world urgently needs a clear and unambiguous commitment to the 1.5 degree goal of the Paris Agreement from all G20 nations”, António Guterres said on Sunday after the Group failed to agree on the wording of key climate change commitments during their recent Ministerial Meeting on Environment, Climate and Energy.

“There is no pathway to this goal without the leadership of the G20. This signal is desperately needed by the billions of people already on the frontlines of the climate crisis and by markets, investors and industry who require certainty that a net zero climate resilient future is inevitable”, the Secretary General urged in a statement.

The UN chief reminded that science indicates that to meet that ‘ambitious, yet achievable goal’, the world must achieve carbon neutrality before 2050 and cut dangerous greenhouse gas emissions by 45 % by 2030 from 2010 levels. “But we are way off track”, he warned.

The world needs the G20 to deliver

With less than 100 days left before the 2021 United Nations Climate Conference COP 26, a pivotal meeting that will be held in Glasgow at the end of October, António Guterres urged all G20 and other leaders to commit to net zero by mid-century, present more ambitious 2030 national climate plans and deliver on concrete policies and actions aligned with a net zero future.

These include no new coal after 2021, phasing out fossil fuel subsidies and agreeing to a minimum international carbon pricing floor as proposed by the International Monetary Fund (IMF).

“The G7 and other developed countries must also deliver on a credible solidarity package of support for developing countries including meeting the US$100 billion goal, increasing adaptation and resilience support to at least 50% of total climate finance and getting public and multilateral development banks to significantly align their climate portfolios to meet the needs of developing countries”, he highlighted.

The UN Chief informed that he intends to use the opportunity of the upcoming UN General Assembly high-level session to bring leaders together to reach a political understanding on these critical elements of the ‘package’ needed for Glasgow.

A setback for Glasgow

The G20 ministers, which met in Naples, Italy on July 23-25, couldn’t agree to a common language on two disputed issues related to phasing out coal and the 1.5-degree goal, which now will have to be discussed at the G20 summit in Rome in October, just one day before the COP 26 starts.

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