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Reversed Abortion Could Cause Heavy Bleeding, Birth Defects – Experts

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Medical experts have warned pregnant women against taking high doses of progesterone in an attempt to reverse or no stop a medical abortion already in progress, noting that they are at risk of haemorrhage (heavy bleeding) and giving birth to babies with abnormalities.
An American non-governmental organisation, Heartbeat International has been propagating the use of Abortion Pill Reversal, claiming that a pregnant woman can reverse the course of an abortion with high intake of progesterone.
However, health practitioners have described the claim by the Christian right anti-abortion outfit as misleading, warning that it lacks scientific evidence.
Speaking in an interview with The Tide’s source, a Pharmacist, Emeka Duru, said taking high doses of progesterone injection in an attempt to reverse a medical abortion is unsafe and exposes the woman to haemorrhage, blood clotting and blockage of the fallopian tubes.
Duru, who is a past National Secretary of the Pharmaceutical Society of Nigeria, maintained that there is no evidence in that progesterone can stop an ongoing abortion.
He said, “Pregnancy is a natural thing and it takes a natural process for it to be established in the womb. The termination process of such established pregnancy is unnatural. And then you have already commenced the process of abortion in and then, you go ahead to take another drug, a steroid to reverse it.
“This should not be encouraged because there must be some very fatal and dangerous effects. It will result in some gynaecological issues that may not be established right away, probably after a while.
Continuing, the pharmacist said, “We encourage Nigerians to only buy drugs that are registered by the National Agency for Food and Drug Administration and Control, and must have gone through the process of research in our institutes, like the National Institute for Pharmaceutical Research and Development.
“If a drug is already in the global market, and is to come to Nigeria, any Nigerian that wants to purchase this type of drug must make sure that such drug is registered with NAFDAC, for it to be legal in Nigeria or for it to be legally used in Nigeria.”
Duru urged Nigerians to avoid drugs considered to be dangerous, especially prescription drugs.
He noted that when it comes to using drugs registered by NAFDAC, the intended user must get a doctor’s prescription and also get it from the right source; that is from a registered pharmacy that is manned by a pharmacist to avoid health issues.
He enjoined pharmacists to desist from practices that go against the ethics of the profession and to also ensure that they do not encourage the use of drugs not registered medications, not certified by NAFDAC.

On his part, a Consultant Obstetrician and Gynaecologist, Dr. Joseph Akinde, said taking high doses of progesterone may reverse abortion in progress.
He, however, noted that the reversal is not always 100 per cent and the foetus may develop abnormalities.
Akinde, a past  Chairman, Society of Gynaecology and Obstetrics of Nigeria, Lagos State chapter, said, “If the effect of the mifepristone is not nullified by the high doses of the progesterone that the woman took, then the abortion process will go to completion.
“So, the woman will be disappointed. On the other hand, she may be lucky, but she may still end up losing the pregnancy despite the fact that she had taken high doses of progesterone.”
Speaking on the health implications, the gynaecologist said if the drug succeeds in reversing the abortion, the baby may come down to with abnormalities.
He said women should be cautious when taking reproductive health decisions, reiterating that the intake of high doses of progesterone may not reverse the abortion and that they may end up losing the pregnancy.
The way Abortion Pill Reversal works, according to experts, is that a pregnant woman who intends to abort within the first three months will first have to ingest mifepristone, after which she is expected to complete the process usually between 24 and 48 hours later with a second medication called misoprostol.
This is technically referred to as medical abortion and it must be strictly done under the supervision of a competent physician.
Abortion is illegal in Nigeria except if it becomes imperative for the safety of the mother or for medical reasons as may be advised by a competent physician.
Experts warn that once a pregnant woman takes mifepristone, the abortion will begin and that it is irreversible.
According to the World Health Organisation, six out of 10, of all unintended pregnancies end in an induced abortion.
“Around 45 per cent of all abortions are unsafe, of which 97 per cent take place in developing countries. Unsafe abortion is a leading – but preventable – cause of maternal deaths and morbidities.”It can lead to physical and mental health complications, and social and financial burdens for women, communities and health systems”, WHO stated.
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WHO Raises Alarm Over Viral Hepatitis Epidemics, STIs

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The World Health Organisation (WHO) says viral hepatitis epidemics and sexually transmitted infections (STIs) are causes of  2.5 million deaths each annually.
According to a new WHO report titled,” Implementing the Global Health Sector Strategies on HIV, Viral Hepatitis and Sexually Transmitted Infections, 2022–2030,” STIs are increasing in many regions.
In 2022, WHO had targetted of reducing the annual number of adult syphilis infections by ten-fold by 2030, from 7.1 million to 0.71 million, but new syphilis cases among adults aged 15-49 years increased by over 1 million in 2022 reaching 8 million. The highest increases occurred in the Region for the Americas and the African region.
Combined with insufficient decline seen in the reduction of new HIV and viral hepatitis infections, the report expressed doubt  to the attainment of the related targets of the Sustainable Development Goals (SDGs) by 2030.
“The rising incidence of syphilis raises major concerns”, said WHO Director-General Dr Tedros Adhanom Ghebreyesus. “Fortunately, there has been important progress on a number of other fronts including in accelerating access to critical health commodities including diagnostics and treatment.
The WHO DG said tools required to curb these epidemics as public health threats by 2030 are available, but that there’s need to ensure that, in the context of an increasingly complex world, countries do all they can to achieve the ambitious targets they set themselves”.
Increasing incidence of sexually transmitted infections four curable STIs – syphilis (Treponema pallidum), gonorrhea (Neisseria gonorrhoeae), chlamydia (Chlamydia trachomatis), and trichomoniasis (Trichomonas vaginalis) – account for over 1 million infections daily.
The report notes a surge in adult and maternal syphilis (1.1 million) and associated congenital syphilis (523 cases per 100 000 live births per year) during the COVID-19 pandemic. In 2022, there were 230 000 syphilis-related deaths.
New data also show an increase in multi-resistant gonorrhoea. As at 2023, out of 87 countries where enhanced gonorrhoea antimicrobial resistance surveillance was conducted, 9 countries reported elevated levels (from 5percent to 40percent) resistance to ceftriaxone, the last line treatment for gonorrhoea. WHO is monitoring the situation and has updated its recommended treatment to reduce the spread of this multi-resistant gonorrhoea strain.
In 2022, around 1.2 million new hepatitis B cases and nearly 1 million new hepatitis C cases were recorded. The estimated number of deaths from viral hepatitis rose from 1.1 million in 2019 to 1.3 million in 2022 despite effective prevention, diagnosis, and treatment tools.
New HIV infections only reduced from 1.5 million in 2020 to 1.3 million in 2022. Five key population groups men who have sex with men, people who inject drugs, sex workers, transgender individuals, and individuals in prisons and other closed settings still experience significantly higher HIV prevalence rates than the general population.

By: Kevin Nengi

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WHO Targets One Billion For Better Health

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The World Health Organisation (WHO) says it is tar-geting 1 billion more people to enjoy better health and wellbeing will  by 2025.
The plan, it said is  driven primarily by improvements in air quality and access to water, sanitation and hygiene measures.
Meanwhile, the body has listed it achievements in a  Report of  2023, the most comprehensive to date.
The report showcases achievements of key public health milestones by the world health apex agency even amid greater global humanitarian health needs driven by conflict, climate change and disease outbreaks.
The report is expected to be released ahead of the 2024 Seventy-seventh World Health Assembly, which runs from 27 May, 1st June, 2024.
WHO revised Programme Budget for 2022–2023 was US$ 6726.1 million, incorporating lessons learned from the pandemic response and addressing emerging health priorities.
With 96percent of WHO country offices providing 174 country reports on achievements, the report shows some progress towards 46 targets and highlights some challenges.
“The world is off track to reach most of the triple billion targets and the health-related Sustainable Development Goals,” said Dr. Tedros Adhanom Ghebreyesus, WHO Director-General. “However, with concrete and concerted action to accelerate progress, we could still achieve a substantial subset of them. Our goal is to invest even more resources where they matter most at the country level while ensuring sustainable and flexible financing to support our mission.”
The report shows advancement in several key areas, including healthier populations, Universal Health Coverage (UHC), and health emergencies protection.
Related to healthier populations, the current trajectory indicates the target of 1 billion more people enjoying better health and well-being will likely be met by 2025, driven primarily by improvements in air quality and access to water, sanitation and hygiene measures.
In terms of UHC, 30percent of countries are moving ahead in coverage of essential health services and providing financial protection. This is largely due to increased HIV service coverage.
Regarding emergencies protection, though the coverage of vaccinations for high-priority pathogens shows improvement relative to the COVID-19 pandemic-related disruptions in 2020–2021, it has not yet returned to pre-pandemic levels.
The Pandemic Fund’s first disbursements totaled US$ 338 million in 2023, supporting 37 countries to fund the initial response to acute events and scale up life-saving health operations in protracted crises. WHO continues to work with countries and partners to enhance genomic sequencing capabilities and strengthen laboratory and surveillance systems worldwide with capacity increased by 62percent for SARS-CoV-2 between February 2021 and December 2023.
It said one of the achievements is the world’s first malaria vaccine, RTS,S/AS01 administered to more than two million children in Ghana, Kenya, and Malawi during the biennium, reducing mortality by 13% among children eligible for vaccination. WHO’s prequalification of a second vaccine, R21/Matrix-M, is expected to further boost malaria control efforts.
The first-ever all-oral treatment regimens for multi-drug-resistant tuberculosis were made available in 2022, allowing the highest number of people with tuberculosis to get treatment since monitoring began almost 30 years ago.

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‘Current Health Insurance Coverage Not Big To Cover Formal Sector’

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The current insurance coverage in Nigeria has been described as not sufficient to cover the formal sector.
A body known as Health Watch Nigeria in its quarterly report indicated that significant non-compliance, especially within the private formal sector is being witnessed.
It proferred that, “ enforce the provision of health insurance, the government could link employee health insurance benefits to public procurement by the private sector.
Additionally, the authorities could explore multi-sectoral partnership by establishing a joint enforcement committee with the Pension Commission (PENCOM), which also seeks to enforce the Pension Act. This joint enforcement would reduce the cost of enforcement and ensure the NHIA can leverage PENCOM’s experience in enforcing social protection.
Among other things it recommended the  enforcement of the Minimum Package of Health Services insisting that ,” all health insurance schemes aim to achieve financial protection, and designating what should be covered to guarantee this financial protection is a fundamental duty of the regulator as prescribed by the Act.
It, however, frowned that different social health insurers sell varying products that differ in coverage and cost from the basic minimum package of healthcare services prescribed by the NHIA through the BHCPF guideline.

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