Sunday, November 29, 2009

Commonwealth leaders back climate change fund

Commonwealth leaders back climate change fund


Queen Elizabeth II in Port of Spain
Queen Elizabeth II got a carnival welcome in Port of Spain

Commonwealth leaders have backed a multi-billion-dollar plan to help developing nations to deal with climate change and cut greenhouse gases.

The fund, proposed by UK and French leaders at the Commonwealth summit on Friday, would start next year and build to $10bn annually by 2012.

Many Commonwealth members are island states threatened by rising sea levels.

Leaders also called for the strongest possible outcome at next month's climate change summit in Copenhagen.

They unanimously agreed to seek a legally binding international agreement, but accepted that "a full legally binding outcome" might have to wait to 2010.

ANALYSIS
James Robbins
James Robbins, BBC News diplomatic correspondent
Did the Commonwealth give a lead to the world on climate change, as the Queen urged when she opened this summit? The Commonwealth Climate Declaration does emphasise that "an internationally binding agreement is essential" but then concedes in the next sentence that "a full legally binding outcome" will have to wait until 2010.

That doesn't mean the Commonwealth has failed. The wording looks cautious but realistic. It is the breakdown in global negotiations which threatens to sink a strong deal.

There does seem to have been some meeting of minds at the Commonwealth on the global fund to distribute money from rich countries to the developing countries to help them adapt and pay for low-carbon alternatives.

Poorer countries can start to see the money now, with the promise of payouts starting soon after a global treaty is agreed.

That's a very direct incentive for the developing world.

Commonwealth leaders "welcomed the initiative to establish, as part of a comprehensive agreement, a Copenhagen Launch Fund starting in 2010 and building to a level of resources of $10 billion annually by 2012," a statement in Trinidad on Saturday said.

UK Foreign Secretary David Miliband said the declaration sent a clear political message.

"The Commonwealth is showing that you can find some common ground amidst countries that are very different, large and small, rich and poor, and that climate change is an issue that affects us all, and that the world needs to show the sort of resolution that we've seen here over the past 24 hours," he said.

It added that "fast start funding" for adaptation should be focused on the most vulnerable countries.

"We also recognise the need for further, specified and comparable funding streams, to assist the poorest and most vulnerable countries, to cope with, and adapt to the adverse impacts of climate change. We recognise that funding will be scaled up beyond 2012."

UK Prime Minister Gordon Brown said half the $10bn fund should go towards helping developing nations reduce their greenhouse gas emissions and the other half towards helping them adapt to climate change.

The first cash would be made available next year, he said, before any emissions deal could take effect.

'Clock ticking'

Kevin Rudd stressed it was "time for action"

Commonwealth leaders met days after pledges by the US and China to limit their greenhouse gas emissions, amid concerns that December's Copenhagen meeting on climate change could fail to agree substantial cuts.

Australian Prime Minister Kevin Rudd told a news conference in Trinidad on Saturday that the Commonwealth - representing a third of the world's population - believed "the time for action on climate change has come."

"The clock is ticking to Copenhagen. We've achieved one further step, significant step forward with this communique and we believe the political goodwill and resolve exists to secure a comprehensive agreement at Copenhagen."

India's Prime Minister Manmohan Singh said that when his country unveils its first targets for carbon emission cuts they would be "ambitious".

But he also stressed that India's offer would be conditional on other countries sharing the burden.

That neatly illustrates the greatest threat to a global deal, says the BBC's James Robbins.

Many countries will only make binding concessions if every other nation also gives ground, our correspondent says.

Speaking earlier at the summit, UN Secretary General Ban Ki-moon said he believed an agreement was in sight, with recent moves by some countries a positive step to cutting emissions.

The head of the UN's panel of climate experts, Rajendra Pachauri, said he was now very optimistic a deal could be reached in Copenhagen.

Honduras voting for new president

Honduras voting for new president


Many walking past political banners, Tegucigalpa
Some Hondurans are optimistic the political crisis may soon be over

Presidential elections are under way in Honduras, five months after a political crisis ousted President Manuel Zelaya.

He was forced from Honduras at gunpoint in June, and replaced by Roberto Micheletti. Neither are candidates.

The favourite to win is conservative Porfirio Lobo from the National Party, and Elvin Santos from the Liberal Party is considered his nearest rival.

Mr Zelaya has called for a boycott of the election. Voting began at 0700 (1300 GMT) and will last nine hours.

Mr Lobo, 61, narrowly lost to Mr Zelaya in 2005, and Mr Santos, 46, was previously Mr Zelaya's vice president in the divided Liberal Party.

About 30,000 soldiers and police are to provide security for the elections, but many fear violence could erupt.

The political crisis and election have divided the region, with the US indicating it would endorse the result if the elections are deemed "free and fair".

Costa Rica, which has long been the mediator between the two sides in this crisis, has said likewise, but other Latin American countries have opposed the vote.

Posters of Porfirio Lobo in a street in Honduras
Porfirio Lobo is considered the favourite to win

Argentina and Brazil have said they will not recognise any government installed after the election, arguing that to do so would legitimise the coup which ousted an elected president, and thus set a dangerous precedent.

The main regional grouping, the Organisation of American States, has declined to send an observer mission.

BBC correspondent Stephen Gibbs in the capital Tegucigalpa says that while supporters of Mr Zelaya are watching events with dismay, many Hondurans are expressing optimism that an end to the country's political crisis is in sight.

Congress is due to vote on Mr Zelaya's reinstatement on 2 December. His term ends on 27 January.

Mr Micheletti temporarily stepped down from office - for a week until 2 December - to allow the elections to proceed "peacefully and transparently", his spokesman said.

Mr Zelaya was forced into exile on 28 June after trying to hold a vote on whether a constituent assembly should be set up to look at rewriting the constitution.

His critics said the vote, which was ruled illegal by the Supreme Court, aimed to remove the current one-term limit on serving as president and pave the way for his possible re-election.

Mr Zelaya has repeatedly denied this and some commentators say it would have been impossible to change the constitution before his term in office was up.

He sneaked back into the country in September and has been living in the Brazilian embassy in Tegucigalpa.

Gordon Brown's tough tone over Afghanistan's future

Gordon Brown's tough tone over Afghanistan's future


By John Pienaar in Trinidad
Political correspondent, BBC News

Gordon Brown
Prime Minister Gordon Brown is under pressure over Afghanistan

Gordon Brown has clearly decided it's time to add urgency and method to the international effort to hand control of Afghanistan to the Afghans.

His tone in setting down terms for co-operation with Hamid Karzai's government has never been more forceful.

The prime minister has been accused by critics of presiding over a mission with unclear aims, and beginning to drift.

Was it driven by the need to deny terrorists a safe haven from which to plan and launch attacks on the UK and its allies? Was it about establishing a functioning democracy in Afghanistan, purged of corruption and endowed with traditions of equality and justice?

And crucially, was it geared to enable Afghanistan to manage its own security within a realistic timetable?

Gordon Brown has now attempted to show all these aims are interlinked, and progress in achieving them will be measured as a condition of British and other troops continuing to risk - and lose - their lives in the Afghan cause.

Conceivably, the newly re-elected Afghan president may resent being handed his marching orders in this way. But the prime minister's tone implied he was not overly concerned with Hamid Karzai's sensitivities.

Continuing criticism

And Mr Brown is under a good deal of pressure on his own account. British public opinion has been growing steadily more sceptical towards the Afghan mission.

Hamid Karzai
Hamid Karzai is under pressure to bring order to Afghanistan

Constant suggestions that British troops have lacked necessary equipment - helicopters in particular - have taken their toll, despite ministerial denials.

The prime minister will be hoping this tough new tone wins over a few British doubters. He seemed confident that the international conference on 28 January next year would bring with it fresh promises of troops.

He seemed on course to confirm 500 more British troops would join the 9,000 already serving in Afghanistan in a statement to the Commons next week.

Mr Brown was offering no timetable for withdrawing those troops, and insisted he would not be doing so.

But an assessment of progress by the end of 2010, he suggested, might finally place the scale of British involvement on the agenda.

The existence of "benchmarks" for progress might also help him as he deals with an inevitably rising casualty list, and an increasingly sceptical public in the run up to the 2010 general election.

Al-Qaeda head Osama Bin Laden was 'within grasp' of US

Al-Qaeda head Osama Bin Laden was 'within grasp' of US


Osama Bin Laden (centre) with Ayman al Zawahiri (left) in an image broadcast by al-Jazeera in October 2001
Osama Bin Laden is believed to be hiding in Pakistan's tribal areas

US forces had Osama Bin Laden "within their grasp" in Afghanistan in late 2001, a US Senate report says.

It says calls for US reinforcements were rejected, allowing the al-Qaeda leader to "walk unmolested" into Pakistan's unregulated tribal areas.

The report was prepared by the Foreign Relations Committee Democratic staff.

It says the failure to kill or capture Bin Laden had far-reaching consequences and laid the foundation for the protracted Afghan insurgency.

The report comes as President Barack Obama prepares to announce a long-awaited decision on sending troop reinforcements to Afghanistan.

It is highly critical of officials in former President George W Bush's administration and military commanders at the time.

'Potent symbolic figure'

It says that while the "vast array of American military power... was kept on the sidelines", US commanders "chose to rely on air strikes and untrained Afghan militias" to pursue Bin Laden in the mountainous complex of caves and tunnels known as Tora Bora.

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"On or around 16 December [2001], two days after writing his will, Bin Laden and an entourage of bodyguards walked unmolested out of Tora Bora and disappeared into Pakistan's unregulated tribal area," where he is still thought to be hiding, the report says.

The then US Defence Secretary Donald Rumsfeld expressed concern at the time that a large US troop presence in the area could provoke a backlash and he said the evidence about Bin Laden's location was not conclusive.

Open door

The report says the "failure to finish the job" laid the foundation for "today's protracted Afghan insurgency and inflaming the internal strife now endangering Pakistan".

It acknowledges that removing Bin Laden "would not have eliminated the worldwide extremist threat".

But it adds that "the decisions that opened the door for his escape to Pakistan allowed Bin Laden to emerge as a potent symbolic figure who continues to attract a steady flow of money and inspire fanatics worldwide".

The report rebuffs claims by Bush administration officials at the time that intelligence about Bin Laden's location was inconclusive.

"The review of existing literature, unclassified government records and interviews with central participants underlying this report removes any lingering doubts and makes it clear that Osama Bin Laden was within our grasp at Tora Bora," it says.

Pakistan must help break al-Qaeda, says Brown

Pakistan must help break al-Qaeda, says Brown


Brown warns Pakistan on al-Qaeda

Gordon Brown has told the BBC that Pakistan must do more to "break" al-Qaeda and find Osama Bin Laden.

Questions must be asked about why nobody had been able "to spot or detain or get close to" the al-Qaeda leader, the prime minister said.

He said he wanted to see "more progress in taking out" Bin Laden and his second-in-command Ayman Zawahiri.

Meanwhile, a Senate report claims US forces had Bin Laden "within their grasp" in Afghanistan in late 2001.

BBC World Affairs correspondent Mike Wooldridge said this was not a new claim.

However, he said, staff working for the Democratic majority on the Foreign Relations Committee now claimed to have evidence that in December 2001 US military power was kept on the sidelines while Bin Laden escaped "unmolested" into Pakistan's unregulated tribal areas.

Air strikes

The report comes days before US President Barack Obama is due to announce additional US troops for Afghanistan - Mr Brown is to announce whether conditions have been met to send an extra 500 British troops.

Speaking in a BBC interview, the prime minister said that if so much effort was going into building up security in Afghanistan, Pakistan had "to be able to show that it can take on al-Qaeda".

The prime minister said Pakistan had made progress against the Taliban in south Waziristan.

We want to see more progress in taking out these two people at the top of al Qaida
Gordon Brown

But he told the BBC: "We've got to ask ourselves why, eight years after September the 11th, nobody has been able to spot or detain or get close to Osama bin Laden, nobody's been able to get close to Zawahiri, the number two in al-Qaeda."

Pakistan had to "join us in the major effort that the world is committing resources to, and that is not only to isolate al-Qaeda, but to break them in Pakistan", he said.

Pakistan's prime minister, Yousuf Raza Gilani, will meet Mr Brown at Downing Street on Thursday. Mr Brown informed Pakistan's president, Asif Ali Zardari by telephone that he intended to speak out about the hunt for Osama Bin Laden.

The prime minister told the BBC that over eight years "we should have been able to do more ... to get to the bottom of where al-Qaeda is operating from".

'Political surge'

Progress had been made he said, but Pakistan had to make sure that "in South Waziristan we are taking on al-Qaeda directly".

"We want, after eight years, to see more progress in taking out these two people at the top of al-Qaeda, who have done so much damage and are clearly the brains behind many of the operations that have hit Britain," said Mr Brown.

Later Foreign Secretary David Miliband said Britain wanted Pakistan to "join us in upping our game" in tackling terrorism on its border with Afghanistan.

"We know that the Pakistani authorities, as the prime minister said, are taking big losses in their drive against the so-called Pakistan Taliban... we recognise that."

But he said it was "right that we recognise that stability in Afghanistan requires stability in Pakistan too and that requires a combined effort."

"We've all got to do more, Pakistan has got to do more, Afghanistan has got to do more and the international community has got to do more, but we've also got to do better."

Shadow defence secretary Liam Fox told BBC One's Politics Show that Pakistan faced economic and political problems and its army did not "really have the capabilities for the sort of anti-terrorist counter-insurgency measures that we want".

"The international community has to give Pakistan a lot of help if Pakistan is to fulfil the role we want it to do," he said.

And Edward Davey, for the Liberal Democrats, said: "The real questions are, why hasn't this happened before and because it hasn't, why is it suddenly going to happen now?

"This looks more like wishful thinking than a new well considered strategy"

Pakistan's High Commissioner in London, Wajid Shamsul Hasan, told BBC Radio 4's The World This Weekend: "We are doing what we could. We have carried out two very big military operations at enormous cost to the country."

He added: "The people of Pakistan want its allies to do more. If you provide us with equipment and expertise we will be able to be more successful - we are successful, but more successful - in tracking down al-Qaeda leadership."

Iran 'planning 10 new uranium enrichment sites'

Iran 'planning 10 new uranium enrichment sites'


File photo of President Mahmoud Ahmadinejad at a nuclear enrichment plant in Natanz
Iran insists its nuclear programme is for peaceful purposes

Iran's government has approved plans to build 10 new uranium enrichment plants, according to state TV.

The government told the Iranian nuclear agency to begin work on five sites, with five more to be located over the next two months, the report said.

It comes days after the UN nuclear watchdog rebuked Iran for covering up a uranium enrichment plant.

Western powers say Iran is trying to develop nuclear arms. Iran says its nuclear programme is peaceful.

BBC Tehran correspondent Jon Leyne says Sunday's announcement is a massive act of defiance likely to bring forward direct confrontation over Iran's nuclear programme.

On Friday, the International Atomic Energy Agency (IAEA) passed a resolution that was heavily critical of Iran for covering up a uranium enrichment plant near the town of Qom.

Earlier on Sunday it was reported that the Iranian parliament had urged President Mahmoud Ahmadinejad's government to reduce co-operation with the IAEA.

Saturday, November 28, 2009

HOW SWINE FLU OUTBREAK EMERGED

HOW SWINE FLU OUTBREAK EMERGED


Flu viruses in different species
Flu viruses mutate over time causing small changes to proteins on their surface called antigens. If the immune system has met a particular strain of the virus before, it is likely to have some immunity; but if the antigens are new to the immune system, it will be weakened.
Flu virus mutation
The influenza A virus can mutate in two different ways; antigenic drift, in which existing antigens are subtly altered, and antigenic shift, in which two or more strains combine. Antigenic drift causes slight flu mutations year on year, from which humans have partial, but not complete, immunity. By contrast, the new strain of H1N1 appears to have originated via antigenic shift in Mexican pigs
Antigenic shift in pigs
The name "swine flu" is a slight misnomer as it is believed pigs acted as a mixing pot for several flu strains, containing genetic material from pigs, birds and humans. Most humans have never been exposed to some of the antigens involved in the new strain of flu, giving it the potential to cause a pandemic.
Virus transmission to humans
The new virus has made the jump from pigs to humans and has demonstrated it can also pass from human to human. This is why it is demanding so much attention from health authorities. The virus passes from human to human like other types of flu, either through coughing, sneezing, or by touching infected surfaces, although little is known about how the virus acts on humans.

Q&A: Advice about swine flu

Q&A: Advice about swine flu


Swine flu has spread across the world since emerging in Mexico and is now officially the first flu pandemic for 40 years. Experts fear millions of people will be infected.

What is swine flu and what are the symptoms?

SWINE FLU SYMPTOMS
Human body with internal organs
Typical symptoms: sudden fever (38C or above) and sudden cough
Other symptoms include:
1. Tiredness and chills
2. Headache, sore throat, runny nose and sneezing

3. Stomach upset, loss of appetite, diarrhoea

4. Aching muscles, limb or joint pain

Source: NHS

Swine flu is a respiratory disease, caused by a strain of the influenza type A virus known as H1N1.

H1N1 is the same strain which causes seasonal outbreaks of flu in humans on a regular basis.

But this latest version is different: it contains genetic material that is typically found in strains of the virus that affect humans, birds and swine.

Although the strain may have originated in pigs, it is now a wholly human disease.

It can be spread from person to person by coughing and sneezing.

Symptoms of swine flu in humans appear to be similar to those produced by standard, seasonal flu - fever, cough, sore throat, body aches and chills. Some people with the virus have also reported nausea and diarrhoea.

However, many people who get flu show no symptoms at all.

Health experts say this could happen in half of all cases and with swine flu an analysis has shown that for children one in four of those infected may not fall ill.

What are the risks of the flu?

Experts have wrestled with the question ever since the pandemic emerged.

The problem is that for most people it is mild - about 98% recover without the need for any hospital treatment.

But doctors have found it very hard to predict who will develop complications, hence it has been dubbed a "Jekyll and Hyde" virus.

A fifth of the people who have died have been previously healthy individuals without any health conditions.

Nonetheless, certain groups are known to be at higher risk.

Pregnant women are between three to four times more likely to get seriously ill.

Young children also have higher rates of hospitalisation - although this could be partly because doctors are quicker to admit them.

Should I have the vaccine if offered it?

The vaccination programme is well under way.

Nearly 14m people, including NHS workers, people with health problems and pregnant women, will be offered the jab by Christmas. Healthy children under the age of five are also due to start getting it.

But already polls suggest people are worried about whether to get vaccinated.

The government says that getting immunised is the best way to protect yourself against flu.

However, its experts recognise that people are jumpy about vaccines and have said it is very much a personal decision.

People who are suspicious of vaccines often talk about the risk of complications.

One of the most common which is mentioned in association with flu vaccines is Guillain-Barré syndrome (GBS), a rare disorder in which a person's own immune system damages the nerve cells, causing muscle weakness and sometimes paralysis.

Most of the evidence suggests vaccines do not increase the risk, however there is research to indicate that getting flu increases it seven-fold.

Another allegation sometimes made is that being given the vaccine could actually give you flu.

Doctors are adamant this is not the case - the two vaccines being used in the UK do not contain the live virus.

As for deaths, the World Health Organization has been monitoring this and while a handful of people have died after being given the vaccine, officials have ruled out any link to the jab.

Why has the UK been more affected than other countries?

The UK has a comprehensive flu surveillance system, hence more cases may be identified in the UK than in other countries with less comprehensive monitoring services.

Also, the spread of the infection in the early stages was linked to flights out of Mexico.

FLU PANDEMICS

1918: The Spanish flu pandemic remains the most devastating outbreak of modern times. Caused by a form of the H1N1 strain of flu, it is estimated that up to 40% of the world's population were infected, and more than 50 million people died, with young adults particularly badly affected

1957: Asian flu killed two million people. Caused by a human form of the virus, H2N2, combining with a mutated strain found in wild ducks. The impact of the pandemic was minimised by rapid action by health authorities, who identified the virus, and made vaccine available speedily. The elderly were particularly vulnerable

1968: An outbreak first detected in Hong Kong, and caused by a strain known as H3N2, killed up to one million people globally, with those over 65 most likely to die

With Mexico being a popular tourist destination for British tourists, Britain was one of the first countries alongside the US and Canada to start seeing cases.

As the UK was affected earlier than some other countries the infection spread to a higher number of people at the start of the pandemic.

However, as the British summer progressed, cases fell, while southern hemisphere countries saw rises as they went through their winters.

More recently cases have started going up again in the UK, but other countries, such as France, also have high rates.

What should I do if I think I have it?

Anyone with flu-like symptoms who suspects they might have the swine flu virus are being advised to stay at home and contact the National Flu Service on 0800 1 513 100 or via the internet at www.direct.gov.uk/pandemicflu

The service allows sufferers to get access to anti-flu drugs without the need to consult a GP.

However, those with underlying health conditions, pregnant women and parents of children under one are still being advised to contact a doctor.

The GP route is also open to anyone who does not want to use the service.

In the initial phase of the outbreak, lab testing was done to diagnose the flu but this is no longer happening routinely.

How is it treated?

Two drugs commonly used to treat flu, Tamiflu and Relenza, are effective at treating infection, reducing the length of the illness and cutting the chances that people will have serious complications.

Use of these drugs may also make it less likely that infected people will pass the virus on to others.

However, the drugs must be administered at an early stage to be effective.

Researchers have also questioned whether the drugs are helpful in children aged between one and 12, saying the risk of side effects might outweigh any benefits.

But the Department of Health maintains a "safety-first approach" of offering antivirals to everyone remains a sensible and responsible way forward.

It said it would keep the policy under review.

Where can I get further advice?

Further information and advice on swine flu can be found at websites of leading health and research organisations around the world. The World Health Organisation gives background information on the virus.

The UK's government services website is carrying regularly updated health and travel information. The Health Protection Agency advises the public about what to do if returning from an affected area. NHS Choices outlines how swine flu is different from other flu.

The European Centre for Disease Prevention and Control is another good source of information.

The US government's Centers for Disease Control and Prevention is counting the number of cases in the US.

You can also track spread of swine flu reports using unofficial sources. Google is mapping search term data as an indicator of flu activity both across the US down to state level and in Mexico. Healthmaps maps viruses using news reports. Social media guide Mashable lists a range of ways to track the virus .

Information and links to useful websites are being shared on Twitter, the micro-blogging service, while social networking website Facebook is tracking swine flu discussion amongst users.

Further questions from our readers have been answered by a UK-based expert.

And the BBC's medical correspondent, Fergus Walsh, is filing regular entries on his blog on H1N1.

Fergus On Flu

Fergus On Flu
http://news.bbc.co.uk

Death rates and mutations

I don't want to end the week on an alarming note, and - let's face it - there's been enough alarmist reporting about H1N1 swine flu.

But I would like to draw your attention to a couple of issues which many of you are likely to pick up elsewhere on the web or perhaps in the papers.

The first is a big jump in the global death toll. The World Health Organization said the number of deaths was up around 1,000 on a week ago, reaching at least 7,826 worldwide since the H1N1 virus emerged in April. That should neither surprise nor alarm you. We are now getting into the peak flu season. Seasonal flu kills several hundred thousand very elderly and frail people each year. The difference with swine flu is that the majority of deaths are in the under-65s.

On a more positive note, the WHO said that the epidemic may have peaked in parts of the northern hemisphere. That seems to be the case in the UK and in the United States, which has had several weeks of falling levels of flu.

Secondly, I have picked up via BBC Monitoring that two patients in France, in different hospitals, have died from mutated H1N1 swine flu. (For those who don't know, the BBC monitoring service is based in Caversham in Reading; it listens to news broadcasts from around the world and provides accurate translations.)

The monitoring translation of La Chaine Info Television went like this:

French newsreader: "The health authorities dreaded this. The H1N1 virus is in the process of mutating. The phenomenon reported in Norway has also been detected in France in two deceased patients who were not related in any way and who were in hospitals in two different cities. This mutation could increase the virus's ability to affect certain airways, as well as the lungs."

Read like that, it seems pretty scary, and it is certainly not good news that mutations are occurring. But, as has been pointed out by me and by many of the wise men and women who post comments here, mutations are what we should expect with flu. Flu is an RNA virus in which genetic replication is pretty poor and which makes lots of mistakes. It's the reason that flu viruses drift and the reason we need a new flu jab every winter.

The mutations reported in France have been seen in Norway and in several other countries, and the WHO put out some very clear advice on this recently.

The French mutation has been found in two cities, but we need to know a lot more about it before becoming unduly alarmed. The patients may have been immuno-compromised, making them more susceptible to mutated viruses, and we don't have any evidence that mutated strains are spreading in the wider community.

To sum up, mutation and deaths are sadly unavoidable when it comes to H1N1 swine flu. But this pandemic is still reassuringly mild for the vast vast majority of those infected.

GPs urged to go 'full throttle' in accelerating vaccination

Around one million people in England are now estimated to have been vaccinated against swine flu.

Across the UK, 10 million doses of the vaccine have been distributed to GPs and hospitals.

That one million figure refers to those in the initial priority groups, such as those with chronic asthma, heart and other organ disease, immune problems and pregnant women.

Clearly there is still a long way to go. There are nine million people in the priority groups in England, and around 11.5 million across the UK. Then add to that the three million or more under fives who will be offered the jab after that.

Professor David Salisbury, Director of Immunisation at the Department of Health said he hoped GPs would now be able to accelerate the vaccination process:

"All GPs have now had some vaccine and we are now at the stage of re-stocking them and so the brakes can come off to some extent. We'd like to get the priority groups vaccinated before Christmas, and there will be enough vaccine to do that. GPs don't want to call in patients if they are unsure there have enough vaccine, but now they know they have it in the fridge they can go full throttle."

Professor Salisbury said he wanted doctors to get through the priority groups as quickly as possible so that they could move on to immunising children under five.

Carers for the elderly and disabled will also be entitled to receive the swine flu jab once the initial priority groups have been cleared.

I hope this answers some of the questions many of you have raised about the roll-out of the vaccine.

There are no figures yet for the uptake of vaccine among more than two million front-line health workers.

But Ian Dalton, National Director for Flu Resilience said that "informal conversations" had shown promising levels of uptake. He gave some examples:

• West Midlands Ambulance Service has offered the jab to around 1,000 front line staff and 70% have accepted.
• Guy's and St Thomas' Hospitals have received 2,000 doses and used 1,500 already.
• They have also immunised 4,000 staff against seasonal flu, double the number last year.

So how much swine flu is there in Britain at present? Estimated figures from across the UK suggest cases are falling very slightly but the number of deaths is rising sharply.

Indeed the past week has seen the biggest single rise in deaths since the pandemic began.

UK deaths to date related to H1N1 swine flu: 245
163 England
13 Northern Ireland
46 Scotland
23 Wales

Why are deaths rising if cases are falling? Firstly, remember that weekly estimates for the number of cases of swine flu are probably wildly out (but are useful for showing trends over time).

The latest weekly estimate for England was 46,000 cases of swine flu with a cumulative total of 760,000. But since the Health Protection Agency now reckons that one in five children may have had swine flu, that cumulative figure maybe just a tenth of the real total (and that's just my guess).

I've discussed this apparent contradiction about falling cases and rising death rates earlier this month - something that has been seen in other countries.

It's important to note that there is no evidence that the H1N1 swine flu virus is mutating into something more deadly.

Finally a few graphs - very useful for showing trends. My thanks to the Department of Health and the RCGP for supplying the data:

Influenza-like illness England and Wales

You can see that the rate of flu is now about average for this time of year but well below the peak we saw in July.

Hospitalised patients in England

This is a snapshot of the number of patients in hospital in England with suspected swine flu related illness as of 25 November. It's always worth showing this because it's a reminder that while flu is mild for most, for a small minority it can be very serious.

Confirmed deaths related to swine flu by week

This is the first time I've seen this. It reveals the death toll from swine flu, in England from week to week. You can see that the rate has risen throughout November.

Useful resources:

Detailed UK weekly epidemiology update
Swine flu figures for Northern Ireland
Swine flu figures for Scotland
Swine flu figures for Wales

Up to a third of children in some areas have been infected

It's been one of the big questions of this pandemic. Just how many of us in Britain have actually had swine flu?

Knowing that would be incredibly useful, as the bigger the proportion infected, the further we are into this pandemic and the less likely there will be a further sting in its tail.

The Health Protection Agency (HPA) has done blood tests of hundreds of children and parents connected to early school outbreaks.

With one school in south west England they tested around 500 people. They found that although around one in 10 children fell ill, three to five times as many got infected and developed antibodies.

After analysing this and other data relating to the number of children being seen by GPs, the HPA has now come up with these interesting estimates:

• Up to one third of children in swine flu hotspots (such as England and the West Midlands) have already been infected with the H1N1 virus.
• Across the UK up to one in five children has had had swine flu.
• About half of those who get infected show no symptoms.

This is all very reassuring. Professor Maria Zambon from the HPA said:

"We didn't get the pandemic that we planned for and you might say that we've been lobbed a soft ball. There hasn't been high case mortality, the virus is sensitive to drugs, and we've been able to make vaccine and roll it out. I am incredibly grateful that we are not dealing with a pandemic of H5 (bird flu)."

Professor Zambon said the virus had had a relatively low impact on older adults and that was probably explained by pre-existing immunity. The HPA has these estimates:

• For those aged over 50 up to four in 10 people have pre-existing protective antibodies to the H1N1 pandemic virus.
• If you are under 50 it falls to around one in 10 of the population.

The professor, who is an acknowledged world expert on flu, did utter a few words of caution. "Influenza is full of mystery and intrigue. It has lots of twists and turns" and she predicted that mutations of the swine flu virus should be expected. She also pointed out that there could still be a substantial outbreak of seasonal flu over winter.

Jump in number of global swine flu deaths

Jump in number of global swine flu deaths


Mexico City commuters on the metro
The virus was first recorded in Mexico

The global number of swine flu deaths has jumped by more than 1,000 in a week, latest figures from the World Health Organization (WHO) show.

At least 7,826 people are now known to have died following infection with the H1N1 virus since it first emerged in Mexico in April.

Europe saw an 85% increase in the week, with the total number of deaths rising from at least 350 to at least 650.

However, in most cases the virus continues to produce mild symptoms.

If every mutation is reported out there it would be like reporting changes in the weather
Keiji Fukuda
WHO special adviser on pandemic influenza

An overwhelming majority of patients usually recover, even without medical treatment, within a week.

The biggest rise in deaths was recorded in the Americas, where the death toll rose to 5,360 - a rise of 554 cases in one week.

Health authorities in Norway and France have each recorded two fatalities from a mutated strain of H1N1.

China, Japan, Norway, Ukraine and the US have also recorded cases of people being infected with a mutated strain.

Uncertainty

French health officials confirmed that two patients infected by a mutation that was also recently detected in Norway had died in two different cities in France.

SWINE FLU SYMPTOMS
Human body with internal organs
1. High temperature, tiredness and lowered immunity
2. Headache, runny nose and sneezing
3. Sore throat
4. Shortness of breath
5. Loss of appetite, vomiting and diarrhoea
6. Aching muscles, limb and joint pain
Source: NHS

"This mutation could increase the ability of the virus to affect the respiratory tracts and, in particular, the lung tissue," said a statement from the government's Health Surveillance Institute.

The French institute added that, in the case of one of the patients who died, the mutation was accompanied by another mutation known to confer resistance to the main drug being used to treat swine flu, which is sold under the brand name Tamiflu.

It was the first drug-resistant strain found in France among the 1,200 strains experts have analysed here, it said.

Speaking on Thursday, Keiji Fukuda, the WHO's special adviser on pandemic influenza, said that conclusions had still to be drawn about the reported mutations.

"The question is whether these mutations suggest that there is a fundamental change going on in viruses out there - whether there's a turn for the worse in terms of severity," he said.

"The answer right now is that we are not sure."

Dr Fukuda noted that mutations were common in influenza viruses.

"If every mutation is reported out there it would be like reporting changes in the weather," he said.

"What we're trying to do when we see reports of mutations is to identify if these mutations are leading to any kinds of changes in the clinical picture - do they cause more severe or less severe disease?

"Also we're trying to see if these viruses are increasing out there as that would suggest a change in epidemiology."

In his latest survey of swine flu developments, the WHO notes that many countries have stopped counting individual cases of swine flu, particularly of milder illness, and the case count is likely to be significantly lower than the actual number of cases that have occurred.

Cell discovery clues to body clock and beating jet lag

Cell discovery clues to body clock and beating jet lag


By Dave Lee
Health Check, BBC World Service

A man yawns
The discovery could hold the key to solving body clock mysteries

New discoveries into how the body clock works could provide clues to help combat jet lag, research suggests.

A University of Manchester team studied special cells which they say play an important role in regulating a person's body clock.

The cells had been thought to be inactive during the day - but their research found the opposite is true.

It is hoped the findings may also pave the way to combating sleep disorders triggered by body clock malfunctions.

Professor Hugh Piggins, an expert in neuroscience at the university, said the research will allow a new approach to being able to tune our daily clock.

Two cells

The Manchester research turns on its head the idea that the brain keeps the body clock on track by firing more cells during daylight and very few during the night.

There's a lot of interest in the pharmaceutical industry, obviously, to try to develop chemical treatments to reset your daily clock
Professor Hugh Piggins

"The traditional model said the clock and the brain communicated to the rest of the brain via the number of electrical impulses that the brain cells were producing," Prof Piggins told the BBC World Service's Health Check programme.

"These impulses would travel around the brain, telling it what time of day it is.

"What we've found is in fact that there are at least two types of cells in this part of the brain."

These brain cells behave unlike any other cell seen so far, and contain a key gene - per1 - which allows them to sustain unusually high levels of "excitability".

The cells becoming so "excited" that they seem quiet or even dead; but then later they calm down, recover and become normally active again.

It is this activity which tells the human body when to be awake.

Sleep dysfunction

HEALTH CHECK
Health Check
Health Check is the weekly health programme broadcast from the BBC World Service
It is broadcast on Monday at 1032GMT and repeated at 1532GMT, 2032GMT and on Tuesday at 0132GMT
It is also available as a podcast

Prof Piggins added: "There's a lot of interest in the pharmaceutical industry, obviously, to try to develop chemical treatments to reset your daily clock to help counteract things like jetlag.

"Or, perhaps more importantly, different kind of sleep disorders for which dysfunctions in this clock are often involved."

This study marks the first time these "quiet" cells have been studied.

"This may mean that elsewhere in the brain there are cells like this that can also survive these very unusual conditions."

Climate change around the world

Climate change around the world


World leaders at the G8 summit in Italy are negotiating a deal to limit the effects of climate change. Click on the buttons and words above to find out more about the impact of global warming.

AFRICA

Some regions are likely to experience water shortages. Coupled with increasing demand, this is likely to result in large increases in the number of people at risk of water scarcity. It is likely to affect livelihoods, the report by the International Panel on Climate Change says.

Projected reductions in the area suitable for growing crops, and in the length of the growing season, are likely to produce an increased risk of hunger. In some countries, yields from rain-fed agriculture could be reduced by up to 50% by 2020.

Rising sea levels threaten large cities. Degradation of coral reefs and mangroves is likely, with impacts on local fisheries and tourism.

Rising temperatures, coupled with over-fishing, will decrease the supply of fish from large lakes, with important impacts on food supplies.

ASIA

Glacier melting in the Himalayas is virtually certain to disrupt water supplies within the next 20 to 30 years. Floods and rock avalanches are virtually certain to increase. Heavily-populated coastal regions, including the deltas of rivers such as the Ganges and Mekong, are likely to be at risk of increased flooding.

Economic development is likely to be impacted by the combination of climatic change, urbanisation, and rapid economic and population growth.

Forecast changes in temperature and rainfall are likely to reduce crop yields overall, increasing the risk of hunger.

The presence of lethal diarrhoeal diseases associated with floods and droughts is expected to rise in East, South and Southeast Asia and rises in coastal water temperature could exacerbate cholera in South Asia.

AUSTRALIA AND NEW ZEALAND

Ongoing water shortages, notably in southern and eastern Australia, are likely to get worse by 2030.

Ecologically important regions such as the Great Barrier Reef and Kakadu National Park are likely to lose a significant part of their wildlife before then, by 2020.

Some coastal communities are very likely to see an increased risk of coastal storms and flooding.

Temperature rises of 1C-2C are likely to bring benefits to cooler areas, such as New Zealand, in the form of longer growing seasons and reduced energy demand. Greater warming is likely to bring a net negative impact - such as increased risk of drought and fire.

EUROPE

Nearly all European regions are expected to be negatively affected by some future impacts of climate change.

Central and Eastern European countries could face less summer rainfall, causing higher water stress. Health risks due to heat waves are expected to increase. Forest productivity is expected to fall and the frequency of peatland fires to increase.

Southern European countries are very likely to see reduced water supplies, lower crop production, more wildfires and health impacts from increased heatwaves.

Northern countries are likely to benefit from increased crop yields, forest productivity, and food supplies from the North Atlantic. By 2020, most areas of Europe are likely to see an increased flood risk.

LATIN AMERICA

Increasing temperatures and decreases in soil water in the eastern Amazon region would lead to replacement of tropical forest by savannah. Species extinctions are likely.

Drier areas are likely to see salinisation and desertification of agricultural land, with falling crop yields and livestock productivity reducing food security. However, soybean yields are likely to increase in temperate zones.

Sea level rise is very likely to bring flooding to low-lying regions such as the coast of El Salvador, Guyana and the Rio de la Plata estuary. Increasing sea temperatures are likely to impact coral reefs and south-east Pacific fish stocks.

Changes in rainfall patterns and the disappearance of glaciers are projected to significantly affect water availability for human consumption, agriculture and energy generation.

NORTH AMERICA

Warming in western mountains is very likely to reduce snowpack, bringing more floods in winter and reduced water supplies in summer.

Increases in problems with pests, diseases and forest fires are likely.

Cities with a history of heat waves are likely to experience many more, with potential health impacts, especially for the elderly.

Rising sea levels, severe weather and storm surges, combined with population growth in coastal areas, are very likely to increase economic losses.

POLAR REGIONS: ARCTIC AND ANTARCTICA

Reductions are likely in the thickness and extent of glaciers and ice sheets, and the extent of sea ice and permafrost.

The depth of summer permafrost melting is likely to increase.

Changes to natural ecosystems are likely to impact migrating birds, mammals and higher predators adversely. Specific ecosystems and habitats are expected to be vulnerable, as climatic barriers to species invasions are lowered.

There are virtually certain to be both negative and positive effects on Arctic peoples. Detrimental impacts would include those on infrastructure and traditional indigenous ways of life while beneficial effects would include reduced heating costs and more navigable northern sea routes.

SMALL ISLANDS

Sea level rise is likely to worsen floods, storm surges and coastal erosion, with impacts on the socio-economic wellbeing of island communities.

Beach erosion and coral bleaching are likely to reduce tourism.

There is strong evidence that water resources in small islands are likely to be seriously compromised.

Increased invasion by non-native species is likely.

WATER

The supply of water is very likely to increase at higher latitudes and in some wet tropics, including populous areas in east and southeast Asia. It is very likely to decrease over much of the mid-latitudes and dry tropics, which are presently water-stressed areas.

Drought-affected areas will likely increase. Instances of extreme rainfall are likely to increase in frequency and intensity, raising the risk of floods. Increases in the frequency and severity of floods and droughts will have implications on sustainable development.

Water volumes stored in glaciers and snow cover are very likely to decline, reducing summer and autumn flows in regions where more than one sixth of the world population currently live.

ECOSYSTEMS

Many ecosystems are likely to be challenged beyond their capacity to adapt over the course of the century by an unprecedented combination of climate change, associated disturbances such as wildfires, and other aspects of modern-day global change.

In the second half of this century, ecosystems on land are likely to become a net source of carbon rather than a net absorber. This extra carbon will amplify climate change.

Roughly 20-30% of species are likely to be at high risk of irreversible extinction if the global average temperature rises by 1.5-2.5C beyond 1990 levels. For increases in global average temperature exceeding 1.5-2.5C, there are very likely to be major changes in ecosystems which will adversely effect the environmental goods and services which humans use.

FOOD

Crop yields are likely to increase at higher latitudes for global average temperature increases of up to 1-3C (depending on the crop), and then decrease beyond that. This is even after allowing for effects of CO2 fertilisation.

At lower latitudes, especially the seasonally dry tropics, crop yield potential is likely to decrease for even small global temperature increases, which would increase risk of hunger.

Global agricultural production potential is likely to increase with increases in global average temperature up to about 3C, but above this it is very likely to decrease.

Increased frequency of droughts and floods would affect local production negatively, especially in subsistence sectors at low latitudes.

COASTS

Coasts are very likely to be exposed to increasing risks due to climate change and sea level rise, and the effect will be exacerbated by increasing human-induced pressures on coastal areas.

It is likely that corals will experience a major decline due to increased bleaching and mortality due to rising seawater temperatures. Salt marshes and mangroves will also be negatively affected by sea-level rise.

Many millions more people are expected to be flooded every year due to sea-level rise by the 2080s, especially in densely populated and low-lying settlements which already face other challenges such as tropical storms or local coastal subsidence. The numbers affected will be largest in the mega-deltas of Asia, but small islands face the highest relative increase in risk.

INDUSTRY

The benefits and costs of climate change for industry, settlement, and society will vary widely by location and scale. Some of the effects in temperate and polar regions will be positive, and others elsewhere will be negative. Generally, a higher degree of warming is more likely to bring negative consequences.

The most vulnerable industries, settlements and societies are those in coastal and river flood plains, those whose economies are closely linked with climate-sensitive resources, and those in areas prone to extreme weather events, especially where rapid urbanisation is occurring.

Poor communities can be especially vulnerable because they tend to be concentrated in relatively high-risk areas, have more limited coping capacities, and can be more dependent on climate-sensitive resources such as local water and food supplies. Where extreme weather events become more intense, the economic costs of those events will increase, and these increases are likely to be substantial in the areas most directly affected.

HEALTH

Projected climate change is likely to affect millions of people, particularly those with low capacity to adapt, through increases in malnutrition and consequent disorders.

This will have implications for child growth and development; increased deaths, disease and injury due to heat waves, floods, storms, fires and droughts, the altered burden of water-related diseases; the increased frequency of cardio-respiratory diseases due to higher concentrations of ground level ozone, and the movement of some infectious disease carriers into new regions. vectors.

Climate change is likely to have some mixed effects, such as the expansion and contraction of the range of malaria in different regions. In some places, climate change is likely to bring some benefits to health such as fewer deaths from cold exposure.

IPCC definitions of probability of occurrence

Virtually certain: more than 99%
Extremely likely: more than 95%
Very likely: more than 90%
Likely: more than 66%
More likely than not: more than 50%
Very unlikely: less than 10%
Extremely unlikely: less than 5%