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"World Health Minute" 6 June, 2017

News Highlights
Unicef Fears Yemen Cholera Outbreak Could Hit 300,000 in Coming Weeks The Yemen UNICEF regional director said he had never seen a cholera outbreak of the size it is in this country, which is already contending with the risk of famine and a collapse of the healthcare system because of the war. Half the cholera cases in Yemen are children, and parents have little recourse to help as many hospitals and clinics are closed or lack supplies
`Nearly 600 cholera deaths` in Yemen over past month An estimated 70,000 cases of cholera have been reported by UNICEF in Yemen, with nearly 600 people dying over the past month, as the disease continues to spread at an alarming rate. The UN agency said that the already dire situation for children in Yemen was quickly turning into a disaster
Indonesian tobacco bill would open tap for ads aimed at kids, health official says A proposed Indonesian tobacco law will roll back regulations to discourage smoking in a country that already has one of the highest smoking rates in the world and additionally open the floodgates to advertising aimed at teenagers, a health ministry official said. If the bill is passed companies will no longer have to put grim pictures on cigarette packs of lung cancer or other diseases linked to smoking
Lack of `safe` jobs keeping educated women from work in India A lack of safe workplaces in India and the danger of reaching them by public transport is keeping more educated women out of the labour force, hurting the economy and leaving women more vulnerable. Nearly two-thirds of Indian women with college degrees are without jobs, pushing female participation in the labour force to 27%, among the lowest in the world, from nearly 40% a decade ago, according to the World Bank
Preparedness, surveillance and response
Unicef Fears Yemen Cholera Outbreak Could Hit 300,000 in Coming Weeks
The Yemen UNICEF regional director said he had never seen a cholera outbreak of the size it is in this country, which is already contending with the risk of famine and a collapse of the healthcare system because of the war. Half the cholera cases in Yemen are children, and parents have little recourse to help as many hospitals and clinics are closed or lack supplies
`Nearly 600 cholera deaths` in Yemen over past month
An estimated 70,000 cases of cholera have been reported by UNICEF in Yemen, with nearly 600 people dying over the past month, as the disease continues to spread at an alarming rate. The UN agency said that the already dire situation for children in Yemen was quickly turning into a disaster
Sri Lanka dengue: ‘Patients are flocking into hospitals’
The Sunday Times reports that patients are flocking into hospitals and the need now is to declare a health emergency with regard to dengue. The latest data from the health ministry puts the dengue case count at 56,887, more than what was recorded during the whole of 2016, and approximately 30 dengue related deaths per 10,000 cases
TB cases up 23% in state in just one year
Despite the Karnataka state government spending large sums on preventative measures, tuberculosis has risen by 23% in the state in just one year. The percentage could even be much higher than this when the number from private hospitals are included. According to revised National Tuberculosis Control Programme figures, the number of registered patients with TB in 2016 was 60,751 up from 49, 396 a year before. Around 900 of the registered patients have been diagnosed with multi-drug resistant TB (MDR-TB)
Peru dengue update: More deaths reported through May than in all of 2016
Throughout May, Peru has reported more dengue-related fatalities (54) than reported in all of 2016 (41) or 2015 (52), according to PAHO. A total of 44,971 dengue fever cases have been seen in the country to date, compared to 26,453 cases throughout the whole of 2016
Zimbabwe reports H5N8 bird flu at poultry farm: OIE
Zimbabwe has reported an outbreak of highly pathogenic H5N8 bird flu at a commercial poultry farm in Mashonaland East province, the World Organization for Animal Health said. The virus was detected on a farm with 2m birds in Lanark and killed 7,845 animals. Another 75,155 birds were culled, the Paris-based OIE said, citing a report from the Zimbabwe’s livestock and veterinary services
Congo reports outbreaks of severe bird flu in Ituri: OIE
The DRC has reported three outbreaks of highly pathogenic H5N8 bird flu among poultry in the north eastern province of Ituri, the World Organization for Animal Health said. The virus was detected among ducks and hens in three villages near the border with Uganda, citing a report from the Congolese agriculture ministry
Bird flu outbreak in Shaanxi province kills 20,000 chickens
More than 20,000 chickens died from an outbreak of H7N9 bird flu in north west China’s Shaanxi province, a local government official said. The outbreak occurred at an egg farm run by Lvxiangyuan Ecology based in Yulin, city of more than 3m people
Ebola epidemic in Congo `under control`: health minister
The DRC has not recorded a new case of Ebola in the last 21 days, the maximum incubation period for the disease, but it is now in a state of heightened surveillance, the health minister told the media. He said the authorities have confirmed four cases, up from two previously, and three other cases are considered probable
Dengue, chikungunya menace Delhi HC summon MCD commissioners on June 21
The Delhi High Court issued notices to the Municipal Corporation of Delhi for violating court orders in relation to sanitation. The court asked the MCD Commissioners to show cause as to why contempt proceedings should not be initiated against them. The court questioned them over their zero preparation leading to clogging of drains everywhere caused by light showers. It also attacked them over the problems of garbage lying unattended in the city causing vector-borne diseases
Sri Lanka Health Ministry rejects claims of dengue medicine shortage
Acting Sri Lanka Health Ministry Services DG, Dr Sarath Amunugama has denied reports that there is a shortage of medicine for dengue patients. Rejecting the claims of the Government Medical Officers Association he said the dextran medicine needed for dengue patients has been distributed to hospitals in sufficient quantities
Days Before Confirming Three Zika Cases, WHO Moved India to Same Category as Brazil
India was moved up from the safest category 4 for possible Zika infection to category 2 level, in the World Health Organization’s country classification system for the Zika virus. This indicates WHO believes India is now “an area with ongoing transmission of Zika”
Spike in Yangon dengue cases expected
According to the Yangon Public Health Department, over 1,000 people were infected with dengue in the first five months, while 270 cases were reported in the same period last year. The Yangon region of Myanmar has seen a five-fold increase in cases
Guangdong reports 8 imported Chikungunya fever cases
A total of eight chikungunya fever cases have been reported since April in south China’s Guangdong province, according to local authorities. The eight people, all from South Asia, were found to be infected with Chikungunya virus at Guangzhou Baiyan International Airport, according to the Guangdong Entry-Exit Inspection and Quarantine Bureau
Fight against malaria begins as disease strikes two kids
The year’s first two cases of malaria have been reported in Gurugram. Both affected patients are children who have been put on radical treatment for malaria and discharged from hospital. The authorities are inspecting the areas the two cases come from and are preparing to react
Health department on toes as dengue spreads in city
Pune Municipal Corporation has recorded 114 cases of dengue from January this year, out of which 79 were reported between March and May. Even though this is not the season for the spread of mosquito-borne illnesses health authorities were clearly concerned
Dengue cases on rise in Ernakulam
The month of May has seen the maximum number of confirmed cases of dengue and leptospirosis this year. While 47 confirmed cases of dengue were reported in May, there were 17 cases of leptospirosis. In contrast, in May last year, Ernakulam registered 131 cases of dengue. Fever cases have gone up by 15,416 in May 2017. There are 18 confirmed cases of viral hepatitis, 108 cases of chicken pox and 53 cases of H1N1
Tanzania: Sixty Tanzania Medical Staff Needed to Rescue Situation in Kigoma Refugee Camp
Medecins Sans Frontieres is being supported by Tanzanian medical staff who are working alongside the charity organization to overcome the recent spike of diseases among Burundian refugees residing in the Nduta camp in the Kigoma region. Nduta camp, originally intended to shelter only 55,000 people, is overwhelmed and overcrowded, leading to a worrying health situation, experts are saying
Este ano, casos de dengue aumentaram 71% em Cuiabá
Dengue cases in Cuiaba have increased by 71% year-on-year. According to health authorities, there were 1,157 cases during the first five months of last year while there have been 1,984 cases this year. There have been reports of 200 probable cases of chikungunya and Cuiaba authorities are on high alert for more
South Korea raises bird flu alert after confirming first case since April
South Korea said it will raise its bird flu alert level to the second highest after small flocks of farm birds tested positive for the H5N8 virus, the first in the country since early April. In the wake of the discovery the ministry said it will slaughter the birds and launch an investigation into the source
Ceará tem nível epidêmico de dengue, zika e chikungunya em 60% dos municípios
The Brazilian state of Ceara has cities with more than 600 cases for every 100,000 inhabitants, way above the WHO epidemic threshold of 300 cases per 100,000 inhabitants. The latest epidemiological bulletin confirmed dengue and chikungunya as having killed 25 people this year, with 20 of them in Fortaleza. There have been 64,031 fever like infections reported in the state and 25,533 cases have seen the disease confirmed
Sesapi investiga comunidade com surto de dengue em Picos
There has been an outbreak in Picos, a municipality in the state of Piauí in north eastern Brazil. Around 70 people have fallen sick with fever and health authorities believe it is an outbreak of dengue and are investigating. Other municipalities reporting high levels of probable cases include Teresina (832), Floriano (66) and Oeiras (61) according to Sesapi’s medical bulletin
Health systems
Ban on foreign funds for non-profits may hurt India health programmes
India’s ban on foreign funding for the Public Health Foundation of India (PHFI), a non-profit group backed by the Bill & Melinda Gates Foundation, may damage some government health programmes, according to the group and a health ministry official. In a letter to the health ministry, dated May 3rd, the non-profit said many of its programmes linked to the ministry were in suspended animation and that its domestic funds would only help it run operations until June. Affected programmes included those on eliminating black fever, HIV prevention, tobacco control and universal health coverage
Nigerian government to set up vaccines joint venture with May & Baker
Nigeria’s cabinet approved a plan to set up a joint venture with pharmaceutical firm May & Baker Nigeria Plc, to produce vaccines, the health minister said, the JV will be based in Lagos, with the government holding a 49% stake and the pharmaceutical firm the rest. It will take off in 2017 and the final agreement will be signed within two weeks
Trump`s Proposed Birth Control Rollback Is a Very Scary Idea
A draft of the Trump administration’s plan to roll back the ACA’s birth control benefit, which requires insurance plans to provide contraception free of charge, has leaked to the press. The plan expands the exemption that allows religious houses to deny health insurance coverage on moral objection grounds, so if a CEO offering insurance provision as part of the work package believes women should not use birth control, they don’t have to cover it
U.S. state, local government issue lawsuits over opioids but face uphill battle
A growing number of US states, counties and cities are filing lawsuits accusing drug companies of deceptively marketing opioid painkillers to downplay their addictiveness. Some lawyers believe the number of lawsuits could snowball leading to a tobacco company style settlement, as was the case in 1998. Other experts say the approval of these products is regulated by the FDA which is the weakness of these lawsuits
Drug makers are bracing for Trump’s proposals to tackle U.S. prices
Two top pharmaceutical CEOs say they expect Trump, a frequent critic of industry pricing practices, to take steps to address high US drug costs, Novartis CEO Joe Jimenez and Allergan CEO Brent Saunders say they anticipate proposals from the Trump administration within the next few weeks to the next few months
Syria opens its first solar-powered hospital aiming to save more lives
After nine months of testing, an international coalition of medical organizations and NGOs say they are launching the first ever solar-powered hospital in Syria. If there is a complete fuel outage, the solar system can power the hospital for up to 24 hours without diesel, Beyond reducing operational costs it also creates a more resilient infrastructure
India must prepare to provide quality health care for all: Dr Nalla G Palaniswami
Economic Times Healthworld interviews Dr Nalla G Palaniswami, chair KMCH, Coimbatore, who explains why India must prepare to provide quality health care for all, pointing to the fact that 40% of the population has no money to pay for advanced treatment and facilities and healthcare must be accessible and affordable to the public
Zika cases in India reveal gaping holes in our healthcare system
A statement by the World Health Organization says that the Zika virus has been present in India since November 2016, so the Hindustan Times says the Zika case was confirmed in January 2017, yet it took until May before this news was publicly released, and this is no way to deal with serious public health emergencies where immediate remedial action is needed to control what could become serious public health outbreaks. Indian officials claim there was no responsibility to inform the WHO while the WHO says there was, both can’t be right
China donates anti-malaria medicine to South Sudan
China donated half a million boxes of anti-malaria medicine to South Sudan to help the East African nation fight the deadly parasitic disease. The donation worth 750,000 U.S. dollars, included tablets and injection doses for adults and children as well as syringes and is designed to benefit 400,000 people across South Sudan
CRM report shows poor blood services in Arunchal
The 10th Common Review Mission report of the National Health Mission expressed its concern about the availability of blood services in six Indian states, including Arunchal Pradesh, particularly at the sub-district level. The limited functioning of blood storage units, either due to a lack of trained human resources or non-linkage with a mother blood bank were significant causes
Pfizer raises US prices of 91 drugs by 20% in 2017
Pfizer hiked the prices of nearly a hundred drugs by an average of 20% so far this year in the United States, the Financial Times reported. Drug pricing has become a contentious issue as a wave of new treatments for cancer and other serious conditions reach the market, some costing tens or hundreds of thousands of dollars
Communicable diseases
Botched anti-measles campaign kills 15 children in South Sudan
At least 15 died in South Sudan in early May after health workers vaccinating them against measles used the same syringe without sterilizing it, the health minister said, about 300 children were vaccinated on May 2-5 in Nacholdokopele village in Eastern Equatoria state, another 32 recovered after falling ill with symptoms which included fever, vomiting and diarrhoea. The team that vaccinated the children in this tragic event were neither qualified no trained for the immunization campaign, the minister said
Local solutions, people-centred health systems key to ending AIDS epidemic – UN deputy chief
In its annual review of the UN Secretary-General’s report there was a call for a reinvigorated global response to HIV/Aids, according to the report, with less than four years to go to 2020, the time by which countries promised to reduce new HIV Aids infections and Aids-related deaths to fewer than 500,000 and end HIV-related stigma and discrimination, all meaningful progress on reducing new HIV infections among adults has stalled, financing for the global response has dried up and more importantly, women and girls continue to bear the brunt of the AIDS epidemic
Pilot program offering 10-minute tests for HIV
ABC News report on a South Australia pilot programme which is offering 10 minute tests for HIV. The article highlights Shine SA’s Rapido programme which now has HIV volunteers and professionals running and handing out these simple tests for people in the community to be easily tested and to know their HIV status. Trained members of the gay community administer the finger prick and provide support as the blood sample develops and can become a non-medicalised expert in whom the person can confide
Diarrhoea kills half a million children globally, shows Lancet study
Half a million children under the age of five died from diarrhoea-related illnesses in 2015, despite a significant reduction in the number of child deaths from such diseases over the past decade, the Lancet Infectious Diseases study say deaths fell by 34% between 2005 and 2015 after concerted efforts to improve water and sanitation. However, 499,000 under-fives and 1.3m people of all ages died as a result of diarrhoea in 2015, making it the fourth leading cause of mortality among young children with 8.6% of all under-fives’ deaths
India continues to record high child mortality rate due to diarrhoea
India continued to have more than 100,000 under-five diarrhoea deaths reported on account of it in 2015, a new Lancet study has found, with the highest rates of mortality for the under-fives were in sub-Saharan Africa and South Asia, with India and Nigeria combined registering 42% of the 499,000 global under five deaths due to diarrhoea in 2015
Veterans say report on anti-malaria drug mefloquine downplays side-effects
An unpublished report on an anti-malarial drug given to thousands of Australia soldiers has been criticized by a decorated war veteran for downplaying the drug’s side-effects. The drug, known also as Lariam, was given to soldiers in Bougainville and Timor-Leste more than 15 years ago as part of clinical trials comparing it to doxycycline. There have been well-documented questions about consent of those involved. Veterans have also spoken of experiencing suicidal thoughts, hallucinations and nightmares and other neurological issues
Non communicable diseases
Indonesian tobacco bill would open tap for ads aimed at kids, health official says
A proposed Indonesian tobacco law will roll back regulations to discourage smoking in a country that already has one of the highest smoking rates in the world and additionally open the floodgates to advertising aimed at teenagers, a health ministry official said. If the bill is passed companies will no longer have to put grim pictures on cigarette packs of lung cancer or other diseases linked to smoking
Cigarette taxes touted by WHO as one of the best ways to cut smoking
Tobacco taxes are one of the most effective ways to cut smoking rates, and one that countries are failing to take full advantage of, WHO said, adding, more than 7.2m people die from tobacco related diseases each year, with 80% of them living in low and middle income countries. Imposing an 80% price increase per pack globally could generate an additional $141bn, which would offset to some small degree some of the costs incurred treating people with smoking-related diseases each year
Small Steps Can Save Millions of Lives
Michael Bloomberg makes the case for far more investment in healthcare and time in policy making to be directed at non-communicable diseases which make up 67% of all deaths, yet only received 1% of healthcare spending. One reason for the lack of attention is people blame a victims’ personal negligence or genetics, but that does not mean the outcome is inevitable. Bloomberg suggests ‘measure scale of the problem,’ ‘obesity prevention,’ ‘ tobacco control’ and ‘road safety’ as being areas which his new Partnership for Healthy Cities hopes to start to tackle
China struggles to kick world-leading cigarette habit
An estimated 316m people in China, almost a quarter of the population, smoke and concerns are growing about the long-term effects on public health and the economy because a decade long study says 59% of all smokers have no plans to quit. Despite major cities moving to ban public smoking, there has only been a modest cigarette tax increase back in 2015. Rising prosperity makes cigarettes more affordable so low taxes reinforce this and more smoke. There is a sense that China is falling behind due to lobbying by its state-owned tobacco monopoly who wants to postpone efforts to toughen tobacco policies
Healthy arteries rare but not impossible for elderly
Some people who avoid risk factors for heart disease like obesity and diabetes may be able to maintain the blood vessels of a healthy 29 year old well into old age, a US study suggests, researchers examined 3,196 adults aged 50 or older to see how their odds of vascular aging was influenced by the seven risk factors for heart disease. Those who avoided at least six of these problems were 10 times more likely to have properly functioning blood vessels than their peers who managed no more than one of these risk factors
Funding the fight against disease
The FT’s Andrew Jack and Darren Dodd report on the World Health Assembly and highlight the rising concern about non-communicable diseases, a growing burden on governments in poorer as well as richer countries, so they point to a resolution on dementia and that fewer than 30 countries even have a dementia plan to respond. They also highlight WHO’s resources, with its budget up 3% on the previous year and the dependence on 22% from the U.S., adding that Mr Tedros needs to refocus the agency and bring in the pledged funding to justify his salary
Obesity costs Asia-Pacific $166 billion annually
A study by the Asian Development Bank Institute suggests that obesity costs about 12% of total healthcare spending in the region per year. So the study concludes that obesity is a serious threat to the prosperity of the region and demands more policymaker attention or the problems will only get worse
Kenya launches guidelines to reduce tobacco use
In Kenya recent surveys estimate that there are two and a half million adult tobacco users, which translates to over 13% of the population, and 14% of the population are exposed to second hand smoke at home so these new guidelines provide up-to-date measures for the entire healthcare system to promote the alleviation of tobacco use through offering dependence treatment and cessation services
Tiny blood vessel damage tied to depression among older adults
Damage to the microvascular system, often caused by high blood pressure or diabetes and made worse by smoking is tied to an increased risk of depression among people aged 40 years and older, researchers have found. Depending on how microvascular dysfunction was measured in the various studies, it increased the risk of depression by up to 58%, according to a report in JAMA Psychiatry. The theory is that blood vessel damage disrupts communication in areas of the brain important for mood control
Cancer Taught Me To Love Sunsets
Jheric Delos Angeles, founder of the Lymphoma Philippines Foundation, writes about his experience as a twice diagnosed cancer sufferer in a developing world country who had to raise cash for his treatment and learnt how the technology for treatment is not there in some far flung places. Now he is fighting to help create better access to healthcare for fellow cancer sufferers through his foundation
Grail passes early test in quest to find cancer in blood
An early stage trial of an ultra-sensitive ‘liquid biopsy’ that scans blood samples for traces of cancer DNA showed it was able to pick up at least one cancer mutation in most of the patients with advanced cancers that were studied. The findings show the new test by Grail, a spin-off from the gene sequencing company Illumina, can spot bits of cancer DNA in the blood of patients already known to have cancer
16 pc tobacco-related deaths taking place in India: Survey
A new global study into deaths from 55m deaths per year linked to smoking says that 9m tobacco-related deaths each year occur in India and the number is set to rise higher in the next decade. This number reflects a higher mortality rate than from other diseases such as TB, HIV/Aids and malaria combined
Study counters claims that alcohol consumption may provide health benefit
A new analysis of 45 studies and nearly 3m people on the potential protective effects of moderate drinking on the heart has exposed flaws in the research design. For example, when non-drinkers are compared with moderate drinkers, the moderate drinkers have reduced risk of heart disease. But many of these studies failed to account for non-drinkers who stopped because of alcohol-related health problems (75% of the studies). Former drinkers should not be included in the abstainer reference group because it artificially supresses the heart disease risks
Promoting health through the life course
Breastfeeding linked to lower endometrial cancer risk
Women who breastfeed their babies for the recommended six months may also be lowering their own risk of developing endometrial cancer, a new study suggests. In the analysis of data from 17 past studies, researchers found that women who had breastfed for the established period were less likely to be diagnosed with endometrial cancer
Online access to abortion pill may be safe alternative to clinics
A study into 1,000 women who used an online telemedicine service to get drugs for medical abortions in the Republic of Ireland and Northern Ireland suggests women can safely use telemedicine to consult with a doctor and get drugs to terminate their pregnancy without surgery. About 85% of the women reported successfully terminating their pregnancies without surgical intervention using medication they received in the mail after providing their medical details and consulting with a trained helpdesk team on how to use the drug. No deaths were reported and less than 3% of the women had complications that required treatment like antibiotics or blood transfusions
One in five twins dies under age 5 in sub-Saharan Africa - Lancet
One in five twins born in sub-Saharan Africa die before turning age 5, even as infant mortality has dropped for lone babies in the region, scientists say in a new study, this new research report indicated that mortality rate was 213 per 1,000 pregnancies, compared to 11 per 1,000 in Finland as an example. The gravity of these findings calls for policy action, the researchers said
Trans, gender non-conforming people report poorer health
People who identify as transgender or gender nonconforming may have higher than average rates of poor or fair health, a new study suggests. For this report researchers used data collected in 2014 and 2015 looking at responses from 315,893 people including 1,443 who identified as transgender or nonconforming gender. About 23% of the transgender group reported poor or fair health, compared to 17% in the non-gender minority group. The gender minority group were also likely to be low income, unemployed, uninsured for health, overweight or have unmet medical needs or to report depression
Big tobacco leaves huge ecological footprint - WHO
Tobacco growing causes massive harm to the environment through extensive use of chemicals, energy and water, and pollution from manufacturing and distribution, WHO said. The United Nations agency called for the tobacco industry to compensate for its products that contribute to greenhouse gases blamed for climate change, but gave no estimate of damage. The ecological footprint goes far beyond the effects of cigarette smoke, WHO said in its first report on tobacco’s impact on the environment. “From start to finish, the tobacco life cycle is an overwhelmingly polluting and damaging process”
Climate change will ruin Hawaii, new study finds
A new report into the impact of climate change on Hawaii has some worrying findings: rising temperatures will lead to a surge in heat related diseases (dengue, cholera), warm oceans will lead to coral bleaching, rainfall will decline more and more leading to lower aquifers with implications for agriculture, wildlife and water access, warming air will pave the way for invasive species to thrive and shorelines will retreat
Cost of childbirth at private hospitals in Tamil Nadu 70% more than national average
Tamil Nadu may boast of high maternal and child health indices, but that comes at a hefty price tag. Expectant mothers head to private hospitals for better treatment but pay 13 times more than what they would at government hospitals, a new study has found. The cost of childbirth at private facilities is 70% higher than the national average, according to a new study
Exclusive: Pupils risking their lives as mental health services collapse
The Times Educational Supplement relates the story that some British youngsters are so desperate for mental health support in a system which has almost totally collapsed, that they are going through the motions of suicide to qualify for help
Child brides are on the rise in India`s towns and cities - report
An increasing number of underage girls in India’s towns and cities are being married off, a study has revealed, challenging long-held assumptions that child marriage in the country is largely a rural phenomenon. Child marriage is illegal in India, but it is deeply rooted and accepted in society and is widespread in some parts of the country. Data from the 2011 census shows more than 5m girls were married before the legal age of 18. Yet while the number of underage brides declined by 0.3% in rural areas, they have increased by 0.7% in urban parts, according to the National Commission for the Protection of Child Rights and the charity Young Lives
Lack of `safe` jobs keeping educated women from work in India
A lack of safe workplaces in India and the danger of reaching them by public transport is keeping more educated women out of the labour force, hurting the economy and leaving women more vulnerable. Nearly two-thirds of Indian women with college degrees are without jobs, pushing female participation in the labour force to 27%, among the lowest in the world, from nearly 40% a decade ago, according to the World Bank
Big data maps India`s human traffic hot spots
An Indian charity (My Choices Foundation) is using big data to pinpoint human trafficking hot spots in a bid to prevent vulnerable women and girls vanishing from high-risk villages into the sex trade. Specifically designed technology identifies villages that are most at risk of modern slavery, then launches local campaigns to sound the alarm