LONDON – The number of women dying in childbirth worldwide has dropped dramatically, a British medical journal reports, adding that it was pressured to delay its findings until after U.N. meetings this week on public health funding.

A separate report by a group headed by the United Nations reached a very different conclusion on maternal mortality, saying the figure remains steady at about 500,000 deaths a year.

The disagreement reveals the politics behind public health, where progress made in tackling a health problem can jeopardize funding. Public health officials are gearing up to ask for billions of dollars this week at U.N. meetings .

The British medical journal Lancet rushed out a paper on Sunday that found the number of women who die in pregnancy or childbirth has dropped by more than 35 per cent over 28 years.

Richard Horton, editor of the Lancet, said he was disappointed when maternal health advocates pressured him to delay publishing the report until September, after several critical fundraising meetings. He also wrote a commentary in Lancet on the pressure.

“Activists perceive a lower maternal mortality figure as actually diluting their message,” he told The Associated Press on Wednesday. “Advocacy can sometimes get in the way of science.”

He did not name any group or individual who tried to pressure him.

In their paper, Christopher Murray and colleagues at the Institute for Health Metrics at the University of Washington found that maternal deaths have fallen from about 500,000 deaths in 1980 to about 343,000 in 2008. The study in the Lancet was based on more data than was previously available in addition to statistical modeling and was paid for by the Bill & Melinda Gates Foundation.

It was a surprising finding for experts who have long assumed that little progress has been made in maternal health.

But on Tuesday, another report by the Partnership for Maternal, Newborn and Child Health, a global alliance hosted by the World Health Organization, claimed progress in maternal health has “lagged.” According to their “detailed analysis,” from 350,000 to 500,000 women still die in childbirth every year. The authors did not explain where their data came from or what kind of analysis was used to obtain that wide range of figures.

In that report, U.N. officials also claimed they need $20 billion every year between 2011 and 2015 to save women and children in developing countries.

Dr. Flavia Bustreo, director of the Partnership for Maternal, Newborn and Child Health, denied there was any conflict between her group’s study and the Lancet study. She said her group was not involved in pressuring the journal not to publish Murray’s study.

“The debate on numbers may continue,” Bustreo said Wednesday. “But we welcome this as good news. There is hope at last for maternal health.”

In the world of public health, good news can paradoxically be bad news. The more people who are dying, the more money U.N. officials can raise, making some experts less keen to acknowledge that a problem is not as bad as they once thought.

The U.N. is hosting a meeting of public health experts and heads of state on maternal and child health this week in New York, followed by another one in Washington in June.

For years, U.N. AIDS officials threatened that the epidemic would spread among general populations in countries worldwide, and claimed more than 40 million people were infected. Money for projects fighting AIDS, meanwhile, grew exponentially.

When U.N. officials finally admitted they had been overestimating the numbers for years and dramatically revised their figures – down to 33 million – donors began to rethink their financial commitments.

Experts say public health figures need to be taken with a huge grain of salt, particularly when they come from people who are also soliciting funds for the campaign.

“The U.N. has a track record of inflating disease figures to keep the aid money flowing, so I’d probably place more faith in the figures which show a lower disease burden,” said Philip Stevens, of International Policy Network, a London think-tank . “This is yet more confirmation that whoever paints the most apocalyptic picture gets the most cash, even if they have to manipulate and spin the data.”

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On the Net:

www.lancet.com

www.who.int

Dozens of countries are unlikely to meet U.N. goals to significantly reduce the deaths of mothers and children by 2015 without a new approach to health care and an additional $20 billion annually, according to a study released Tuesday.

The study, conducted by the scientific-advocacy group Countdown to 2015, found progress lagged mainly in sub-Saharan Africa and South Asia where an estimated 82 per cent of maternal, newborn and child deaths take place.

The study was released on the eve of a press conference by Secretary-General Ban Ki-moon to kick off a new global initiative on reproductive, maternal and newborn health.

“This is a multi-layered problem that can be addressed with a combination of many, very simple interventions,” said Dr. Flavia Bustreo, director of The Partnership for Maternal, Newborn and Child Health, a group of more than 300 organizations, foundations, institutions and countries hosted by World Health Organization, working to achieve the U.N. goals.

What’s needed is “seamless” continuing care that includes family planning, breast feeding, hand washing, skilled attendants at delivery and childhood immunizations, Dr. Zulfiqar Bhutta of Pakistan’s Aga Khan University, who co-chairs of Countdown to 2015, said in a statement.

While countries have almost doubled their donations for maternal, newborn and child health in recent years, the study found there is a funding gap of about $20 billion per year between 2011 and 2015.

The U.N. Millennium Development Goals call for reducing the under-five mortality rate by two thirds and the maternal mortality ratio by three quarters by 2015.

According to UNICEF, 135 countries have child mortality rates of less than 40 per 1,000 live births or have a rate of reduction sufficient to meet the U.N. goal, but 39 show insufficient progress and 18 show no progress or a worsening of child mortality.

Countdown to 2015 estimated 350,000 to 500,000 women still die in childbirth every year.

If the funding gap was filled by 2015, the study found the lives of up to 1 million women, 4.5 million newborn babies and 6.5 million children aged 1 month to 5 years would be saved.

BEIJING – A top Chinese leader called for stepped-up research into vaccines and drugs for hand, foot and mouth disease after 40 children died from outbreaks last month, a state news agency said Saturday.

The Ministry of Health reported 77,756 cases of the disease in March. The number of deaths increased sharply, up from 10 in February.

“Preventing and controlling various infectious diseases such as the hand-foot-mouth disease is a key task,” Xinhua News Agency quoted Vice Premier Li Keqiang as saying.

China sees deadly outbreaks of hand, foot and mouth disease every spring and summer, particularly in rural areas where hygiene is poor. There were 353 deaths from the disease in 2009, according to Health Ministry figures.

Li called for more research into vaccines and drugs to fight the disease, plus stronger prevention and control efforts, Xinhua said. Outbreaks were reported in southern China’s Guangxi Autonomous Region as well as Guangdong, Henan, Hebei and Shandong provinces.

Currently, there is no vaccine or specific treatment for the virus, but most children recover quickly without problems.

Hand, foot and mouth disease typically strikes infants and children and is characterized by fever, mouth sores and a rash with blisters. It is spread by direct contact with nose and throat discharges, saliva, fluid from blisters, or the stool of infected people.

The virus is unrelated to the foot and mouth disease that affects livestock.

The first known conjoined twins born in the Palestinian territories made a rare journey from the impoverished Gaza Strip to a Saudi hospital aboard a plane chartered by the Saudi king.

To get there on Tuesday, the tiny, 11-day-old girls had to overcome a particularly Gazan string of obstacles: blockaded borders, squabbling governments and holiday restrictions in Israel and Egypt.

The twins, who are joined at the chest and share a small intestine, arrived safely for separation surgery in Saudi Arabia and doctors say they have a good chance to survive and lead normal lives.

Khaled al-Marghalani of the Saudi Health Ministry said the girls named Rital and Ritaj were taken to the National Guard Hospital in the capital, Riyadh.

The twins were born on March 27 in the southern Gaza town of Khan Younis. They weighed four kilograms (8.8 pounds), said Gaza doctor Ayman Abu Amouna, who treated them.

Each girl has her own heart, lungs and other organs, he said, increasing chances they’ll be able to survive apart.

TV footage of the twins in the Gaza hospital shows them sleeping face to face, each in her own diaper, one with an arm around the other’s body.

The birth sparked curiosity in Gaza, and doctors from around the territory came to see a condition they had only read about in books, said Mohammed al-Kashif of Gaza’s Health Ministry.

“This is a very rare and strange case,” he said. “The doctors have never seen anything like it.”

Al-Kashif said the girls’ birth was the first of conjoined twins on record in the Palestinian territories. A spokesman for the West Bank-based Palestinian Authority’s Health Ministry concurred.

Separating the twins requires a skilled surgeon and resources not available in Gaza.

Gaza’s hospitals have suffered under the Israeli-Egyptian blockade imposed after the Islamic militant Hamas seized control of the territory in 2007. Since then, Hamas has ruled Gaza, while the Western-backed Palestinian Authority governs only the West Bank. All attempts at reconciliation have failed.

Al-Kashif said Gaza health officials knew they lacked the resources to separate the twins, so they requested help from the Saudi Embassy in Egypt.

Saudi King Abdullah heard about the twins through the media and ordered they be brought to the kingdom for surgery, said Ahmad al-Sedairi, the Saudi ambassador to Egypt. The king has funded such surgeries in the kingdom from other parts of the world.

But these twins ran into obstacles in getting there. The girls and their father lacked passports, which must be issued by the West Bank’s Palestinian Authority.

Since Israel forbids nearly all Palestinian travel between the territories, the Saudis enlisted the West Bank Health Ministry, which made special arrangements to have the passports issued on Saturday, said health ministry spokesman Omar Nasser.

Since the family hadn’t paid their fees, the health minister himself paid the required $190, Nasser said.

Because Israel was observing the last Sabbath of the Passover holiday, the passports couldn’t be transferred across the Jewish state to Gaza until Sunday, Nasser said. The family received them, but couldn’t travel on Monday because of a separate holiday in Egypt.

Further complications arose because Egypt has minimal contact with Gaza’s Hamas government, preferring to deal with the rival Palestinian Authority.

But on Tuesday, the Saudis intervened again, and Hamas facilitated the twins’ trip to the border, which Egypt opened specially so they could cross.

Tuesday afternoon, the family boarded a special medical plane chartered by the Saudi king. In Saudi Arabia, the Kingdom’s chief surgeon and Health Minister Abdullah al-Rabia will perform the surgery, said al-Sedairi, the ambassador.

The king will pick up the bill.

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Hubbard reported from Ramallah, West Bank. Mohammed Daraghmeh in Ramallah, Ashraf Sweilam in Rafah, Egypt, and Maamoun Youssef in Cairo contributed reporting.

WASHINGTON – The U.S. Food and Drug Administration is cracking down on what are billed as fat-melting injections used in spas across the U.S., saying the drugs have not been proven safe or effective.

Lipodissolve injections, a popular nonsurgical alternative to liposuction, are used to dissolve small fat deposits around the legs, arms and belly. The FDA said Wednesday the drugs have not been cleared by federal scientists, as required by law.

The agency issued warning letters to a half-dozen spas that offer the injections, citing them for making unsubstantiated claims about lipodissolve therapy.

“The claims made for your lipodissolve products are false and misleading in that they are not supported by substantial evidence or substantial clinical experience,” states a letter to All About You Medspa in Madison, Ind.

Other spas cited by the FDA included: Pure Med Spa of Boca Raton, Fla., Monarch Med Spa of King of Prussia, Pa., and three others.

The website for Monarch Med Spa claims that, “Rather than go through the pain and discomfort associated with liposuction, patients now have the option of a series of injections with very minimal discomfort.”

Calls to Monarch Med Spa were not immediately returned Wednesday.

FDA regulators called on the spas to stop using such claims and notify the agency within 15 working days of steps they are taking to correct the violations.

“FDA is not aware of any credible scientific evidence to support these claims,” said Kathleen Anderson, an FDA deputy director, on a call with reporters.

Spas that offer the injections say they are safe and effective. But public safety advocates have called for proof and urge patients to think twice before paying thousands of dollars for an unproven procedure.

FDA said it has received reports of permanent scarring, hard lumps and dark spots on their skin after receiving the therapy.

The FDA also issued a warning to a Brazilian company that sells lipodissolve treatments on two websites: zipmed.net and mesoone.com.

Lipodissolve and similar treatments use two chemicals, phosphatidylcholine, or PC, and sodium dioxycholate, or DC. Those chemicals occur naturally in the human body, but that doesn’t necessarily make them safe, said Lenox Hill Hospital plastic surgeon Dr. Jennifer Walden.

“They are used in the metabolic process of our bodies to break down fat, but they were never intended to be extracted, mixed with other ingredients and reinjected to break down fat,” said Walden.

According to Walden, lipodissolve injections are often performed by beauty care specialists who have little or no medical training.

Other ingredients in the cocktails often include the drug Infasurf, which is used to treat respiratory problems in premature infants, according to the FDA.

Lipodissolve formulations are usually mixed at medical spas through a process called compounding, in which a pharmacist combines multiple drugs to create a new formulation, Walden said. The FDA does not regulate the practice of medicine and declined to discuss drug compounding.

“We’re not aware of where these spas are getting their drugs, therefore we cannot comment on the issue of compounding this product,” said FDA pharmacist Suda Shukla.

The FDA urged physicians who are using the drugs cosmetically to submit an approval application for regulatory review.

New research shows that light exercise during pregnancy may improve the future health of a child by controlling weight in the womb.

The New Zealand and U.S. experts claim that overweight or obese moms are more likely to have larger babies which could be at higher risk of health problems later in life. A study of 84 first-time mothers found exercise was associated with slightly lighter babies.

Dr Paul Hofman, from the University of Auckland, says, “Given that large birth size is associated with increased risk of obesity, a modest reduction in birth weight may have long-term health benefits for offspring by lowering this risk later in life.”

The rising weight of the U.K. population over the years has led to a rise in the number of overweight mothers.

(CL/WNWCCB/PAW)

How much straw should you agree to carry each day? I’m not referring to work on a farm. But recently the problems of several patients reminded me of the famous story about “The Camel and the Straw,” of the merchant who kept insisting his camel carry another straw. Finally, the last straw broke the camel’s back, and he slumped to the desert sand. The following are ways to prevent the same fate.

No. 1

Some people never learn to say “no.” But like the camel, we have only so much energy and time to accomplish daily tasks. The obedient camel never complained or tried to strike a compromise with his master. People who always say “yes” to every family, social and business request can end up like the camel. No one can solve all the burdens of the world.

No. 2

Joseph Stalin, one of the worst despots of all time, who killed millions of Russians, is hardly a role model. But he gave good advice when he remarked: “One has to learn to live with the devil until one reaches the end of the bridge.” Every week in my office I see family, emotional and work problems that a trainload of psychiatrists could not cure. There is no remedy for some people unless a demanding employer retires or dies, or an end to financial problems unless they win the lottery. And if a partner has run off with their best friend, only tincture of time will ease the pain. So play for time rather than try to solve immediately unsolvable problems.

No. 3

Learn to live with less. Alexander Hamilton, a brilliant U.S. politician and economist, remarked more than 200 years ago that the “progressive accumulation of debt is the natural disease of all governments.” Personal debt, like public debt, is also a curse, as has been demonstrated in the last couple of years. Many sleepless nights could be prevented if people realized that it is not necessary to have the latest electronic gismo, or be tricked by unscrupulous ads into believing that “play now, pay later” is the road to Minerva.

No. 4

One of the smartest businessmen I’ve known once said to me, “I have only one problem on my desk at a time.” I’ve often remembered his wise counsel when faced with multiple problems that suddenly arise. It’s much easier and more effective to tackle and solve one situation at a time than to cope blindly and ineffectively with several issues simultaneously.

No. 5

I often write a prescription for massage to prevent patients from buckling under that extra straw, caused by the stress of modern life. Massage, unlike many of the drugs that doctors prescribe to fight stress, is free of side effects. Today, many companies recognize that massage is a form of stress management to ease fatigue, headache and back strain often related to long hours at computer screens. Massage also helps to remove lactic and carbonic acid, the toxic products of metabolism. That’s why boxers and other athletes routinely get rubdowns.

No. 6

During the week find something you enjoy doing to temporarily remove your attention from the problems of everyday life. For some it may just be playing solitaire, meditation or being engaged in various forms of exercise. But whatever it is, make it a habit.

No. 7

Remember the value of sex. It’s one of the best forms of psychological and physiological relaxation. Who doesn’t sleep like a baby following “amour”? A study at Scotland’s Royal Edinburgh Hospital of 3,500 people concluded that frequent sex also slows the aging process. This report included a person of 102, so there’s always hope! But even if the Scotch are wrong you have nothing to lose, unless there’s too much “Tiger” in you. Then overindulgence will give you plenty to keep you awake and regret. So, in thinking about this I’m reminded of Aristotle’s remark: “There is a stupid corner in the brain of every wise man”. That’s when the straw breaks the back, with disastrous consequences.

TORONTO – A seriously ill child who defied death a year ago after her parents had offered her heart to another infant is on life-support in a Toronto hospital.

Kaylee Vitelli is on a respirator after experiencing severe seizures while on a walk with her mom on Tuesday evening.

A family spokesman says the family has been told to prepare for the worst.

Kaylee captured national attention last April when her parents – fearing their first-born would soon die of a rare genetic condition – offered her heart for transplant.

Against all odds, Kaylee rallied and became well enough to go home with her parents a few weeks later.

Kaylee suffers from Joubert syndrome, a malformation of the brain and brain stem accompanied by frequently interrupted breathing.

More than one million baby slings have been recalled in Canada and the U.S. after three babies died while in the slings.

Health Canada and the U.S. Consumer Product Safety Commission (CPSC) are advising people to immediately stop using the Infantino SlingRider and the Wendy Bellissimo infant sling, which are both meant for children younger than four months, because children in them could suffocate.

The CPSC says it’s aware of three reports of children dying in the slings in 2009: a five-week-old infant in Philadelphia, Pa.; a six-day-old infant in Salem, Ore.; and a three-month-old infant in Cincinnati, Ohio.

The Infantino SlingRider is a soft fabric baby carrier with a padded shoulder strap that is worn by parents and caregivers to carry an infant weighing up to 20 lbs. Infantino is printed on the plastic slider located on the strap.

Wendy Bellissimo branded sling carriers were sold exclusively at Babies ‘R’ Us and have a sewn-in label on the inside of the sling strap that says in part Wendy Bellissimo Media, Inc. and lists item numbers 3937500H7 and 3937501H7.

Infantino LLC sold the slings in Canada and the U.S. from January 2003 through March 2010 at Walmart, Burlington Coat Factory, Target, Babies ‘R’ Us, BJ’s Wholesale, various baby and children’s stores and other retailers, and on the web at Amazon.com.

People who own the slings should call Infantino at 1-866-860-1361 to receive a replacement product.

WASHINGTON – More than 1 million baby slings made by Infantino were recalled Wednesday after claims linking them to three infant deaths.

The U.S. Consumer Product Safety Commission said babies could suffocate in the soft fabric slings. The agency urged parents to immediately stop using the slings for babies under 4 months old.

The recall involves 1 million Infantino “SlingRider” and “Wendy Bellissimo” slings in the United States and 15,000 in Canada.

Infantino President Jack Vresics said the company has been working closely with the commission on its sling concerns.

“Our top priority is the safety of infants whose parents and caregivers use our products,” Vresics said in a statement. He said the company would offer a free replacement baby carrier, activity gym or shopping cart cover to any affected consumer.

The slings wrap around the chest so on-the-go parents can carry their babies or just stay close as they bond with their infants.

Earlier this month, CPSC issued a broad warning about sling-style baby carriers, saying they pose a potential suffocation risk to infants, especially babies under 4 months. Babies who had a low birth weight, were born prematurely or had breathing problems such as colds were also at risk.

At the time, the commission did not single out a specific type of sling or manufacturer. It said it had identified or was investigating at least 14 deaths in the last 20 years associated with baby slings.

In Wednesday’s announcement, CPSC said three of the deaths occurred last year and were linked to Infantino slings. It did not say exactly how the babies died.

In its general sling warning earlier this month, CPSC said infants can suffocate in two different ways:

-A sling’s fabric can press against a baby’s nose and mouth, blocking the baby’s breathing and suffocating a baby within a minute or two.

-The other scenario involves slings where the baby is cradled in a curved or “C-like” position, nestling the baby below the mother’s chest or near her belly. That curved position can cause a baby who doesn’t have strong neck control to flop its head forward, chin-to-chest, restricting the infant’s ability to breathe. “The baby will not be able to cry for help and can slowly suffocate,” warned the commission.

Slings have been promoted by baby experts as a way to calm fussy babies or for nursing moms who can breast-feed their little ones in the sling.

Consumer Reports raised concerns about slings back in 2008, and had called on CPSC to issue a recall of the Infantino SlingRider. Safety advocates criticized the curved position that the baby can fall into while inside the sling.

Baby experts and breast-feeding advocates insist that not all slings are dangerous. They say carriers that keep a newborn baby solidly against the mother’s body in an upright position are safe.

The Infantino slings being recalled were sold from 2003 through 2010 at several retailers, including Target, Babies R Us and Burlington Coat Factory. Consumers can call Infantino at 866-860-1361 to receive a free replacement product.

There are no federal safety rules for baby slings.

Infantino says it’s working with CPSC and ASTM International, an organization that sets voluntary safety standards, to develop a standard for slings.

The CPSC specializes in product safety, and often negotiates agreements with manufacturers for recalls, when necessary.

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On the Net:

Consumer Product Safety Commission: http://www.cpsc.gov

Infantino: http://www.infantino.com