Many patients with minor complaints are now choosing to dial 999 or head to casualty departments at hospitals because they do not understand how to make proper use of the out of hours service.

In the last five years the amount of people heading to A&E has increased by 1.35m according to a report by the Nuffield Trust, the independent health charity.  Follow-up services show that the heavy demand is costing the NHS about £330m more every year and is straining the already limited resources and hospital staff.

Doctors in emergency rooms blame the increase in the poor GP cover, stating that patients either do not believe in the care they receive from the out of hours GP cover, or simply are not sure how to reach their local service.

The new contract was a Labour introduction in 2004 and also increased the average salary of GPs up to £106,000 even though nine out of ten choose not to provide care to their patients over the weekends or in the evenings.

As a result many Primary Care Trusts were also forced to hire doctors from overseas with poor English skills leading to a large shift in public perception in the out of hours service.  The failings were exemplified in 2008 when a patient died after being treated by a German GP.

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The programme is endorsed by the World Health Organization as well as many others including the U.K. Health Protection Agency (HPA).  It is funded in part by the MTHR, and research in the U.K will be carried out by Imperial College London.

Cosmos, or the cohort study on mobile communications, will involve about 200,000 participants from the U.K., Denmark, Finland, Sweden and the Netherlands.  The study will last for 20 to 30 years, with initial reports submitted expected to be submitted in 2020.  Researchers will monitor the use of WiFi, cordless phones and baby monitors as well, in order to get the most comprehensive results.

Health professionals and organizations concerned with the safely of mobile phones over the long term say that studies undertaken to date leave too many uncertainties.  Many forms of cancer cannot be detected in the first ten years of their existence, and other problems such as headaches, depression and sleep disorders may not be correctly diagnosed as to cause.

The other concern is that previous studies have been based on the participant’s memory of how much time they spent on the (mobile) phone.  Cosmos will monitor the length of every single call, though not the numbers dialled or those of incoming calls – no invasion of privacy, just a passive background presence.

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“I get bitten loads of times at night. I get sick five times a year, I think. I do not have a mosquito net. My brother does, but I don’t.”

Many families like Nanawewje’s do not have enough mosquito nets. Their extreme poverty forces them to prioritise who will get to sleep under the net or even who gets malaria treatment if they become sick.

As World Malaria Day (26^th April) approaches, it is shocking to think that a preventable and curable disease like malaria still kills nearly 850,000 people each year – mostly children even younger than Nanawewje and mostly in sub-Saharan Africa.

Yet this year marks a significant milestone in the meeting of malaria control targets among the development community and  there has been some excellent progress in the fight against the disease. It is as a result of these interventions that the number of child deaths from malaria is estimated to have dropped from 3,000 a day to 2,000, according to the latest Roll Back Malaria Partnership (RBM) report.

“If it takes us almost 15 years to reduce child deaths from malaria from a child every 30 seconds to a child every 45 seconds, we will never beat malaria,” said Sunil Mehra, Executive Director of Malaria Consortium at a recent reception to mark World Malaria Day at the United Nations in New York.

“We’re at a critical crossroads in the fight against malaria,” he added. “There has been significant support from donors in recent years, but what really needed is sustained, long-term resources for a wide range of activities to beat this disease.”

In RBM’s report it is estimated that $6 billion will be needed in 2010 for the widespread malaria control activities. At the moment, funding amounts to one third of that requirement. This annual amount will gradually lessen, however, once control measures become embedded and sustainable.

“It is crucial that donors don’t stop their support for malaria control activities, but what is really needed is over the long term is for the national governments of those countries affected by the disease to commit resources from within their health budgets.”

Mr Mehra was co-hosting a reception with RBM at the public gallery of the UN Headquarters in New York, with guests of honour Secretary General Ban Ki-moon and HRH Princess Astrid of Belgium. Some 250 guests attended the reception, which included a special viewing of the highly successful photographic exhibition Malaria: blood, sweat, and tears by award-winning photographer Adam Nadel, which was commissioned by Malaria Consortium, the world’s leading non-profit organisation dedicated to comprehensive control of malaria.  The story of Nanawewje is just one of the featured portraits of people living with malaria on a daily basis. To view the exhibition online, please visit www.malaria-bloodsweatandtears.com.

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The committee states that there are benefits to be gained for the elderly by protecting them against the virus that leads to a painful skin ailment.  It is possible that a large scale vaccination program might be enacted by the end of 2010 if a cost-effective way to distribute it is developed.

Most of the reports about the new shingles vaccine were spurred after the JCVI (Joint Committee on Vaccination and Immunisation) made a short statement.  The responsibility of the committee is to advise the government on ways to prevent the spread of disease via vaccinations.

The short statement from the committee advised the government that the elderly should be vaccinated against shingles after reviewing a suitable amount of economic, medical, and epidemiological evidence.  After its review, it found that adults between the ages of 70 to 79 would benefit from the vaccine.

Shingles is caused by the virus herpes zoster and results in a painful sin rash.  It is usually the result of a reactivation of the same virus that causes chickenpox in children.  Thus, anyone who has suffered from chickenpox in the past is at risk for shingles although it usually occurs in those over the age of 60.

Symptoms include a rash that develops into blisters that are often quite painful and oftentimes debilitating.

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