The Global Tuberculosis Report 2013, published today by the World Health Organization (WHO), confirms that the world is on track to meet the Millennium Development Goals (MDGs) target of reversing TB incidence, along with the target of a 50 per cent reduction in the mortality rate by 2015 (compared to 1990).

The report also underlines the need for a “quantum leap” in TB care and control which can only be achieved if two major challenges are addressed, WHO stated in a news release.

First, there are around three million people – equal to one in three people falling ill with TB – who are currently being ‘missed’ by health systems. WHO estimates that 75 per cent of the three million are in 12 countries.

Also, the response to test and treat all those affected by multidrug-resistant TB (MDR-TB) is inadequate. Not only are the links in the MDR-TB chain weak, the links are simply not there yet, according to the report. WHO estimates that 450,000 people fell ill with MDR-TB in 2012 alone. China, India and Russia have the highest burden of MDR-TB followed by 24 other countries.

At the heart of both challenges, said WHO, is insufficient resources for TB.“Quality TB care for millions worldwide has driven down TB deaths,” said Mario Raviglione, WHO Director of the Global TB Programme. “But far too many people are still missing out on such care and are suffering as a result. They are not diagnosed, or not treated, or information on the quality of care they receive is unknown.”

While the number of people detected worldwide with rapid diagnostic tests increased by more than 40 per cent to 94,000 in 2012, three out of four MDR-TB cases still remain without a diagnosis.

Even more worrying, WHO pointed out, is that around 16,000 MDR-TB cases reported to the agency in 2012 were not put on treatment, with long waiting lists increasingly becoming a problem. Also, many countries are not achieving high cure rates due to a lack of service capacity and human resource shortages.

“The unmet demand for a full-scale and quality response to multidrug-resistant tuberculosis is a real public health crisis,” Dr. Raviglione stated. “It is unacceptable that increased access to diagnosis is not being matched by increased access to MDR-TB care.

“We have patients diagnosed but not enough drug supplies or trained people to treat them. The alert on antimicrobial resistance has been sounded; now is the time to act to halt drug-resistant TB.”

Another challenge, according to the report, relates to the TB and HIV ‘co-epidemic’. While there has been significant progress in the last decade in scaling-up antiretroviral treatment for TB patients living with HIV, less than 60 per cent were receiving antiretroviral drugs in 2012.

The report recommends five priority actions that could make a rapid difference between now and 2015. These include reaching the three million TB cases missed in national notification systems by expanding access to quality testing and care services across all relevant public, private or community based providers, including hospitals and non-governmental organizations which serve large proportions of populations at risk.

Other priorities include addressing with urgency the MDR-TB crisis; intensifying and building on TB-HIV successes to get as close as possible to full antiretroviral therapy (ART) coverage for people co-infected with TB and HIV; increasing domestic and international financing to close the resource gaps – now estimated at about $2 billion per year – for an effective response to TB in low- and middle-income countries; and accelerating rapid uptake of new tools.

“The WHO Global TB report highlights the very big gains the global community has made in the fight against tuberculosis,” said Osamu Kunii, Head of the Strategy, Investment and Impact Division of the Global Fund to Fight AIDS, Tuberculosis and Malaria.

“We are now at a crucial moment where we cannot afford to let these gains go into reverse. We need the commitment of the international community to address the significant funding gap to fight this disease.”

“Lead poisoning remains one of the most important environmental health concerns for children globally, and lead paint is a major flashpoint for children’s potential lead poisoning,” said the World Health Organization’s (WHO) Director for Public Health and Environment, Maria Neira.

“The good news is that exposure to lead paint can be entirely stopped through a range of measures to restrict the production and use of lead paint.”

On the occasion of International Lead Poisoning Prevention Week of Action, WHO chose to highlight the role that governments play in protecting the health of workers, children and women of reproductive age through the adoption of procedures to eliminate the use of lead decorative paints and the provision information to the public on renovation of homes where lead paint may have already been applied.

The Week of Action runs from 20-26 October 2013. This year’s theme – Lead-Free Kids for a Healthy Future – underscores the importance of avoiding the use of lead paint and using safe alternatives in order to prevent children coming to harm from lead poisoning.

Lead paint may be found in the home, on toys, furniture and on other objects. Decaying lead paint on walls, furniture and other interior surfaces creates lead-contaminated dust in the home that young children easily ingest. Mouthing lead-painted toys and other objects also exposes young children to lead. The sweet taste of lead paint means that some children even pick off and swallow small chips of paint.

WHO estimates that 143,000 deaths per year result from lead poisoning, with lead paint is a major contributor. Exposure also contributes to 600,000 new cases of children with intellectual disabilities every year, and the vast majority – 99 per cent – of children affected by high exposure to lead live in low- and middle-income countries.

Exposure to lead creates health problems for many years into the future. Even in countries that have banned leaded paint decades previously, such paint continues to be a source of exposure until it is finally stripped and replaced. The cost of replacing lead paint means that people living in older, poorly-maintained housing are particularly at risk, and this disproportionately affects economically-deprived communities.

“Paints with extremely high levels of lead are still available in most of the developing countries where paint testing has been conducted as part of the efforts of the Global Alliance to Eliminate Lead Paint,” said David Piper, the Deputy Director of the UN Environment Programme Division of Technology, Industry and Economics (UNEP DTIE) Chemicals Branch. “In most of the countries with lead paint, equivalent paint with no added lead is also available, suggesting that alternatives to lead are readily available to manufacturers.”

Worldwide, 30 countries have already phased out the use of lead paint. The Global Alliance to Eliminate Lead Paint, co-led by WHO and UNEP, has set a target of 70 countries by 2015.

At high levels of exposure, lead damages the brain and central nervous system to cause coma, convulsions and even death. Children who survive such poisoning are often left with intellectual impairment and behavioural disorders.

At lower levels of exposure, lead affects brain development in children, resulting in reduced IQ, behavioural changes such as shortening of attention span and increased antisocial behaviour, and reduced educational attainment. These effects are believed to be irreversible. Adults are at increased risk of kidney disease and raised blood pressure.

Prior to the crisis in Syria, more than 90% of medicines were locally produced.

Since then, the effects of economic sanctions, currency fluctuations, difficulty in the availability of hard currency and an increase in operational costs have negatively affected the production of medicines and pharmaceutical products.

The escalation of clashes has resulted in substantial damages to the pharmaceutical plants located in Rural Aleppo and Rural Damascus, where 90% of the country’s plants are based.

Many of the plants have reportedly been destroyed or are closed because the workers cannot access their work place.

As a result, local production of medicines has been reduced by 90%.

Additionally, the main government storage for imported medicines, which included most of the required needs for the first quarter of 2013, has been destroyed.

Assessments by  WHO indicate that insulin, oxygen, anesthetics, serums and intravenous fluids are no longer available inside Syria to meet needs, with health facilities and local pharmacies increasingly unable to provide medicines, particularly those for the continuous treatment of chronic diseases.

Until recently, WHO had been unable to assess the extent of damage to public health due to the lack of a reference pharmaceutical list assessed and validated by experts on the basis of WHO’s Essential Drug List.

To overcome this obstacle, health experts from Syria and pharmaceutical experts and health professionals from WHO and Jordan met in Amman to address critical shortages in medicines and medical supplies inside Syria, resulting in an updated Essential Medicines List for the entire country.

Reflecting disease profiles, current gaps and critical needs, the list is an essential tool for enhancing the effectiveness of the international community’s emergency health response by enabling projection and quantification of essential medicine requirements and the development of standard procurement procedures.

WHO has evaluated the needs for the next 12 months in terms of essential medicines, medical supplies, medical consumables and anti-cancer medicines and estimated that these will require a minimum of US$900 million.

A list of the most urgently-needed and life-saving items has also been developed, containing 168 items (92 urgently needed essential medicines, 33 cancer medicines and 43 consumables) and estimated to require US$ 467 million for 2013.

WHO calls on the international community for urgent support to cover these critical gaps in essential medicines inside Syria.

The largest number of cases and suspected cases, almost 70 per cent, is in the Yusuf Batil camp in Upper Nile state which holds 37,229 refugees, according to the Office of the UN High Commissioner for Refugees (UNHCR).

Other camps in Upper Nile state – Jamam, Gendrassa and Doro – have recorded nearly 2,000 cases and 30 deaths. Further west, in Unity state, 125 cases or suspected cases and four deaths have been recorded at the Yida site, which, with a population of 65,541 people, holds the largest number of refugees in South Sudan.

“The majority of refugees in camps where the disease is most widespread are from Blue Nile state, an isolated rural area in Sudan where there are few established toilet facilities and uncontaminated water is not readily available,” said UNHCR spokesperson Adrian Edwards.

“UNHCR believes the growth in the population due to the refugee influx from Blue Nile could be one of the factors in the rapid spread of the disease,” he told reporters in Geneva.

The risk of being infected with Hepatitis E – for which there is no treatment or vaccine approved by the World Health Organization (WHO) – can be dramatically reduced by washing hands with soap, especially after using the toilet, drinking clean water, using latrines, and avoiding eating uncooked fruits and vegetables. Hepatitis E is a virus that damages the liver, and is transmitted by consuming contaminated food or water.

UNHCR said emergency measures are being taken to curb the increase, with about 70 per cent of the 701 latrines under construction in Yusuf Batil completed and the remainder expected to be operating by this weekend. In the Doro Camp region, 65 per cent of the 323 latrines being built in the most affected areas around the Jumjum and Ingasana villages have been completed so far. Soap distributions are also being carried out, in addition to enhanced disease surveillance and water chlorination.

There are currently 112,981 Sudanese refugees in South Sudan’s Upper Nile and Unity states, according to UNHCR.

Between 2000 and 2011, measles deaths dropped from 542,000 to 158,000 globally, representing a 71 per cent decrease. New cases also dropped during the same period by 58 per cent, according to new data released by the UN World Health Organization (WHO).

However, the agency warned that despite global progress, some populations remain unprotected, with an estimated 20 million children lacking vaccinations. More than half of them are concentrated in five countries: the Democratic Republic of the Congo (DRC), Ethiopia, India, Nigeria and Pakistan. India has the largest number of unvaccinated children – 6.7 million – followed by Nigeria and Ethiopia with 1.7 million and 1 million, respectively.

In 2011, outbreaks of the disease were reported in all five countries, as well as France, Italy and Spain. Most of these countries are in WHO regions which have committed to eliminate measles by 2015 or 2020.

Measles is a highly infectious disease that occurs through the spread of nasal and oral fluids and causes complications and deaths, even in previously healthy individuals. It is one of the leading causes of death among young children even though a safe vaccine is available.

“The measles outbreaks pose a serious challenge to the regional elimination efforts and signal where national health systems and routine immunization programmes need strengthening,” WHO stated in a news release. “Resuming progress in reducing measles cases and deaths means strengthening health systems so that they can provide effective immunization services and laboratory-supported surveillance for vaccine-preventable diseases to all children.”

The new data, published in WHO’s Weekly Epidemiological Record, shows overall progress in reducing deaths is linked largely to increased vaccination coverage. Two doses of measles vaccine are recommended by WHO since about 15 per cent of vaccinated children fail to develop immunity from the first dose.

The UN health agency noted that the outbreaks indicate the need to ensure that parents are fully aware of the benefits of immunization and the risks associated with not vaccinating children.

Since 2000, with support from the Measles & Rubella Initiative, more than one billion children have been reached through mass vaccination campaigns ? about 225 million of them in 2011.

Launched in 2001, the Measles & Rubella Initiative is a partnership — led by the American Red Cross, the UN Foundation, the US Centers for Disease Control and Prevention, the UN Children’s Fund (UNICEF) and WHO — committed to reducing measles deaths worldwide.

In April, the partners of the Initiative introduced a new global plan to jointly tackle measles and rubella using the same strategy and a combined vaccine. The new Measles & Rubella Initiative aims to reduce measles deaths worldwide by 95 per cent between by 2015 and to eliminate measles and rubella in at least five of six WHO regions by 2020.

Uruguayan President José Mujica has signed into law a bill that waives criminal penalties for abortion in the first 12 weeks of gestation, with certain procedural requirements, and in the first 14 weeks of gestation in the cases of rape.

Mujica had promised he would sign the bill passed by the Senate to waive penalties for abortion with few restrictions in December 2011. However, it took until September 2012 for the bill to pass through the Chamber of Deputies, the lower house of Uruguay’s legislature. The lower house made significant changes to the Senate bill, adding procedural requirements that must be met for women to access abortions. The bill passed by a margin of just one vote. In October, Uruguay’s senate ratified the Chamber of Deputies’ version of the bill, clearing the way for the president’s signature. The final version retains abortion as a crime under the criminal code, but waives penalties.

Latin American countries have some of the most restrictive abortion policies in the world. Several countries, such as Chile, El Salvador, and Nicaragua have absolute bans on abortion with no exceptions whatsoever. These highly restrictive laws fuel clandestine abortions, putting women’s lives at risk. The United Nation’s World Health Organization estimates that 13 percent of maternal deaths in the region are from unsafe abortion.

“This bill is an important step forward to prevent the life-threatening risks of clandestine abortion,” said Amanda Klasing, women’s rights researcher at Human Rights Watch.

The law requires women seeking abortions to inform a doctor of the circumstances of the conception and the economic, social, or family hardships which would prevent her from continuing the pregnancy. The same or next day, the doctor is required to consult an interdisciplinary team of at least three professionals, including at least one gynaecologist, one mental health professional, and one specialist in social support. The interdisciplinary team must meet with the woman to inform her about the law, the process of abortion, and any inherent risks of the procedure.

After the woman meets with the team, the law requires a five-day reflection period before she can reassert her choice to continue with the abortion. Upon her informed consent, a doctor can perform the procedure.

Nevertheless, the United Nations Special Rapporteur on the Right to Health has found that legal restrictions can make legal abortions impossible. Examples of abortion restrictions that the Rapporteur criticized in a 2011 report include: “requirements of counselling and mandatory waiting periods for women seeking to terminate a pregnancy” and “requirements that abortions be approved by more than one health-care provider.”

Every year, worldwide, about 42 million women with unintended pregnancies choose abortion, and nearly half of these procedures, 20 million, are unsafe. Some 68,000 women die of unsafe abortion annually, making it one of the leading causes of maternal mortality (13%). Of the women who survive unsafe abortion, 5 million will suffer long-term health complications.

Uruguay’s Ministry of Public Health is now charged with developing regulations to implement the law. There is hope these regulations will ensure that any woman who seeks an abortion within the legal time frame is not denied the procedure; otherwise, desperate women facing the financial burdens and social stigma of unintended pregnancy, will continue to risk their lives by undergoing unsafe abortions.

“Having taken this positive step, Uruguay should now ensure that in practice women seeking this essential medical service can do so without arbitrary interference,” Klasing said.

According to the World Health Organization (WHO), every 8 minutes a woman in a developing nation will die of complications arising from an unsafe abortion; maybe it is time this reality to be something relegated in the past for Uruguay.

“The recent escalation of clashes had resulted in substantial damages to the pharmaceutical plants located in rural Aleppo, Homs and Rural Damascus, where 90 per cent of the country’s plants were located,” a WHO spokesperson, Tarik Jasarevic, told reporters in Geneva today. “Many of these plants had now closed down, thus resulting in a critical shortage of medicines.”

Prior to the violence which has wracked the Middle Eastern country, Syria produced 90 per cent of its medicines and drugs locally.

However, this production has slowed down due to insecurity, the decreased availability of raw materials, sanctions and increased fuel costs stemming from the violence that has killed an estimated 17,000 people, mostly civilians, since the uprising against President Bashar al-Assad began some 17 months ago.

Over recent days, there have been reports of an escalation in violence in many towns and villages, as well as the country’s two biggest cities, Damascus and Aleppo, with the latter reportedly the centre of intense combat between Government and opposition forces, involving both aerial bombardments and heavy weaponry.

Among the most urgently needed medicines are drugs to treat tuberculosis, hepatitis, hypertension, diabetes and cancer, as well as haemodialysis for kidney diseases, according to WHO. Chemical reagents for blood screening tests are also urgently needed to ensure the safety and quality of blood used in surgical and trauma cases.

“The health sector had been heavily affected in conflict areas as hospitals and health centres had been closed, damaged or controlled by parties to the conflict,” Jasarevic said. “Public health facilities were often inaccessible due to ongoing violence and lack of public transportation.”

The spokesperson added that the main challenge faced by WHO staff remained unhindered access to those in need. The health agency has been working with Syria’s Ministry of Health, the Syrian Arab Red Crescent and partners since the beginning of the conflict to address the health needs of crisis-affected populations.

“This [includes] the provision of ambulances, the refurbishing and equipping of mobile health clinics, and providing medicines and medical supplies for 700,000 people,” Jasarevic said, noting that the Ministry of Health had reported having lost 200 ambulances over the last few weeks.

To ensure access to essential health services – including life-saving medical and surgical services in directly and indirectly affected areas – WHO and its health sector partners are supporting trauma management at primary health care centres and hospitals.

This includes providing support to mobile medical clinics and outreach services, as well as supporting the procurement and provision of hygiene kits, medicines, medical equipment and supplies, among other things.

Addressing reporters at the same media encounter in Geneva, a spokesperson for the UN World Food Programme (WFP), Elisabeth Byrs, said that the food relief agency has sent assistance for distribution to 28,000 people in Aleppo over the next few days to address food shortages there.

Since the intensification of clashes in Aleppo in July, WFP has reached close to 46,000 people in the city with urgent food assistance. Overall, during the month of July, WFP’s food assistance reached 541,575 people in most of Syria’s governorates – the agency had aimed to reach 850,000 people, but was prevented from doing so by the violence.

“Following the recent escalation in Damascus on 18 July, it has become extremely difficult to secure trucks for deliveries and labour for packaging,” Byrs said. “Nevertheless, since that date, WFP has managed to dispatch food to close to 228,000 beneficiaries to Aleppo, Damascus, Rural Damascus, Deir Ezzor, Idlib, Quneitra and Tartous, amid increased challenges.”

In line with the target established by the Syrian Humanitarian Assistance Response Plan and following a request from the Syrian Arab Red Crescent, WFP aims to reach 850,000 people inside Syria in August.

According to the UN Office for the Coordination of Humanitarian Affairs (OCHA), the Syrian Humanitarian Assistance Response Plan seeks $180 million to cover humanitarian relief activities in Syria. So far, it has received $69 million, or just over 38 per cent of the amount sought.

Findings from the review, published in the medical journal The Lancet, indicate that children with disabilities are 3.7 times more likely those without disabilities to be victims of any sort of violence. They are also 3.6 times more likely to be victims of physical violence, and 2.9 times more likely to be victims of sexual violence.

Children with disability associated with mental illness or intellectual impairments appear to be among the most vulnerable, with 4.6 times the risk of sexual violence compared with their peers who do not have disabilities.

“The results of this review prove that children with disabilities are disproportionately vulnerable to violence, and their needs have been neglected for far too long,” noted the Director of WHO’s Department of Violence and Injury Prevention and Disability, Etienne Krug, in a news release on the review.

“We know that specific strategies exist to prevent violence and mitigate its consequences. We now need to determine if these also work for children with disabilities. An agenda needs to be set for action,” added Dr. Krug.

Some of the factors which place children with disabilities at higher risk of violence include stigma, discrimination, and ignorance about disability, as well as a lack of social support for those who care for them.

Placing children with disabilities in institutions also increases their vulnerability to violence, according to the review, which provides the strongest available evidence on violence against children with disabilities.

The 17 studies included in the review reflect data from 18,374 children with disabilities from high-income countries – Finland, France, Israel, Spain, Sweden, the United Kingdom, and the United States – underscoring the urgent need for high-quality research in low-income and middle-income countries.

“The impact of a child’s disability on their quality of life is very much dependent on the way other individuals treat them,” stressed Mark Bellis, Director of the Centre for Public Health at Liverpool John Moores University, a WHO Collaborating Centre for Violence Prevention, and lead researcher on the review. “It is the duty of government and civil society to ensure that such victimization is exposed and prevented,” he added.

Certain nurse home visiting programmes for children at risk of violence and training to improve parenting skills have been shown to work to prevent violence against non-disabled children. These and other measures outlined in WHO’s Preventing child maltreatment and Violence prevention: the evidence should be implemented for children with disabilities, and their effectiveness evaluated, stated the news release.

The UN Convention on the Rights of Persons with Disabilities, which seeks to ensure that persons with disabilities enjoy the same human rights as everyone else, stipulates that children with disabilities should be protected against all forms of discrimination, and that they should have access to education, health services and protection from violence.

Other measures adopted by the Codex Alimentarius Commission – jointly run by WHO and the UN Food and Agriculture Organization (FAO) – include new food safety standards on seafood, melons, dried figs and food labelling, WHO added in a news release.

The Commission sets international food safety and quality standards to promote safer and more nutritious food for consumers worldwide, with Codex standards serving, in many cases, as a basis for national legislation, and providing food safety benchmarks for international food trade.

The 49-year-old body is meeting in Rome, Italy, this week with more than 600 delegates in attendance, representing 184 countries plus the European Union.

According to WHO, melamine can be lethal at high concentrations and has been used illegally to increase apparent protein content in food products, including infant formula and milk powder. Milk tainted with melamine has caused death and illness in infants.

Two years ago, the Commission adopted a maximum melamine level of one milligram (mg) per kilogramme (kg) and 2.5 mg/kg in other foods and animal feed. The Commission has now set a maximum limit of 0.15 mg/kg for melamine in liquid infant milk.

Melamine is used to make dishware and kitchenware, among other industrial applications, WHO said. It added that the new limit will help governments protect consumers by determining if detected levels of melamine result from unavoidable melamine contamination that does not cause health problems or from deliberate adulteration.

In regard to aflatoxins, a group of mycotoxins produced by molds, which are toxic and known to be carcinogenic, the Commission agreed on a safe maximum limit of 10 micrograms/kg for dried figs, together with details on how test sampling should be conducted. The toxic substances can be found in a variety of products such as dried fruits, nuts, spices and cereals at high levels if the produce is not stored properly, WHO said.

The Commission recommended that pre-cut melons should be wrapped or packaged and refrigerated as soon as possible and distributed at temperatures of 40 degrees Celsius or less. Cooling and cold-storing was recommended as soon as possible after harvest, while knife blades used for cutting or peeling should be disinfected on a regular basis.

The Commission’s action in his regard was due to an emerging public health issue related to the increased popularity of pre-cut melon slices. “Exposed pulp of the fruit can become a breeding ground for bacteria. This has been linked to life-threatening salmonella and listeria outbreaks, WHO said in the news release.

The Commission also dealt with the issue of food hygiene in seafood, particularly for molluscs, such as mussels and oysters, which have become “a major food safety concern,” with the adoption of a set of preventive hygiene measures aimed at controling food-borne viruses.

“Viruses are generally more resistant than bacteria and those transmitted by the faecal-oral route can persist for months in bivalve molluscs, soil, water and sediments,” WHO noted. “They can survive freezing, refrigeration, UV radiation and disinfection but are sensitive to heat.”

In the area of mandatory nutrition labelling, the Commission recommended that food manufacturers across the world label nutritional content on their products to ensure that consumers are better informed.

WHO said that the Commission’s recommendation is in line with the health agency’s Strategy on Diet, Physical Activity and Health and is a “major step forward in promoting healthy eating worldwide.”

The Framework Convention on Tobacco Control (FCTC) that came into force in 2005 requires parties to restrict tobacco advertising, sponsorship and promotion, set new labelling and clean indoor air controls and strengthen laws against tobacco smuggling.

The new report by the UN World Health Organization (WHO), entitled “Mortality Attributable to Tobacco,” shows that five per cent of all deaths from communicable diseases worldwide and 14 per cent of deaths resulting from non-communicable illnesses among adults aged 30 and above were attributable to tobacco use.

“Although many people associate tobacco with non-communicable diseases such as cancers, heart and respiratory diseases, tobacco is also a major cause of communicable diseases – tuberculosis being a case in point where the disease is at times in latent or dormant state until activated by tobacco use,” said Ala Alwan, the WHO Assistant Director-General in charge of Non-communicable Diseases and Mental Health, in a forward to the report.

The regions with the highest number of deaths related to the use of tobacco are the Americas and Europe where tobacco use has been in use longer, according to the report.

Globally, deaths from tobacco-related cardiovascular diseases were more likely to occur among younger adults. Thirty-eight per cent of deaths of adults resulting from ischemic heart disease in the 30-44 age group were attributable to tobacco, while 71 per cent of all lung cancer deaths were linked to the use of tobacco.

“The five million deaths translate to an incredible statistic – one death every six seconds,” said Dr. Alwan. “Unless strong actions are taken to halt the tobacco epidemic, one billion people are projected to die this century – we cannot let this happen,” he added, urging all countries to implement the Convention on tobacco control.

The report contains country-specific estimates including death rates attributable to tobacco. It is intended to help countries assess the mortality of tobacco use and measure the success of efforts to discourage the use of the substance.

It follows the 2008 WHO report on the issue, which prompted some Member States to request the agency to consider generating estimates to give them an indication of their progress in combating tobacco use.