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Establishing a reform agenda for the World Health Organization (WHO) requires understanding its role within the wider global health system and the purposes of that wider global health system. In this paper, the focus is on one particular purpose: achieving universal health coverage (UHC). The intention is to describe why achieving UHC requires something like a Framework Convention on Global Health (FCGH) that have been proposed elsewhere,(1) why WHO is in a unique position to usher in an FCGH, and what specific reforms would help enable WHO to assume this role., (Copyright © 2013 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.)

A serolocigical survey was conducted for the detection of Theileria parva antibodies in 176 African buffaloes (Syncerus caffer) sampled between 1996 and 2005 in livestock-wildlife interface areas of Zambia. Rhipicephalus appendiculatus, Rhipicephalus species, and Amblyomma variegatum were the most abundant tick species identified on buffaloes. T. parva sero-positives were reported in buffaloes sampled from game management areas at Mlanga and Nanzhila bordering the Kafue National Parks and in the Lochnivar National Park while buffaloes sampled from Lower Zambezi National Park were sero-negative. Given that Game Management Areas serve as interface areas that permit the co-existence of livestock and wildlife in similar ecological habitats our findings suggest that buffaloes could play a significant role in the epidemiology of theileriosis in livestock-wildlife interface areas. Thus far, the disease has only been reported in livestock and is herein being reported in the African buffalo for the first time in Zambia.

Objective: To assess the effect of short-term treatment with GH on left ventricular contractility and remodeling, after the development of heart failure in cardiomyopathic hamsters (CMH)., Design: Two groups of 200-day-old UM-X7.1 CMH received daily subcutaneous injections of recombinant bovine (rb) GH (1mg/kg/day) or 0.9% NaCl for 40 days. Golden Syrian hamsters (GSH) were used as controls. At 240-day-old, the hamsters were randomly subjected to (i) assessment of left ventricular systolic function in a Langendorff perfused mode followed by the determination of the passive diastolic pressure-volume relationship and morphometric measurements; (ii) assessment of left ventricular mRNA expression of genes belonging to the fetal gene program including atrial (ANP) and brain (BNP) natriuretic peptides and cardiac myosin heavy chain isoforms and of the circulating levels of the natriuretic peptides., Results: Hearts from CMH were hypertrophied and dilated (p<0.05) compared to hearts from GSH, along with a approximately 10-fold increase in the circulating ANP and BNP levels. Left ventricular BNP and ANP mRNAs were elevated by 2- and 3-fold, respectively, compared to GSH. rbGH reduced both ANP mRNA and ANP circulating levels by 34% (p<0.01) but did not significantly modulate BNP levels. This effect was associated with a preserved systolic function and reverse remodeling as assessed by a leftward shift of the passive diastolic pressure-volume relationship indicating reduced ventricular dilatation., Conclusions: The data show that a short-term administration of GH in the terminal phase of the disease confers cardioprotection by attenuating systolic dysfunction and by inducing beneficial reverse remodeling.

East Coast fever (ECF), a tick-borne disease of cattle, is a major constraint to livestock development in Africa in general and southern Zambia in particular. Understanding the transmission patterns of this disease complex is very difficult as shown by previous studies in southern and eastern Zambia due to the interplay of risk factors. In this long-term study, we investigated whether global weather changes had any influence on disease transmission in traditionally kept cattle in southern Zambia. The results from this study show a strong association between increased Theileria parva contacts in cattle and the presence of El Niño, clearly linking a simple climatic index to disease outbreaks. We therefore propose that in southern Zambia, the simple and readily available multiple El Niño Southern oscillation index (MEI) ranks be used in planning ECF control programmes and early warning.

Serological surveys using the schizont indirect fluorescence antibody test (IFAt) are routinely carried out to monitor the Theileria parva infection prevalence. The present study evaluates the diagnostic accuracy of the IFAt in eastern Zambia, where the transmission of T. parva is highly seasonal. The data set resulted from a sentinel herd (n = 105 animals) study carried out between 1995 and 2000 and was split into an epidemic period, during which the majority of the cattle became infected, and an endemic period with seasonal disease incidence in calves. In the epidemic period the T. parva seroprevalence followed closely the build up of the herd immunity. In the endemic period the seroprevalence fluctuates considerably although most of the animals had been infected. Overall, the diagnostic sensitivity of the IFA test was 55% at cut-off titre 1:40 and 28% at cut-off 1:160. The specificity of the test was 86 and 95%, respectively. A logistic regression model demonstrates that the sensitivity is significantly lower when the T. parva transmission is low (p < 0.01). The analysis of receiver operator characteristic curves classifies the test as moderately accurate (area under the curve, AUC = 0.79) during the epidemic period and less accurate in the endemic period (AUC = 0.63). Neonatal serology surveys yield a better estimate of the infection prevalence. The sensitivity of the neonatal test was 73% at cut-off titre 1:40 and 24% at cut-off 1:160.

Field studies were conducted to assess the occurrence of resistance to isometamidium chloride and diminazene aceturate in trypanosomes infecting cattle in Kénédougou Province of Burkina Faso. Forty-five of the 166 villages in Kénédougou were randomly sampled and visited to assess livestock numbers, trypanosomosis risk, and tsetse challenge. The proportion of cattle infections associated with drug-resistant trypanosomes was assessed in the nine villages with the highest trypanosome infection prevalence and one village with a confirmed history of drug-resistant infections. These studies showed that resistance to both isometamidium and diminazene was widespread. However, there was considerable variation between villages in drug-resistance parameters, with the proportion of treated cattle with trypanosome infections 3 months after isometamidium prophylaxis varying from 6.9 to 63.8% and the proportion of cattle having infections 2 weeks after treatment with diminazene varying from 0 to 36.8%. The demonstration of widespread resistance to both isometamidium and diminazene has important implications, as administration of trypanocides is the most commonly employed method to control trypanosomosis in this area.