Your virtual Cancer prevention center and its Purpose

We need to have more Research/education/collaboration/knowledge exchange.

Our public need to know Cancer prevention information and programs


Smoking & tobacco use

Conclusions: Smoking prevalence is high in our communities in Pakistan. Most of the smokers know that smoking is dangerous and want to quit smoking but fail to stop for various reasons. Interventions are needed to decrease the prevalence of smoking in Pakistan.

50% cancers are preventable

Components of strategy development

  • Credibility
  • Advocacy
  • Research

Family history/environmental factors Public education/community action/advocacy Partnership collaboration


Smoking causes

6 million deaths per year globally 500,000 deaths annually in US Smokers live 10 years less than non smokers


Pakistan’s need to establish primary health care centers and clinics throughout the country that provide preventive, prenatal, emergency and basic services. In addition, a fleet of mobile clinics provides remote rural areas with services such as vaccinations and basic medical care.

These centers and clinics would greatly improve health standards by making health care available to the general public. They is a step forward in reducing the Pakistan’s infant mortality rate that stands very high per 1,000 live births. We have to achieve 100 percent of all children to be vaccinated against common diseases.


Pakistan need to continue improve a network of advanced hospitals and specialized treatment facilities. Located in major urban areas, these facilities must be accessible to all.


School Programs

Activity in schools kindergarten to 8th grade 150 minutes per week activity Beverages availability & Choices of foods School activity program 2 to 3 days a week “Health is social Investment”


Environmental Health

Environmental Health illnesses are Meningococcal, Amoebic dysentery, typhoid and hepatitis A Schigella and Salmonella and Dengue fever requires special preventive programs funded privately or in collaboration with government participation.


What is brucellosis?

Brucellosis is an infectious disease caused by the bacteria of the genus Brucella. These bacteria are primarily passed among animals, and they cause disease in many different vertebrates. Various Brucella species affect sheep, goats, cattle, deer, elk, pigs, dogs, and several other animals. Humans become infected by coming in contact with animals or animal products that are contaminated with these bacteria. In humans brucellosis can cause a range of symptoms that are similar to the flu and may include fever, sweats, headaches, back pains, and physical weakness. Severe infections of the central nervous systems or lining of the heart may occur. Brucellosis can also cause long-lasting or chronic symptoms that include recurrent fevers, joint pain, and fatigue. But brucellosis can be very common in countries where animal disease control programs have not reduced the amount of disease among animals.


Where is brucellosis usually found?

Although brucellosis can be found worldwide, it is more common in countries that do not have good standardized and effective public health and domestic animal health programs. Areas currently listed as high risk are the Mediterranean Basin (Portugal, Spain, Southern France, Italy, Greece, Turkey, North Africa), South and Central America, Eastern Europe, Asia, Africa, the Caribbean, and the Middle East. Unpasteurized cheeses, sometimes called “village cheeses,” from these areas may represent a particular risk for tourists.


How is brucellosis transmitted to humans, and who is likely to become infected?

Brucellosis has many synonyms derived from the geographical regions in which the disease occurs (e.g., Mediterranean fever, Malta fever, Gibraltar fever, Cyprus fever


Humans are generally infected in one of three ways: eating or drinking something that is contaminated with Brucella, breathing in the organism (inhalation), or having the bacteria enter the body through skin wounds. The most common way to be infected is by eating or drinking contaminated milk products. When sheep, goats, cows, or camels are infected, their milk is contaminated with the bacteria. If the milk is not pasteurized, these bacteria can be transmitted to persons who drink the milk or eat cheeses made it. Inhalation of Brucella organisms is not a common route of infection, but it can be a significant hazard for people in certain occupations, such as those working in laboratories where the organism is cultured. Inhalation is often responsible for a significant percentage of cases in abattoir employees. Contamination of skin wounds may be a problem for persons working in slaughterhouses or meat packing plants or for veterinarians. Hunters may be infected through skin wounds or by accidentally ingesting the bacteria after cleaning deer, elk, moose, or wild pigs that they have killed.


Bilharziasis: a parasite infection by a trematode worm acquired from infested water. Also known as schistosomiasis. Species which live in man can produce liver, bladder, and gastrointestinal problems. Species of the schistosomiasis parasite which cannot live in man cause swimmer’s itch. Bilharzia is through water with Snails, causes diarrhea.


Leishmania is cutaneous and intestinal.

Leishmaniasis is caused by protozoan parasites belonging to the genus Leishmania. The parasites are transmitted by the bite of a tiny – only 2–3 mm long – insect vector, the phlebotomine sand-fly. There are some 500 known phlebotomine species, but only about 30 have been found to transmit leishmaniasis. Only the female sandfly transmits the parasites. Female sandflies need blood for their eggs to develop, and become infected with the Leishmania parasites when they suck blood from an infected person or animal. Over a period of between 4 and 25 days, the parasites develop in the sandfly. When the infectious female sandfly then feeds on a fresh source of blood, it inoculates the person or animal with the parasite, and the transmission cycle is completed.



Rotary International works in conjunction with the CDC, World Health Organization, UNICEF, and the Bill and Melinda Gates Foundation as a partner of the Global Polio Eradication Initiative (GPEI). GPEI is a public-private partnership led by national governments. Its goal is to eradicate polio worldwide.Launched in 1988 after the World Health Assembly passed a resolution to eradicate polio, GPEI, along with its partners, has helped countries to make huge progress in protecting the global population from this debilitating disease. As a result, global incidence of polio has decreased by 99.99% since GPEI’s foundation.



Pakistan has a population of 180 million inhabitants of which 177 million are at risk of malaria. With 3.5 million presumed and confirmed malaria cases annually.


Malaria that is the second most reportedly disease in Pakistan with an estimated well over four million cases each year remains the fourth largest preventable cause of death in the country among communicable diseases.


Massive scale-up of malaria interventions since 2001 has helped to save an estimated 7 million lives, according to the World Malaria Report 2018. But an estimated 3.2 billion people, almost half the world’s population across 91 countries or territories, are still at risk of malaria. Malaria was responsible for 435,000 deaths in 2017, mostly among children under 5 years of age in sub-Saharan Africa, and in the same year malaria caused 219 million people to become ill. However, there is progress: In 2017, 46 countries reported fewer than 10,000 cases of malaria, and the number of countries with fewer than 100 cases increased from 15 countries in 2010 to 26 countries in 2017.

The World Health Organization recently proposed conducting in vivo studies in pregnant women with falciparum to evaluate molecular markers for detecting resistance precociously. Malaria spread across borders by migration of refugees.


Pakistan Goal: By 2020, reduce the malaria burden by 75% in high and moderate endemic districts/agencies and eliminate malaria in low endemic districts of Pakistan



  1. To achieve <5 API in high endemic areas of province of Balochistan, Sindh, KPK and FATA region by 2020
  2. To achieve <1% API within moderate endemic districts of Balochistan, Sindh, KPK and Punjab by 2020
  3. To achieve Zero API within low endemic districts of Sindh, KPK and Punjab by 2020


Role of Directorate of Malaria Control (Post 18thconstitutional amendment)

  1. To function as a Principal Recipient for Global Fund supported malaria control specific initiatives
  2. To develop liaisons with national and international donor agencies to provide support to the provincial governments and organizations
  3. To provide technical and material resources to provinces for successful implementation of malaria control strategies, and its surveillance



Worldwide 1.2 billion people live in extreme poverty. This means little or no access to housing, clean water, basic toilet facilities, or any health care.

Education levels are low in poor areas. Poor people have shorter life expectancy than wealthier people. More mothers and children die in poor areas. Each year 9.7 million children worldwide die before their 5th birthday. Infectious disease of all types are present in poor areas. Close contact among persons sharing housing and limited sewage and waste treatment means that infections can spread more easily. They lack preventive health care or means to manage chronic diseases. Low literacy rates contribute to poor health.



Accidents, Fuel leaks, shipwrecks, factory or forest fires Earthquakes Nuclear proliferation


Impact on public health

  • Immediate
  • Intermediate
  • Long Term


March 11, 2011: A massive magnitude 9.0 earthquake and Tsunami occurred in Japan. Tsunamis can have serious public health consequences. Japan 12,000 missing 2000 dead Sea water radiation Radiation in air, water, land, milk, vegetables, fish Travel Health Precautions Cholera in Haiti


Polio Outbreak in Tajikistan, Cases in Russia, Risk of Spread to other Central Asian Countries Rabies in Bali, Indonesia Yellow Fever in Côte d’Ivoire Dengue, Tropical and Subtropical Regions Yellow Fever in Uganda
Cholera in the Dominican Republic Yellow Fever in Brazil


Pakistan currently ranks 26th in the world for under-5 child mortality rates. The under-5 mortality rate (per 1000 live births) has reduced from 141 in 1990 to 89 in 2012, but is much slower than the goal of reducing it to 46 by 2015

Pakistan Population 177 million
Life Expectancy 67.2   Yrs
Infant Mortality Rate/1000 63.3
Mortality Rate under 5/1000 89
Population Avg. Annual % Growth 2.1



2010-11 Stats

Health & Nutrition Expenditure Rs. 42 Billion
Health Expenditures as % of GDP 0.23


Healthcare Facilities

Health Manpower 2008-09 2009-10 2010-11
Registered Doctors 133,925 139,555 144,901
Registered Dentists 9,013 9,822 10,508
Registered Nurses 65,387 69,313 73,244
Population per Doctor 1,212 1,183 1,222
Population per Dentist 18,010 16,914 16,854
Population per Bed 1,575 1,592 1,701

Source: Ministry of Health


Common causes of early death

Childhood diseases

Communicable diseases


Infant and maternal mortality



Severe malnutrition





Antibiotics without prescription and self medication


Funding shortage

Government policies

Illiteracy among rural mothers

Lack of quality control

Law and order

Pollution  air – water – land

Shortage of health care facilities

Shortage of health care workers

Unsafe drinking water



Food Safety

Lettuce Spinach Melons Eggs Mushrooms Water
Campylobacter is a bacterial pathogen that causes fever, diarrhea, and abdominal cramps.  It is the most commonly identified bacterial cause of diarrhea illness in the world.  These bacteria live in the intestines of healthy birds, and most raw poultry meat has Campylobacter on it.  Eating undercooked chicken, or other food that has been contaminated with juices dripping from raw chicken is the most frequent source of this infection.



Wash produce. Rinse fresh fruits and vegetables in running tap water to remove visible dirt and grime. Remove and discard the outermost leaves of a head of lettuce or cabbage. Because bacteria can grow well on the cut surface of fruit or vegetable, be careful not to contaminate these foods while slicing them up on the cutting board, and avoid leaving cut produce at room temperature for many hours. Don’t be a source of food borne illness yourself. Wash your hands with soap and water before preparing food. Avoid preparing food for others if you yourself have a diarrhea illness. Changing a baby’s diaper while preparing food is a bad idea that can easily spread illness.

Don’t cross-contaminate one food with another. Avoid cross-contaminating foods by washing hands, utensils, and cutting boards after they have been in contact with raw meat or poultry and before they touch another food. Put cooked meat on a clean platter, rather back on one that held the raw meat.

Cook meat, poultry and eggs thoroughly. Using a thermometer to measure the internal temperature of meat is a good way to be sure that it is cooked sufficiently to kill bacteria. For example, ground beef should be cooked to an internal temperature of 160o F. Eggs should be cooked until the yolk is firm.

Refrigerate leftovers promptly. Bacteria can grow quickly at room temperature, so refrigerate leftover foods if they are not going to be eaten within 4 hours. Large volumes of food will cool more quickly if they are divided into several shallow containers for refrigeration.


Report suspected food borne illnesses to your local health department. The local public health department is an important part of the food safety system. Often calls from concerned citizens are how outbreaks are first detected. If a public health official contacts you to find out more about an illness you had, your cooperation is important. In public health investigations, it can be as important to talk to healthy people as to ill people. Your cooperation may be needed even if you are not ill.


Diseases from Farm Animals

Cattle manure may contain germs that can make people, especially young children, very sick. To best protect yourself from getting sick, wash your hands with soap and running water after visiting a farm and after having contact with farm animals.

cow in enclosure

Farm animals including cows, sheep, pigs, chickens and goats, can pass diseases to people. As you know, farm animals are not like house pets and do not have places to rest or eat that are away from where they pass manure. Therefore, you should thoroughly wash your hands with running water and soap after contact with them or after touching things such as fences, buckets, and straw bedding, that have been in contact with farm animals, adults should carefully watch children who are visiting farms and help them wash their hands well.


Like other animals, wild animals and primates can get diseases. Some of these diseases, called zoonoses, can cause illness in people. Since wild animals (including monkeys, raccoons, and skunks) can carry diseases that are dangerous to people, CDC discourages direct contact with wildlife.

Baylisascaris Infection (raccoon roundworm): A parasitic disease associated with raccoons.

Brucella Infection (brucellosis): A bacterial disease associated with bison, deer, and other wild animals.

Giardia Infection (giardiasis): A parasitic disease associated with animals and their environment (including water).


Hantavirus Pulmonary Syndrome (hantavirus): A rare viral disease associated with some types of wild mice.
Herpes virus simiae Infection (B virus): A deadly viral disease associated with macaque monkeys.
Histoplasma Infection (histoplasmosis): A fungal disease associated with bat guano (stool).
Lymphocytic Choriomeningitis: A viral disease associated with rodents and house mouse.
Mycobacterium tuberculosis Infection (TB): A bacterial disease associated with deer, elk, and bison.
Plague (Yersinia pestis Infection): A rare bacterial disease associated with wild rodents and fleas.
Rabies: A viral disease associated with wildlife especially raccoons, skunks, and bats.
Tularemia: An infectious disease associated with wildlife especially rodents, rabbits, and hares.
Incubation period up to one year Migratory skin and subcutaneous swellings fish, shrimp, crab, crayfish, frog, or chicken.


Air Travel

Mosquitos Zika virus, Malaria, Dengue fever Scorpion Passenger dragging



In March 2003, reports of healthcare workers with unexplained pneumonia in Vietnam initiated an international investigation of the infection that came to be known as severe acute respiratory syndrome (SARS)


On February 23, 2003, a 78-year-old Canadian woman returned from a visit to Hong Kong. While there, she had unknowingly been infected with SARS-CoV during her stay at a hotel in Kowloon (5). After returning to Toronto, the patient’s condition worsened, and she died at home. SARS developed in her son, and he was hospitalized with respiratory distress on March 7. Before his death on March 13, he infected two other patients and one healthcare worker, all of whom subsequently exposed others to the infection before SARS was eventually recognized.


Avian influenza

Measles a virus that mainly spreads by direct contact with airborne respiratory droplets. … as encephalitis (brain swelling) or severe respiratory illness, and there Recognition diagnosis Isolation Treatment



AIDS is a serious disease that represents the late clinical stage of infection with human immunodeficiency virus (HIV). HIV progressively damages the immune system. Without an effective immune system, life-threatening infections and other noninfectious conditions related to failing immunity (such as certain cancers) eventually develop.

MERS CoV Middle East Respiratory Syndrome Corona Virus  Travel warnings to Saudi Arabia

African sleeping sickness, African trypanosomiasis for International Travel)


Heavy rainfall and infectious diseases

In the past, outbreaks of water-borne diseases,such as Cryptosporidium and Escherichia coli,
have been linked to heavy rainfall events.increased water stress and may experience a rise in the incidence of water-related diseases as people are forced to rely on increasingly contaminated sources of fresh water for
all of their daily needs—drinking, cooking, bathing, and irrigation.

  As scientific evidence continues to mount that the earth’s climate is rapidly changing, it is clear that global warming is no longer just a prediction.Rising oceans, stronger hurricanes, prolonged droughts, and more intense heat waves are signs of the already discernable impacts that global warming is having worldwide. Global average surface temperatures have increased by about one degree Fahrenheit since the beginning of the 20th century,1 and the five hottest years on record have all occurred within the last decade.2 With the atmospheric concentration of carbon dioxide (CO2) now higher than at any point in the last 420,000 years, widespread
consensus within the scientific community points to the burning of fossil fuels as the primary cause of this warming of the planet.3 Unless emissions of heat-trapping greenhouse gases are reduced, temperatures will increase by an additional 2.5 to 10.4 degrees Fahrenheit during the next 100 years—a rate likely to be without precedent in the last 10,000 years.

1 Beyond the serious and potentially irreversible impacts on physical and biological systems,4 a growing body of research also suggests that global warming will adversely affect public health in a number of important ways.
The 2003 European heat waves resulted in a surge of heat-related deaths. Across the United Kingdom, France, Italy, the Netherlands, Portugal, and Spain, the heat waves that occurred during the summer of 2003 are
estimated to have caused at least 22,000 excess deaths, with some arguing that this figure could be revised upward by as much as an astounding 50–100 percent.7 In the United States, a seven-day (July14 – 20) heat wave in Chicago during the summer of 1995 resulted in 485 heat-related deaths 1970 Clean Air Act, as recently as 2002 approximately 146 million people in the United States lived in counties that did not meet air quality
standards for at least one regulated pollutant Ozone levels, for example, are likely to increase because higher temperatures accelerate the rate at which ground-level ozone (the main component of smog) is formed.

10 While long term exposure to ozone is linked to the development and exacerbation of chronic lung diseases,
even short-term exposure to relatively low ozone concentrations can cause lung inflammation, acutely decreased lung function, and respiratory impairment. In recent decades, spring flowering, and thus the allergenic pollen season, has advanced at a rate of nearly a day per year.15 In Europe, spring events such as leaf unfolding
advanced by six days, while autumn events such as leaf coloring have been delayed by nearly five days in the last 35 years.16 Experimental studies have demonstrated significant increases in pollen production resulting from exposure to increased CO2 concentrations Combined with the observed doubling of pediatric asthma
prevalence within the past twenty years, The fastest and most affordable way to curb greenhouse gas emissions is to increase energy efficiency. Replacing older home appliances such as refrigerators and washing machines with more efficient models; improving heating and cooling systems; better insulating both commercial and residential buildings; and replacing old lighting systems with new advanced lighting systems that use compact fluorescent
or LED bulbs—all these actions can drastically reduce energy use without having to sacrifice functionality or comfort. Wind turbine and Solar energy is another renewable energy source capable of making a significant contribution to meeting U.S. energy needs renewable energy production is the harnessing of both geothermal heat energy and ocean tides and currents for electricity generation. hybrid engines, flex-fuel vehicles capable of
running on ethanol, and biodiesel engines are all gaining in popularity and commanding an increasing share of the automotive market.


Global warming

Consequences of global warming include receding waters, food supply, changing climate, bird migration
Older population double in 2050 brings Increased demands and opportunities


Health challenges

Health challenges such as the Ebola outbreak, together with the wider impact of conflict, environmental degradation, climate change and the frequency of natural disasters put the progress made against NTDs
under significant threat. Yet NTDs are markers, agents and drivers of poverty. Controlling and eliminating NTDs
can make a proportionately greater contribution than any other investment – more health for less money.

Case history

Ecuadorian whipworms (Trichuris trichiuria) Humans worldwide (600 million) are infected with Ascaris lumbricoides and Trichuris trichiura; the eggs of these roundworms (nematode) are “sticky” and may be carried to the mouth by hands, other body parts GI symptoms.

The man appeared confused and had swelling over his right eye. His parents told doctors that he’d also been having pain in his groin for a week. An MRI of his head showed numerous cysts in the outer layer of his brain (known as the cerebral cortex), as well as in his brain stem, according to the report, published today (March 27) in The New England Journal of Medicine. He also had cysts in his right eye and testes. [27 Oddest Medical Case Reports]


The Challenge

Around the world nearly 98 million girls are not in school. Globally, 1 in 3 women will experience gender-based violence in her lifetime. In the developing world, 1 in 7 girls is married before her 15th birthday, with some child brides as young as 8 or 9. Each year more than 287,000 women, 99 percent of them in developing countries, die from pregnancy- and childbirth-related complications.

While women make up more than 40 percent of the agriculture labor force only 3 to 20 percent are landholders. In Africa, women-owned enterprises make up as little as 10 percent of all businesses. In South Asia, that number is only 3 percent. And despite representing half the global population, women comprise less than 20 percent of the world’s legislators.


Although the statistics above make for grim reading, an important underlying cause of all these deaths is poverty. The World Health Organization (WHO) and others repeatedly point out that many of these diseases are “diseases of poverty.”

However, some diseases are now not only the result of poverty, but have been contributing to poverty—a nasty feedback loop. In the case of malaria, for instance, the WHO notes that,

Malaria has significant measurable direct and indirect costs, and has recently been shown to be a major constraint to economic development.

… Annual economic growth in countries with high malaria transmission has historically been lower than in countries without malaria. Economists believe that malaria is responsible for a “growth penalty” of up to 1.3% per year in some African countries.

… The indirect costs of malaria include lost productivity or income associated with illness or death.

… Malaria has a greater impact on Africa’s human resources than simple lost earnings. Although difficult to express in dollar terms, another indirect cost of malaria is the human pain and suffering caused by the disease. Malaria also hampers children’s schooling and social development through both absenteeism and permanent neurological and other damage associated with severe episodes of the disease.

The simple presence of malaria in a community or country also hampers individual and national prosperity due to its influence on social and economic decisions. The risk of contracting malaria in endemic areas can deter investment, both internal and external and affect individual and household decision making in many ways that have a negative impact on economic productivity and growth.


Short & Long Term Health Impact of Disasters

Such as Earthquakes and floods have great impact on:

Communication ,Control of Funds ,Coordination ,Language Barriers ,Local Community and International Health Impact ,Local Customs ,Long Term Goals ,Rehabilitation ,Safe Transportation ,Short Term Issues
,Uncertain Reliability Who is In-Charge


  • Access to Care
  • Coordination of Rescue Efforts
  • Cultural Competence
  • Injury Surveillance System
  • Tobacco Prevention
  • Trauma Evacuation
  • Undisclosed Illness

Global Health

The World Health Report 2007 – A safer future: global public health security in the 21st century marks a turning point in the history of public health, and signals what could be one of the biggest advances in health security in half a century. It shows how the world is at increasing risk of disease outbreaks, epidemics, industrial accidents, natural disasters and other health emergencies which can rapidly become threats to global public health security. The report explains how the revised International Health Regulations (2005), which came into force this year, helps countries to work together to identify risks and act to contain and control them. The regulations are needed because no single country, regardless of capability or wealth, can protect itself from outbreaks and other hazards without the cooperation of others. The report says the prospect of a safer future is within reach – and that this is both a collective aspiration and a mutual responsibility.

Zika virus is a member of the virus family Flaviviridae. It is spread by daytime-active Aedes mosquitoes, such as A. aegypti and A. albopictus. Its name comes from the Ziika Forest of Uganda, where the virus was first isolated in 1947. Zika virus is related to the dengue, yellow fever, Japanese encephalitis, and West Nile viruses. Since the 1950s, it has been known to occur within a narrow equatorial belt from Africa to Asia. From 2007 to 2016, the virus spread eastward, across the Pacific …WORLD IS AT RISK


Some countries find it more difficult than others to confront threats to public health security effectively because they lack the necessary resources, because their health infrastructure has collapsed as a consequence of under-investment and shortages of trained health workers, or because the infrastructure has been damaged or destroyed by armed conflict or a previous natural disaster. With rare exceptions, threats to public health are generally known and manageable.


For years, 30,000 red and white balloons flooded into the blue sky above Gibraltar each September, symbols of the joy and pride of the small community jutting into the sea as it celebrated its National Day.