News Bites (cont)

International tuberculosis targets ­reachable—International goals for reducing the number of tuberculosis (TB) cases and deaths by 2015 can be achieved, but the challenge will be greatest in Africa and eastern Europe, says a study in the TB theme issue of JAMA.TB is currently infecting one third of the world's population and killing some 2 million people every year. Some developed countries, such as the United States, have had declining numbers of individuals infected with TB over the past decade, but 23 countries account for 80% of all new TB cases, with more than half concentrated in five countries—Bangladesh, China, India, Indonesia, and Nigeria (http: //jama.ama-assn.org/cgi/content/extract/293/22/2793).

Lack of sleep harms patient care, students say—Almost half of medical students and residents believe that sleep deprivation or fatigue may have negatively affected patient care, says a survey by the American Medical Association. Residents in the United States work a total of 68 hours per week and medical students 60 hours. However, the survey found that 11% of residents work more than 80 hours a week, which is the maximum amount set to them by the Accreditation Council for Graduated Medical Education. Half of the residents said they would feel uneasy reporting these excess hours. No guidelines have been set for medical students (www.ama-assn.org/ama/pub/category/15195.html).

High debt load affects medical students' career choice—Medical students' high debt load often influences the type of medicine they want to practise. The results of the National Physicians Survey released by the Canadian Medical Association found that, for example, seven in 10 Ontario medical students thought that high debt is affecting their choice of specialty and choice of practice location. Medical school tuition in Canada has nearly tripled since 1997 and is currently as high as $16207 per year for a four year programme. Students with high debt are less likely to enter family medicine and instead choose specialty practices. It is feared that high tuition fees are also deterring students from low and middle income families from entering medicine (www.bcma.org/public/news_publications/).

Health professionals should have 24 hour ethics access—Health professionals should have access to ethics support at a local level and be able to ask for advice on ethical dilemmas 24 hours a day, a report from the Royal College of Physicians has recommended. The report says that healthcare institutions should review their existing arrangements for providing support on ethics and develop and implement guidelines on how to recognise and handle advice on ethical issues. This should be done by an identified lead individual working with others and with the full support of management. Centres at which complex dilemmas often occur should consider setting up a clinical ethics committee if they do not already have one (http: //bmj.bmjjournals.com/)

US AIDS infections top one million—The number of US citizens living with HIV has surpassed one million for the first time, the Centers for Disease Control and Prevention has estimated. The numbers partly reflect the success of new treatments and drugs that allow HIV-infected people to survive longer. AIDS, which was originally predominant in the US among gay white men, is now most prevalent among gay and bisexual black men. Worldwide, an estimated 38 million people are living with HIV or AIDS, according to the United Nations (www.cdc.gov).

STAFAN ROUSSEAU/PA/EMPICS

G8 protestors get something to smile about

G8 cancels debt of the world's poorest countries—G8 finance ministers have agreed immediately to cancel the debt of the world's 18 most heavily indebted poor countries for a total of $40bn. The deal will include all debts owed by the qualifying countries to the World Bank, the African Development Bank, and the International Monetary Fund. Fourteen of the countries included in the deal are African—Benin, Burkina Faso, Ethiopia, Ghana, Madagascar, Mali, Mauritania, Mozambique, Niger, Rwanda, Senegal, Tanzania, Uganda, and Zambia. The four others are in Latin America—Bolivia, Guyana, Honduras, and Nicaragua (http: //bmj.bmjjournals.com/cgi/content/full/330/7505/1407).

BMA calls on G8 governments to address "brain drain"—The BMA and the Royal College of Nursing have called on the G8 leaders to take action to limit the exodus of healthcare workers from developing countries to help improve the health of people living there. The chairman of the BMA, James Johnson, and general secretary of the royal college, Beverley Malone, warned in letters sent to Prime Minister Tony Blair and the chancellor of the exchequer, Gordon Brown, that migration of healthcare workers from developing nations had led to serious shortages of staff in these countries, hampering efforts to improve health (www.bma.org.uk/ap.nsf/content/).

One third of scientists admit to research violations—More than a third of US scientists, in a survey of thousands, admitted to violating some of the bedrock rules of scientific research, according to a report by a team of Minnesota researchers. Less than 1.5% admitted to outright falsification or plagiarism. But 15.5% said they had changed the design, methods, or results in response to pressure from funding sources, and 12.5 admitted overlooking other's use of flawed data. In addition, 7% admitted ignoring "minor" rules of requirements regarding the use of human subjects. This is the first survey of its kind, so it is not known whether the conduct is growing more common or not (Nature 2005;435: 718-9).

Armed conflict leading cause of world hunger—Armed conflict is now the leading cause of hunger around the world, says a report from the United Nations Food and Agriculture Organization (FAO). The report warns that the goal of reducing the number of the world's hungry by half by 2015, set by the World Food Summit in 1996, is almost certain to be missed by a wide margin if current trends persist. The major obstacles for the goal are armed conflicts with the effects of HIV/AIDS and climate change not far behind, the report concludes (www.fao.org/newsroom/en/).