Tag Archives: says

Arts can help recovery from illness and keep people well, report says

GPs prescribing arts activities to some ill patients could lead to a dramatic fall in hospital admissions and save the NHS money, according to a new report into the subject of arts, health and wellbeing published after two years of evidence-gathering.

The inquiry report was published on Wednesday; a huge document that includes hundreds of interviews and dozens of case studies showing how powerfully the arts can contribute to people’s health and wellbeing.

David Shrigley illustration


Illustration: David Shrigley

Co-chaired by former arts ministers Alan Howarth and Ed Vaizey, the all-party inquiry contends that the arts can keep people well, aid recovery from illness, help people to live longer, better lives and save money in health and social services.

Lord Howarth said it was a comprehensive review of evidence that had never been produced before. “Sceptics say where is the evidence of the efficacy of the arts in health? Where is the evidence of the value for money it can provide? We show it in this report.

“The arts can help people take responsibility for their own health and wellbeing in ways that will be crucial to the health of the nation.”

Art helps you see


Illustration: David Shrigley

The report was welcomed by the current arts minister, John Glen, appointed five weeks ago. He pledged to act on its recommendations, saying: “This sort of work isn’t window-dressing, please don’t be cynical about it. It gives a dataset and some real stories that we can use as we go through the treacle of Whitehall.”

The case studies include an Artlift arts-on-prescription project in Gloucestershire where patients with a wide range of conditions, from depression to chronic pain to stroke, were referred to an eight-week course involving poetry, ceramics, drawing, mosaic or painting.

A cost-benefit analysis showed a 37% drop in GP consultation rates and a 27% reduction in hospital admissions. That represents an NHS saving of £216 per patient.

The Strokestra project between the Royal Philharmonic Orchestra and Hull stroke service running a music-making service for patients


The Strokestra project between the Royal Philharmonic Orchestra and Hull stroke service running a music-making service for patients.

Strokestra, a collaboration between the Royal Philharmonic Orchestra and Hull stroke service, found that 86% of patients felt music-making sessions – which included percussion and conducting – relieved their symptoms and improved their sleep.

The report also includes contributions from artists including David Shrigley, who has provided illustrations, and Grayson Perry, who writes: “Making and consuming art lifts our spirits and keeps us sane. Art, like science and religion, helps us make meaning from our lives, and to make meaning is to make us feel better.”

Howarth said there were many examples of good practice and innovation around the UK, but also areas where little was going on.

'The arts' sun shining on a sunflower


Illustration: David Shrigley

“We are calling for an informed and open-minded willingness to accept that the arts can make a significant contribution to addressing a number of the pressing issues faced by our health and social care systems.”

The report makes 10 “modest and feasible” recommendations that would not need additional public spending or require new legislation, the report authors said.

They include setting up a philanthropically funded strategic centre to support good practice, promote collaboration and coordinate research.

There are also recommendations about politicians and policymakers from different areas working better together, something Vaizey acknowledged was an issue.

Arts minister for six years until being sacked by Theresa May, Vaizey added: “I was very conscious as a minister that I worked in a silo and it was incredibly hard to break out of that silo, incredibly hard to engage with ministers from other government departments. The arts, almost more than any sector, is a classic example where silo working does not work.”

The All-Party Parliamentary Group on Arts, Health and Wellbeing report is available here.

Arts can help recovery from illness and keep people well, report says

GPs prescribing arts activities to some ill patients could lead to a dramatic fall in hospital admissions and save the NHS money, according to a new report into the subject of arts, health and wellbeing published after two years of evidence-gathering.

The inquiry report was published on Wednesday; a huge document that includes hundreds of interviews and dozens of case studies showing how powerfully the arts can contribute to people’s health and wellbeing.

David Shrigley illustration


Illustration: David Shrigley

Co-chaired by former arts ministers Alan Howarth and Ed Vaizey, the all-party inquiry contends that the arts can keep people well, aid recovery from illness, help people to live longer, better lives and save money in health and social services.

Lord Howarth said it was a comprehensive review of evidence that had never been produced before. “Sceptics say where is the evidence of the efficacy of the arts in health? Where is the evidence of the value for money it can provide? We show it in this report.

“The arts can help people take responsibility for their own health and wellbeing in ways that will be crucial to the health of the nation.”

Art helps you see


Illustration: David Shrigley

The report was welcomed by the current arts minister, John Glen, appointed five weeks ago. He pledged to act on its recommendations, saying: “This sort of work isn’t window-dressing, please don’t be cynical about it. It gives a dataset and some real stories that we can use as we go through the treacle of Whitehall.”

The case studies include an Artlift arts-on-prescription project in Gloucestershire where patients with a wide range of conditions, from depression to chronic pain to stroke, were referred to an eight-week course involving poetry, ceramics, drawing, mosaic or painting.

A cost-benefit analysis showed a 37% drop in GP consultation rates and a 27% reduction in hospital admissions. That represents an NHS saving of £216 per patient.

The Strokestra project between the Royal Philharmonic Orchestra and Hull stroke service running a music-making service for patients


The Strokestra project between the Royal Philharmonic Orchestra and Hull stroke service running a music-making service for patients.

Strokestra, a collaboration between the Royal Philharmonic Orchestra and Hull stroke service, found that 86% of patients felt music-making sessions – which included percussion and conducting – relieved their symptoms and improved their sleep.

The report also includes contributions from artists including David Shrigley, who has provided illustrations, and Grayson Perry, who writes: “Making and consuming art lifts our spirits and keeps us sane. Art, like science and religion, helps us make meaning from our lives, and to make meaning is to make us feel better.”

Howarth said there were many examples of good practice and innovation around the UK, but also areas where little was going on.

'The arts' sun shining on a sunflower


Illustration: David Shrigley

“We are calling for an informed and open-minded willingness to accept that the arts can make a significant contribution to addressing a number of the pressing issues faced by our health and social care systems.”

The report makes 10 “modest and feasible” recommendations that would not need additional public spending or require new legislation, the report authors said.

They include setting up a philanthropically funded strategic centre to support good practice, promote collaboration and coordinate research.

There are also recommendations about politicians and policymakers from different areas working better together, something Vaizey acknowledged was an issue.

Arts minister for six years until being sacked by Theresa May, Vaizey added: “I was very conscious as a minister that I worked in a silo and it was incredibly hard to break out of that silo, incredibly hard to engage with ministers from other government departments. The arts, almost more than any sector, is a classic example where silo working does not work.”

The All-Party Parliamentary Group on Arts, Health and Wellbeing report is available here.

Long working days can cause heart problems, study says

A long hours office culture can affect more than just your social life – long days at work can be bad for your heart as well, according to a major study.

It’s been established that too many hours in the office can increase the risk of a stroke. Now it seems that clocking up more than 55 hours a week means a 40% higher chance of developing an irregular heartbeat, known as atrial fibrillation (AF), when compared to those with a better work-life balance.

AF happens because the natural electrical impulses controlling the heart’s normal regular rhythm lose their co-ordination. Sufferers may get palpitations – the sensation of a racing or irregular pulse – as well as feeling breathless and dizzy.

But some people with AF get no symptoms at all, which is why the British Heart Foundation encourages people to check whether their pulse is regular and to see a GP if they have any doubts. It’s important to diagnose AF because it increases the chance of having a stroke five-fold, and blood thinning treatments can greatly lower this risk.

The research team, led by Professor Mika Kivimaki from the department of epidemiology at University College, London, analysed data on the working patterns of 85,494 mainly middle-aged men and women drawn from the UK, Denmark, Sweden and Finland.

Participants were put into groups according to their work pattern, with 35-40 hours a week regarded as the control group. No one had AF at the start of the study, published in the European Heart Journal.

After 10 years of follow-up, an average of 12.4 per 1,000 people had developed AF, but among those working 55 hours or more, this figure was higher at 17.6 per 1,000 people.

Those working the longest hours were more overweight, had higher blood pressure, smoked more and and consumed more alcohol. But the team’s conclusions about longer working hours and AF still remained after taking these factors into account.

The researchers acknowledge some limitations to their study: they only asked participants about working hours at the start, and so couldn’t account for how working patterns might have changed over 10 years. The team also could not tell whether any particular job type was more risky.

Kivimaki offered worried workers some reassurance. “For a healthy person, the risk of AF is very low, and a 1.4-fold increase in that small risk due to long working hours does not much change the situation.”

Tim Chico, a Sheffield cardiologist not involved with the study also had some helpful advice for those concerned that their job might harm their heart: “Most people who work long hours won’t have the luxury of being able to change their working patterns. We already know that obesity, diabetes, high blood pressure and smoking all increase the risk of AF and so people can reduce their risk of AF by addressing these factors without needing to find another job!”

Long working days can cause heart problems, study says

A long hours office culture can affect more than just your social life – long days at work can be bad for your heart as well, according to a major study.

It’s been established that too many hours in the office can increase the risk of a stroke. Now it seems that clocking up more than 55 hours a week means a 40% higher chance of developing an irregular heartbeat, known as atrial fibrillation (AF), when compared to those with a better work-life balance.

AF happens because the natural electrical impulses controlling the heart’s normal regular rhythm lose their co-ordination. Sufferers may get palpitations – the sensation of a racing or irregular pulse – as well as feeling breathless and dizzy.

But some people with AF get no symptoms at all, which is why the British Heart Foundation encourages people to check whether their pulse is regular and to see a GP if they have any doubts. It’s important to diagnose AF because it increases the chance of having a stroke five-fold, and blood thinning treatments can greatly lower this risk.

The research team, led by Professor Mika Kivimaki from the department of epidemiology at University College, London, analysed data on the working patterns of 85,494 mainly middle-aged men and women drawn from the UK, Denmark, Sweden and Finland.

Participants were put into groups according to their work pattern, with 35-40 hours a week regarded as the control group. No one had AF at the start of the study, published in the European Heart Journal.

After 10 years of follow-up, an average of 12.4 per 1,000 people had developed AF, but among those working 55 hours or more, this figure was higher at 17.6 per 1,000 people.

Those working the longest hours were more overweight, had higher blood pressure, smoked more and and consumed more alcohol. But the team’s conclusions about longer working hours and AF still remained after taking these factors into account.

The researchers acknowledge some limitations to their study: they only asked participants about working hours at the start, and so couldn’t account for how working patterns might have changed over 10 years. The team also could not tell whether any particular job type was more risky.

Kivimaki offered worried workers some reassurance. “For a healthy person, the risk of AF is very low, and a 1.4-fold increase in that small risk due to long working hours does not much change the situation.”

Tim Chico, a Sheffield cardiologist not involved with the study also had some helpful advice for those concerned that their job might harm their heart: “Most people who work long hours won’t have the luxury of being able to change their working patterns. We already know that obesity, diabetes, high blood pressure and smoking all increase the risk of AF and so people can reduce their risk of AF by addressing these factors without needing to find another job!”

Dementia and Alzheimer’s main cause of death for women, says Public Health England

Alzheimer’s disease and dementia are the biggest cause of death among women, according to a government report on the state of the nation’s health.

Public Health England (PHE)’s report, which uses population health data to produce a wide-ranging national report for the first time, suggests that while life expectancy has been steadily increasing – now 79.5 years for men and 83.1 years for women – more of those extra years are now spent in poor health.

Women can expect to live nearly a quarter of their lives in ill-health and men a fifth. The causes of death have shifted since the turn of the century, the analysis found, with the rise in deaths from dementia and Alzheimer’s the most significant features – alongside declines in other diseases.

Cause of death – women

“Since 2001, death rates from heart disease and stroke have halved for both males and females,” the report said. “Over the same time deaths from dementia and Alzheimer’s have increased by 60% in males and have doubled in females.”

In 2015, heart disease was the most common cause of death among men, but Alzheimer’s and dementia are now the most likely among women. These diseases are better diagnosed, while the prevention and treatment of heart disease have improved.

The report prompted warnings that investment in dementia research must not slow. Dr Matthew Norton, director of policy at Alzheimer’s Research UK, said: “To achieve the same successes as we have with other health conditions like heart disease and cancer, we need dementia research to remain a national priority. We have been able to make promising steps forward, thanks to a renewed focus, but we are not there yet.”

Cause of death – men

The PHE report also sheds light on the ailments that afflict people in earlier years. Lower back and neck pain are the biggest cause of ill-health in England, while obesity is the biggest risk factor for becoming unwell.

Where you live and how you live make a big difference to the likely length of your life and chances of good or poor health. Men and women in the most deprived areas can expect to spend 20 years fewer in good health compared with those living in the least deprived areas.

The PHE director of health improvement, John Newton, said: “For both men and women, almost half the population live in areas where healthy life expectancy is slightly less than the current state pension [age]. It is a slightly larger proportion of men than women … [but] a significant proportion of our population cannot expect to live in their pension age in good health.”

Diabetes, most of which is type 2 and linked to being overweight, has for the first time become one of the top 10 causes of ill-health and disability. The bill has been predicted to potentially cripple the NHS, which spends £14bn a year on testing and treatment.

Leading cause of morbidity

But lower back pain and neck pain are ranked ahead of diabetes. Part of that is down to the ageing population, but excess weight and lack of activity are also factors.

Among men, skin disorders, such as acne and psoriasis, are the second most common cause of ill-health, although they are three times less common than lower back and neck pain. Third among men and second among women is depression.

Lifestyle, poverty and education all make a difference to health. Among the medical risks are being overweight or obese and having high cholesterol. High BMI (body mass index, a measurement of obesity) can lead to heart disease, stroke, osteoarthritis, back pain, chronic kidney disease, diabetes and some cancers.

“Behavioural risks include smoking, alcohol and unsafe sex, while environmental and occupational risks include air pollution, unclean water and other risks due to the working or living environment,” said the report.

Dementia and Alzheimer’s main cause of death for women, says Public Health England

Alzheimer’s disease and dementia are the biggest cause of death among women, according to a government report on the state of the nation’s health.

Public Health England (PHE)’s report, which uses population health data to produce a wide-ranging national report for the first time, suggests that while life expectancy has been steadily increasing – now 79.5 years for men and 83.1 years for women – more of those extra years are now spent in poor health.

Women can expect to live nearly a quarter of their lives in ill-health and men a fifth. The causes of death have shifted since the turn of the century, the analysis found, with the rise in deaths from dementia and Alzheimer’s the most significant features – alongside declines in other diseases.

Cause of death – women

“Since 2001, death rates from heart disease and stroke have halved for both males and females,” the report said. “Over the same time deaths from dementia and Alzheimer’s have increased by 60% in males and have doubled in females.”

In 2015, heart disease was the most common cause of death among men, but Alzheimer’s and dementia are now the most likely among women. These diseases are better diagnosed, while the prevention and treatment of heart disease have improved.

The report prompted warnings that investment in dementia research must not slow. Dr Matthew Norton, director of policy at Alzheimer’s Research UK, said: “To achieve the same successes as we have with other health conditions like heart disease and cancer, we need dementia research to remain a national priority. We have been able to make promising steps forward, thanks to a renewed focus, but we are not there yet.”

Cause of death – men

The PHE report also sheds light on the ailments that afflict people in earlier years. Lower back and neck pain are the biggest cause of ill-health in England, while obesity is the biggest risk factor for becoming unwell.

Where you live and how you live make a big difference to the likely length of your life and chances of good or poor health. Men and women in the most deprived areas can expect to spend 20 years fewer in good health compared with those living in the least deprived areas.

The PHE director of health improvement, John Newton, said: “For both men and women, almost half the population live in areas where healthy life expectancy is slightly less than the current state pension [age]. It is a slightly larger proportion of women than men … [but] a significant proportion of our population cannot expect to live in their pension age in good health.”

Diabetes, most of which is type 2 and linked to being overweight, has for the first time become one of the top 10 causes of ill-health and disability. The bill has been predicted to potentially cripple the NHS, which spends £14bn a year on testing and treatment.

Leading cause of morbidity

But lower back pain and neck pain are ranked ahead of diabetes. Part of that is down to the ageing population, but excess weight and lack of activity are also factors.

Among men, skin disorders, such as acne and psoriasis, are the second most common cause of ill-health, although they are three times less common than lower back and neck pain. Third among men and second among women is depression.

Lifestyle, poverty and education all make a difference to health. Among the medical risks are being overweight or obese and having high cholesterol. High BMI (body mass index, a measurement of obesity) can lead to heart disease, stroke, osteoarthritis, back pain, chronic kidney disease, diabetes and some cancers.

“Behavioural risks include smoking, alcohol and unsafe sex, while environmental and occupational risks include air pollution, unclean water and other risks due to the working or living environment,” said the report.

Nations that cannot fight tobacco industry should raise taxes, says WHO

African nations whose attempts to regulate cigarettes are increasingly bogged down in the courts by wealthy tobacco companies should impose high taxes to deter people from developing a smoking habit, the World Health Organization says.

Vinayak Prasad of WHO’s Tobacco Free Initiative said many African governments were at a disadvantage in the fight against the industry over regulatory controls, like graphic health warnings on packs, which are the norm in the west. They have neither the funds nor enough expertise to deal with the big tobacco companies’ threats, intimidatory letters and law suits.

His comments follow the exposure by the Guardian of the attempts by multinational tobacco companies to delay and dilute regulatory controls in Africa through litigation and threats. At least eight African governments have been pressured by the industry.

“Just focus on getting the tax raised,” urged Prasad. WHO, the World Bank and others were trying to encourage and assist countries in changing their tobacco taxation, which countries from the Philippines to India had demonstrated could raise millions of dollars for healthcare or other essential government spending.

Developing nations do not have enough money or staff devoted to public health, he said. Often those in government who lead on tobacco control are also the key players for other areas, such as mental health.

“The tobacco epidemic has already reached the African continent. Countries have started to prioritise it but inherently the systems are weak. They need to build human resource capacity and technical capacity to respond to industry threats,” he told the Guardian. “We are working extremely hard [to help them] but we need to do more.”

Reacting to the Guardian’s reports, the former public health minister Caroline Flint said: “It is sad to see firms like BAT fighting African governments for years over health warnings on cigarette packages and modest taxes. In any western nation they would have conceded these issues years ago. It speaks volumes about their approach to Africa that the tobacco giants appear willing to fight on all fronts to protect their sales.”

Lord Rennard, the vice chair of the all-party parliamentary group on smoking and health, said a tax on the profits of firms “could provide funds for legal support to governments in poorer countries seeking to resist tobacco damaging the health of their local populations”.

The tobacco industry also vigorously opposes hikes in the taxation of cigarettes, which is proven to reduce the numbers who smoke. The companies and tax advisers who intervene on their behalf with governments claim that tax hikes lead to smuggling from countries where the prices are lower. Prasad says that is not so if taxation is simplified, so that the same sum is levied on every carton regardless of brand.

Deborah Arnott, chief executive of campaigning group ASH, said the revelations showed that the industry had not turned over a new leaf, focusing on vaping and aiming for a smoke-free future, as it claims. “The Guardian has thrown a spotlight on the dirty truth, the leopard hasn’t changed its spots, it’s still promoting the same old lethal products the same way it always did, in countries where it can get away with it,” she said.

“Last century 100 million people died from smoking, if Big Tobacco isn’t stopped then this century a billion will be killed by their lethal products and most of them will be from low and middle income countries. The tactics being used in Africa of denial, deception and delay were used very successfully in the UK in the last century, but they’re no longer being allowed to get away with it here and smoking rates have plummeted as a result. Africa needs to learn from our experience, if you regulate the industry strictly the smoking epidemic can be halted and reversed.”

Dr Tom Frieden, former director of the Centers for Disease Control and Prevention in the US, said in a tweet that the revelations showed the “outrageous and shameful activities of tobacco industry in Africa”. US senator Richard Blumenthal, who spent his career promoting anti-smoking legislation, and was one of 46 state attorneys general to secure hundreds of billions of dollars in damages from tobacco companies in a 1990s settlement, said that in developing markets “tobacco companies have actively resisted” health regulation. “They have actively intervened with governments, and particularly so in Africa.”

José Luis Castro, president and chief executive officer of Vital Strategies, an organisation which promotes public health in developing countries, said: “The danger of tobacco is not an old story; it is the present. The industry is using every tool at its disposal to hook new smokers, especially kids, in Africa and other parts of the world.” There is a huge gap between what the industry says and what it does, he said. “It’s time this sham was called out in every country and in every public forum. When the tobacco industry gets near government, it poisons efforts to protect health.”

The multinational companies say they do not oppose tobacco regulation that is sound and evidence-based. “However, where there are different interpretations of whether regulations comply with the law, we think it is entirely reasonable to ask the courts to assist in resolving it,” British American Tobacco told the Guardian. Imperial Tobacco also said it supported regulation, but it would “continue to make our views known on excessive, unnecessary and often counter-productive regulatory proposals”.

Philip Morris International said it has contact with public authorities on a range of issues, “such as taxation, international trade, and tobacco control policies. Participating in discussions and sharing points of view is a basic principle of public policy making and does not stop governments from taking decisions and enacting the laws they deem best”.

This content is funded, in part, by Vital Strategies.

Meningitis vaccine may also cut risk of ‘untreatable’ gonorrhoea, study says

Hopes to fight untreatable strains of gonorrhoea have risen after it emerged that a new vaccine against meningitis unexpectedly reduced the risk of people getting the sexually transmitted infection.

Some strains of gonorrhoea are resistant to all available drugs, making vaccine development an urgent global health priority. But according to a study in The Lancet, a vaccine has offered protection against the sexually transmitted disease for the first time.

Gonorrhoea spreads through unprotected vaginal, oral or anal sex and many of those who contract the disease experience no symptoms. If left untreated, the disease can cause infertility and can increase the transmission of HIV infection.

A New Zealand meningitis epidemic in the early 2000s prompted the mass vaccination of a million people and fortuitously set the scene for the current study. The vaccine used, known as ‘MeNZB’, was designed to protect against meningococcal group B infection – the cause of the most deadly form of meningitis.

But intriguingly, over the next few years, scientists noticed fewer gonorrhoea cases than expected in those who had been vaccinated against meningitis.

Dr Helen Petousis-Harris, a vaccine specialist from the University of Auckland who led the study, was optimistic: “Some types of gonorrhoea are now resistant to every antibiotic we have, and there appeared [to be] little we could do to prevent the steady march of gonorrhoea to ‘superbug’ status. But now there’s hope,” she added.

The research team studied over 14,000 people aged 15-30 who’d been diagnosed with gonorrhoea at sexual health clinics across New Zealand and who had been eligible for the MeNZB vaccine during the emergency vaccination programme. They found vaccinated individuals were over 30% less likely to develop gonorrhoea.

Despite meningitis and gonorrhoea being very different illnesses, both are caused by bacteria from the same family and share much of the same genetic code, providing a possible explanation for the cross-protection that the team observed.

More than 78 million people worldwide get gonorrhoea each year with most infections in men and women under the age of 25. It is the second most common bacterial sexually transmitted infection in the UK after chlamydia. In England alone, almost 35,000 people were affected in 2014.

British Association for Sexual Health and HIV’s President, Dr Elizabeth Carlin, who was not involved in the study, was more sceptical: “These early findings are to be welcomed but it’s important to keep in perspective that the vaccine offered only “moderate” protection …. an individual receiving this vaccine remains susceptible to gonorrhoea but just less so than if unvaccinated.”

The MeNZB vaccine used in the current study is no longer manufactured, but Petousis-Harris has high hopes for a similar meningitis vaccine called ‘4CMenB’, available in many countries.

Petousis-Harris was clear about what needed to happen next. “We need an urgent assessment of current meningitis vaccines to see if they protect against gonorrhoea. It may be possible to eliminate many gonorrhoea infections using a vaccine with only moderate protection. It does not need to be perfect,” she added.

Yemen’s cholera death toll rises to 1,500, says World Health Organisation

The death toll from a major cholera outbreak in Yemen has risen to 1,500, Nevio Zagaria, the World Health Organisation’s representative in Yemen, said on Saturday, and appealed for more help to put an end to the epidemic.

Yemen has been devastated by a 27-month war between a Saudi-led coalition and the Iran-aligned Houthi group, making it a breeding ground for the disease, which spreads by faeces getting into food or water and thrives in places with poor sanitation.

Speaking at a joint news conference with representatives of the United Nations Children Fund and the World Bank, Zagaria said there had been 246,000 suspected cases up to 30 June.

Although most of Yemen’s health infrastructure has broken down and health workers have not been paid for more than six months, the WHO is paying “incentives” to doctors, nurses, cleaners and paramedics to staff an emergency cholera network.

With funding help from the World Bank, the WHO is setting up treatment centres with 50-60 beds each, overseen by shifts of about 14 staff working around the clock. The aim is to provide 5,000 beds.

Yemen’s cholera death toll rises to 1,500, says World Health Organisation

The death toll from a major cholera outbreak in Yemen has risen to 1,500, Nevio Zagaria, the World Health Organisation’s representative in Yemen, said on Saturday, and appealed for more help to put an end to the epidemic.

Yemen has been devastated by a 27-month war between a Saudi-led coalition and the Iran-aligned Houthi group, making it a breeding ground for the disease, which spreads by faeces getting into food or water and thrives in places with poor sanitation.

Speaking at a joint news conference with representatives of the United Nations Children Fund and the World Bank, Zagaria said there had been 246,000 suspected cases up to 30 June.

Although most of Yemen’s health infrastructure has broken down and health workers have not been paid for more than six months, the WHO is paying “incentives” to doctors, nurses, cleaners and paramedics to staff an emergency cholera network.

With funding help from the World Bank, the WHO is setting up treatment centres with 50-60 beds each, overseen by shifts of about 14 staff working around the clock. The aim is to provide 5,000 beds.