Friday, 17 November 2017

ADDRESSING GLOBAL OBSTACLES TO CARE OF BORRELIOSIS PATIENTS (LYME AND RELAPSING FEVER)





Jenna Luché-Thayer: Addressing Systemic Obstacles in the Borreliosis Pandemic 


Jenna Luché-Thayer gave this presentation at the International Lyme and Associated Diseases Society (ILADS) Annual Scientific Conference in Boston, November 10, 2017. Jenna is the founder of the Ad Hoc Committee for Health Equity in ICD11 Borreliosis Codes. In this presentation, Jenna explains how the Ad Committee is trying to address global obstacles to care experienced by Lyme and relapsing fever borreliosis patients and describes how you can use this information to address these human rights abuses. The Ad Hoc Committee was formed in 2016 to:  update the World Health Organization’s (WHO) International Classification of Disease (ICD) codes for Lyme borreliosis (LB)  demonstrate how the outdated codes are contributing to human rights violations The Ad Hoc Committee members:  represent Asia Pacific region, Africa, North and South America and Eastern, Western and Northern Europe  represent scientific, medical and human rights experts, clinicians and professors across well respected academic and research centers and as advisors to governments and WHO  have worked on borreliosis for two and three decades  have many hundreds of peer-reviewed publications and studies The Ad Hoc Committee’s report, Updating ICD11 Borreliosis Diagnostic Codes was accepted by WHO prior to the March 30, 2017 deadline for code revisions. Also, as per WHO’s required rules and process for ICD revisions, each recommendation with supporting references was entered onto the WHO ICD Beta Platform. The Updating ICD11 Borreliosis Diagnostic Codes report was also submitted to Dr. Dainius Pūras, the United Nations Human Rights Council’s Special Rapporteur for the right of everyone to the enjoyment of the highest attainable standard of physical and mental health. The Ad Hoc Committee was then invited to meet with Dr. Pūras in his official capacity on June 7, 2017 —an event that does not take place unless there exists a legitimate cause for concern about violations of the right to health and other health-related human rights. Dr. Pūras accepted all the Committee’s documentation including reports, books and videos, PowerPoint and verbal testimony, his Senior Human Rights Officer and Team Leader put them into record. Dr. Pūras also told the Ad Hoc Committee how he could support this effort within the framework of his mandate. The report is now a published document with an assigned ISBN number. Therefore, it may be cited and quoted as a reference for many purposes including medical, scientific, legal, human rights, public health and economic analysis. For more details - see https://www.linkedin.com/pulse/addressing-systemic-obstacles-borreliosis-pandemic-jenna-luche-thayer/ 
 (posting below for those who don't use linkedin.)

Addressing Systemic Obstacles in the Borreliosis Pandemic

November 15, 2017 —contact jennaluche@gmail.com


On November 10, 2017 global human rights expert Jenna Luché-Thayer gave a comprehensive presentation to over 700 medical and scientific professionals attending the International Lyme and Associated Diseases Society (ILADS) 18th Annual Scientific Conference in Boston [1].

Luché-Thayer is the founder of the Ad Hoc Committee for Health Equity in ICD11 Borreliosis Codes. In this videoed presentation, Jenna explains how the Ad Hoc Committee is trying to address human rights abuses such as the obstruction to healthcare experienced by Lyme and relapsing fever borreliosis patients across the globe.

Luché-Thayer provides compelling evidence as to how this disease has been politicized by the World Health Organization (WHO) and other key institutions responsible for public health and medical care. The entire presentation —Addressing Systemic Obstacles in the Borreliosis Pandemic— is for available for free viewing on YouTube.

The presentation also explains how the Ad Hoc Committee’s report, Updating ICD11 Borreliosis Diagnostic Codes: Edition One [2], may be used by those concerned with the injustices associated with this pandemic.

The report was accepted by WHO prior to the March 30, 2017 revisions deadline for international classification of diseases (ICD) codes. Also, as per WHO’s required rules and process for ICD revisions, each recommendation with supporting references was entered onto the WHO ICD Beta Platform. 

The Updating ICD11 Borreliosis Diagnostic Codes report was also submitted to Dr. Dainius Pūras, the United Nations Human Rights Council’s Special Rapporteur for the right of everyone to the enjoyment of the highest attainable standard of physical and mental health.

The Ad Hoc Committee was then invited to meet with Dr. Pūras in his official capacity on June 7, 2017 —an event that does not take place unless there exists a legitimate cause for concern about violations of the right to health and other health-related human rights. Dr. Pūras accepted all the Committee’s documentation including reports, books and videos, PowerPoint and verbal testimony, his Senior Human Rights Officer and Team Leader put them into record. Dr. Pūras also told the Ad Hoc Committee how he could support this effort within the framework of his mandate.

The report is now a published document with an assigned ISBN number. It may be cited and quoted as a reference for many purposes including medical, scientific, legal, human rights, public health and economic [3]. The following key information can be cited from the report:

The record now shows 100s of peer-reviewed studies —written by nationally and internationally recognized scientists and medical researchers from across the globe— describing:

Congenital Lyme disease, persistent infection, Borrelial lymphocytoma, Granuloma annulare, morphea, localized scleroderma, lichen sclerosis and atrophicus, Lyme meningitis, Lyme nephritis, Lyme hepatitis, Lyme myositis, Lyme aortic aneurysm, coronary artery aneurysm, late Lyme endocarditis, Lyme carditis, Late Lyme neuritis or neuropathy, Meningovascular and Neuroborreliosis – with cerebral infarcts, Intracranial aneurysm, Lyme Parkinsonism, Late Lyme meningoencephalitis or meningomyelo-encephalitis, Atrophic form of Lyme meningoencephalitis with dementia and subacute presenile dementia, Neuropsychiatric manifestations, late Lyme disease of liver and other viscera, late Lyme disease of kidney and ureter, late Lyme disease of Bronchus and lung and seronegative and Latent Lyme disease, unspecified.

Furthermore, no medical condition was entered into record if it had less than three supporting peer-reviewed publications. The Committee members then gave verbal and additional written testimony as to how medical practitioners on the Committee had collectively and effectively treated tens of thousands of patients with persistent and complicated LB with clinical practice guidelines that have meet internationally accepted standards

These materials firmly establish the significant possibility that patients with persistent Lyme require biological medical care —not as a matter of opinion, but as a matter of scientific fact. Furthermore, treatment options for persistent Lyme —including extended and combination antimicrobial therapies— that have met internationally recognized standards for clinical guidelines are available, as are accredited educational programs on how to implement such therapies.

The record also shows many different types of health human rights violations. These include how obstruction of access to treatment options from clinical practice guidelines that meet internationally accepted standards for guidelines violates the Availability, Accessibility, Acceptability, Quality (AAAQ) of Health Human Rights imperatives for "non-discriminatory" practices and medical ethics. The record also shows how LB patients who have received clinical diagnosis are routinely denied care should laboratory tests fail to confirm their clinical diagnosis.  

Many practices resulting from these codes are recognized as human rights violations. Furthermore, the codes are linked to policies recommending practices that:

—for many patients, prevent proper diagnosis and obstruct access to treatment options that meet internationally accepted standards

—promotes discrimination based on illness manifestations 

—misapplies somatic diagnosis [4] to deny medical care 

—obstructs treatments based on illness manifestations  

—promotes discrimination based on financial status 

—supports attacks on human rights defenders —including medical practitioners, scientists and researchers who act on behalf of this vulnerable patient group

—restricts information regarding treatment options that meet internationally accepted standards

—routinely excludes key stakeholders —such as medical practitioners, researchers, patients and caretakers who are concerned with persistent and complicated cases of LB —from decision-making venues … making these stakeholders invisible to policy makers, economists and other practitioners and researchers

—permit sick children under treatments that meet internationally accepted standards be forcibly removed from their parents —and there are many cases where such parents are falsely accused of poisoning their children or Munchausen by Proxy  

—support alarming cases where euthanasia is encouraged over treatments that meet internationally accepted standards

To summarize, the science and medical knowledge regarding persistent and complicated LB —from hundreds of peer reviewed publications written by nationally and internationally recognized experts— has been routinely ignored or suppressed. Furthermore, the human rights defenders of this patient group are routinely threatened and punished for fulfilling their Hippocratic oath to this marginalized patient community. Despite this institutionalized obstruction to care, tens of thousands of patients with persistent and complicated Lyme and relapsing fever borreliosis have regained quality of life, manage their illness and have become productive and contributing members of society by overcoming these obstructions and gaining access to extended treatments that meet internationally accepted standards for clinical guidelines.

The widespread discrimination experienced by Lyme and relapsing fever patients has been systemic and institutionalized across ICD codes, national health policies and medical and insurance systems. Altogether, these factors have led to gross human rights violations that are on record with the United Nations Human Rights Council’s Special Rapporteur for the right of everyone to the enjoyment of the highest attainable standard of physical and mental health.


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[1] The full presentation is available for viewing on youtube: https://www.youtube.com/watch?v=LLIO0r1mCcE (titled: Jenna Luché-Thayer: Addressing Systemic Obstacles in the Borreliosis Pandemic)

[2] Updating ICD11 Borreliosis Diagnostic Codes Authors: Jenna Luche-Thayer,‎ Holly Ahern,‎ Dominick DellaSala, Sherrill Franklin,‎ Leona Gilbert,‎ Richard Horowitz,‎ Kenneth Liegner, Clement Meseko, Mualla McManus, Judith Miklossy,‎ Natasha Rudenko,‎ Astrid Stuckelberger‎. Contributing researchers: Joseph Beaton,‎ John Blakely,‎ Phyllis Freeman,‎ Kunal Garg,‎ Huib Kraaijeveld,‎ Vett Lloyd,‎ Leena Merilainen. Cees Hamelink - Senior Advisor, Jeff Levy - editorial support, Angelica Johannson - organizational support. Publisher: CreateSpace Independent Publishing Platform (October 7, 2017). ISBN-10: 1978091796 and ISBN-13: 978-1978091795

[3] The report is now available on Amazon and all proceeds support the voluntary work by the Committee.

[4]Medically Unexplained Symptoms or MUS has been repudiated by the American Psychiatric Association (APA) and removed from the Diagnostic and Statistical Manual of Mental Disorders (DSM). 




Sunday, 5 November 2017

NICE DRAFT LYME DISEASE GUIDELINES SHAME UK MEDICINE

CONCLUSION TO THE VIRAS STAKEHOLDER COMMENTS 

In view of the extraordinary number of opportunities that these NICE (National Institute for Health and Care Exellence) guidelines provide for putting doctors and patients at serious risk, it is essential for all interested parties to be aware that NICE take no responsibility for any misleading information or dangerous advice included in their guidelines. Here is a typical NICE Guidance disclaimer:



 “Health care providers need to use clinical judgement, knowledge and expertise when deciding whether it is appropriate to apply guidances. The recommendations cited here are a guide and may not be appropriate for use in all situations. The decision to adopt any of the recommendations cited here must be made by the practitioners in light of individual patient circumstances, the wishes of the patient, clinical expertise and resources. The National Clinical Guideline Centre disclaims any responsibility for damages arising out of the use or non-use of this guidance and the literature used in support of this guidance.” (https://www.nice.org.uk/guidance/cg138/evidence/full-guideline-pdf-185142637) 


Whilst NICE have discarded a wealth of research and evidence as unsuitable in preparing their guidance, that same evidence may nevertheless stand-up in court.

Examples of foreseeable harms to patients are: if and when the restrictive treatment recommendations fail to eradicate a Lyme infection and a patient suffers injury as a result, or, if and when laboratory testing deprives a patient of a necessary diagnosis and treatment, and they suffer injury as a result. 

Then the evidence that has been ignored may receive a fair hearing in legal proceedings, especially as much of this information comes from very experienced scientists and physicians. Harms to patients and complaints against doctors are not just predictable, they are inevitable if doctors with Lyme disease patients follow the advice as presented in the draft form. However, none of this is any consolation to doctors who do not want to spend their time dealing with GMC complaints and law suits, but who simply want to help their patients based on a balanced presentation of the available pool of knowledge.


VIRAS and others have provided ample evidence of foreseeable harms resulting from misleading advice about Lyme disease. NICE may wash their hands of any responsibility by claiming that individual doctors are responsible for their clinical decisions, but they can and will be held to account for negligently misleading the public and government agencies, discriminating against sick and disabled patients, and permitting their procedures to be exploited by groups and individuals with competing interests. 


Doctors do not have to follow NICE guidelines but they must be able to justify their clinical decisions. The USA Centers for Disease Control and Prevention (CDC) now estimate that they have over 300,000 cases of Lyme disease per year. Some of the most experienced and knowledgeable Lyme disease doctors and scientists in the USA have produced reliable and trustworthy advice on the management of diverse aspects of Lyme disease. For doctors who want a thorough understanding of Lyme disease medicine, including the limitations of current 18 knowledge, VIRAS recommends the authoritative resources listed here: 
http://www.ilads.org/Lyme/treatment-guideline.php


VIRAS reject the NICE draft guideline as unfit for purpose. It contains some downright dangerous advice and too many contradictions to even form the basis of a semi-reasonable guideline. It is biased, discriminatory and appears to be designed to serve undeclared agendas. It implies certainty where there is none. Where it admits uncertainty it omits to provide balanced views to allow doctor’s and patients to make informed choices and give informed consent as is required in the practice of medicine in the UK. This makes the draft unethical. It evades awkward and potentially embarrassing issues such as the inaccuracy of testing provided by the NHS, which it misrepresents with false assurances. It evades the serious medical issues of chronic Lyme disease, coinfections, misdiagnosis of Lyme as some other condition, and inadequate treatment. The guideline is not quantitative or qualitative or a rational amalgam of both. It is bereft of scientific discipline or basic humanistic and medical values.


NICE should have halted the process and rejected the task of producing a guideline when it became apparent that the vast majority of research did not meet the threshold for inclusion. Instead, it has produced a draft based on just a tiny and biased proportion of decades of research. The draft guideline is irrelevant to 99% of UK Lyme patients who would be harmed by its publication. The number and nature of the Research Recommendations clearly shows that not enough is known to produce a guideline that could remotely approach the required standards for NICE Guidance. These Research Recommendations relate to absolutely basic medical science concerned with the diagnosis, treatment and management of Lyme disease. Without good data to work with, or a balanced presentation of all the evidence available, the end product could only ever be a self-contradictory and impractical mess. 


Thousands of UK Lyme disease patients have been obliged to take matters into their own hands due to the ignorance and incompetence of Public Health England. PHE (incorporating the HPA) have actively obstructed the diagnosis and treatment of Lyme disease patients for decades. The victims of this discrimination have been forced to either accept terrible illness which for many, represents a life-sentence of loss and suffering, or to seek medical help elsewhere. Patients spend their often meagre income and all their savings to get accurate tests and treatment that have been denied to them by the NHS. 


The outcome of the treatment that they are forced to pay for, may not always be the cure that they sought. This is partly due to the incompetence that has delayed their diagnosis and treatment for months, years or even decades. Yet for many, their treatment brings great relief. Some of the appalling chronic symptoms improve or resolve completely. Physical and mental functioning which could have been reduced to just a tiny percentage of their pre-Lyme infection levels, are substantially improved and can be maintained with treatment. These patients KNOW what PHE policies have done to them and are doing to others. They will recognise the PHE official position on Lyme disease permeating the NICE draft guideline. They are not paranoid or conspiracy-theorists, they know from their own lived experience that Lyme disease is a national health threat that is being controlled by vested interests that disregard their Human Rights and the fundamental tenets for the practice of medicine. It is in spite of PHE that many of these patients have improved health, and such is the suffering that many have endured, they do not want others to have a similar experience. With the finest motives that grace humanity, even though their health and fitness may still be just a sad remnant of the energy they once enjoyed, they give of that time and energy to help others who will otherwise be doomed by PHE to the living hell of chronic Lyme disease. 


The draft guideline shames UK medicine and will bring the good names of the NHS and NICE into disrepute. The danger to patients is obvious. This confused and confusing guide will predictably harm patients and threaten the reputation and values of doctors who place their trust in it


The above is the Conclusion, the Summary can be read in full from the VIRAS ( Vector-borne Infection - Research, Analysis, Strategy)  website.
  

Summary of VIRAS response to NICE Draft Guideline for Lyme Borreliosis available
 http://counsellingme.com/VIRAS/VIRAS.html 


the Draft Nice Guidelines for Lyme Disease.
https://www.nice.org.uk/guidance/indevelopment/gid-ng10007/consultation/html-content-2


Wednesday, 19 July 2017

HUMAN RIGHTS VIOLATIONS AND ETHICAL DECISION MAKING ABOUT CHRONIC LYME DISEASE





Published on Jun 2, 2017 Presentation to UN Special Rapporteur on Health and Human Rights, June 8 2017, as a member of the Ad Hoc Committee for Health Equity in ICD11 Borreliosis Codes.



Human Rights Violations of Relapsing Fever and Lyme Disease Patients Under International Investigation

FOR IMMEDIATE RELEASE June 27, 2017

Contact author: Jenna Luché-Thayer 

EMAIL: jennaluche@gmail.com

Human Rights Violations of Relapsing Fever and Lyme Disease Patients Under International Investigation

A report submitted to World Health Organization resulted in a meeting between a United Nations Human Rights Council Special Rapporteur and medical professionals, scientists, human rights experts and advocates on June 7, in Geneva, Switzerland. This meeting focused on the violations against persons living with borreliosis infections, such as relapsing fever and Lyme disease.

Special Rapporteur, Dr. Dainius Pūras heard presentations on the range of these violations by representatives from an international Ad Hoc Committee dedicated to updating the World Health Organization’s (WHO) diagnostic codes for borreliosis infections and Global RBCC, a consortium responding to the Lyme disease epidemic.

Jenna Luché-Thayer, a human rights expert with 32 years of experience in 42 nations reported, “Borreliosis infections are pandemic – these include relapsing fever and Lyme borreliosis. The WHO diagnostic codes do not recognize many of the disabling conditions caused by these infections. Across the globe, medical systems use these codes to diagnose illness and determine treatments. The outdated codes result in very sick people being denied treatment —even when treatment options meet the internationally accepted gold standard for guidelines set by the Institute of Medicine (IOM). In addition to denial of care, there are attacks on medical professionals who are following these guidelines to treat chronic Lyme disease patients.” 

The former Senior Advisor to the United Nations and U.S. government asked, “Can you imagine very sick children, in the process of healing through treatments from gold standard guidelines, being forcibly removed from their parents? This is happening in many countries. Can you imagine health insurance companies telling Lyme patients they will not cover such treatments but will pay for their euthanasia? According to Dutch researcher Huib Kraaijeveld, this is happening in Europe. These are shameful and predatory actions, and appear to be largely driven by outdated science, outdated codes and skewed financial motivations,” says Luché-Thayer. 

The Lyme disease bacteria —spirochetes similar to syphilis— are known to evade immune response and form biofilms that are difficult to eradicate. Disputes about appropriate treatment often leave patients with no treatment options for their disabling neurological, cardiac and arthritic symptoms, as well as unrelenting fatigue and pain. Lyme carditis, an infection of the heart, can cause death and undiagnosed Lyme can lead to dementia.

Hundreds of peer reviewed publications describe serious physical conditions caused by the infection. They include Lyme nephritis, hepatitis, aortic aneurysms, persistent infection, strokes and congenital Lyme disease. The complications from Syphilis are clearly listed and detailed in the WHO codes whereas most Lyme complications are not. 

Dr. Clement Meseko, Chief Research Officer and Onehealth/Ecohealth advocate at the National Veterinary Research Institute in Vom, Nigeria told the Special Rapporteur, “Many Africans depend on livestock for their livelihood and this exposes them to zoonotic borreliosis. WHO diagnostic codes for these infections need to be updated and surveillance across Africa needs to be improved. Until this happens, many people in Africa will just suffer.” 

The WHO diagnostic codes for Lyme disease parallel the views held by the Infectious Diseases Society of America (IDSA). IDSA is a private medical society that promotes strict treatment limitations, regardless of Lyme patient response, and in contrast to their recommendations for other patient groups suffering from persistent infection. Some IDSA members theorize that undiagnosed mental illness, rather than persistent infection, might explain why IDSA recommended protocols fail thousands of clinically diagnosed Lyme patients.

The 2006 IDSA Lyme treatment guidelines do not meet the IOM’s internationally accepted standards for guidelines. Some of the guideline authors provide expert witness for insurers against Lyme patients; and insurers use the 2006 IDSA guidelines to deny coverage of treatments from guidelines that do meet IOM standards. 

Dr. McManus is a Founder of the Tick Borne Diseases Unit at the University of Sydney and a Board Director of International Lyme and Associated Diseases Society (ILADS). ILADS is a medical society that developed the patient-centered treatment guidelines that meet the IOM’s standards

Dr. McManus is very concerned by the lack of diagnostic tools for the thousands of Australian patients who show symptoms of tick borne diseases but never test positive for Lyme disease because they have variant forms of relapsing fever. According to McManus, poor diagnostic tools and lack of clinical familiarity leave most of these patients untreated. 

In testimony to the Special Rapporteur, bioethicist Diane O’Leary, of the Kennedy Institute of Ethics at Georgetown University notes that global health organizations have clear ethical obligations. “In the context of scientific debate about the biological origins of chronic Lyme, policy makers have a duty to proactively protect the right to health.”  Ethically speaking, it is not possible to justify the risk involved in continuing to obstruct access to medical care for chronic Lyme patients, stated O’Leary.

Prof. Christian Perronne is an internationally renowned Infectious and Tropical Diseases specialist with over 300 scientific publications and has played an advisory role to WHO. Prof. Perronne asked the Special Rapporteur, “How can any treatment options be withheld from these very sick patients? This goes against the Hippocratic oath of do no harm. In France, I have used prolonged treatment options longer than six weeks to successfully help thousands of patients.” 

The representatives also attended the Special Rapporteur’s annual presentation to the United Nations Human Rights Council and met with official and diplomatic delegates from many nations to discuss their concerns.

According to Ad Hoc Committee and Global RBCC founder Luché-Thayer, this is just the beginning of their actions. “We will report any government agency, medical board, medical society or health insurance company that interferes with these human rights, said Luché-Thayer. “We are stakeholders with a global reach and an international presence and the Special Rapporteur has the mandate to investigate all these abuses.”

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Jenna Luché-Thayer, Ad Hoc Committee for Health Equity in ICD11 Borreliosis Codes and Global RBCC, Copyright © All Rights reserved