Every year, World Toilet Day is observed to raise awareness about the global sanitation crisis and encourage action to solve it. The goal set by the United Nation is to achieve safe toilets for all by 2023, as a part of their Sustainable Development Goals.

The UN also states that 3.5 billion people live without proper sanitation and many children also lose their lives due to poor sanitation and unsafe water. This is why World Toilet Day is observed to raise awareness on this issue.

Theme

This year, the theme for World Toilet Day 2024 is "Toilets - A Place for Peace'. This focuses on the growing threat to sanitation that is caused by conflict, climate change, disaster and neglect. When there is a threat to using toilets, it can lead to many health risks.

Not using toilets for too long may lead to Urinary Tract Infection or UTI. For many who do not have access to clean toilets do not drink enough liquid or hold pee for too long. Doctors suggest that holding in pee for too long can cause bacteria to multiply and lead to UTI. By not drinking enough water, your bladder fails to tell the body to pee often, and can cause the bacteria to spread through the urinary tract, which can lead to infection.

Symptoms of UTI:

• Burning or stinging feeling while urinating
• Pain in pelvis or lower abdomen
• Constant urge to empty the bladder
• Strong or foul smelling urine
• Consistently dark urine
• Blood in urine

Holding in pee for too long can also cause your bladder to stretch, making it difficult or even impossible for the bladder to contract and release pee normally. It can also damage your pelvic floor muscles or could lead to kidney stones.

World Toilet Day History And Significance

To prevent such conditions, it is important that everyone has access to clean and safe toilets. In terms of history, the day was established in 2001, by the World Toilet Organization (WTO), which was founded by Jack Sim. However, it was officially recognised by the UN in 2013. The Government of Singapore worked with WTO to create the first UN resolution called Sanitation for All.

India too promotes safe and hygiene toilet through its Swachh Bharat Yojna.

Russia has reported a milestone in its experimental personalised cancer vaccine development. The first patient to complete treatment with the country's mRNA-based cancer vaccine is reportedly doing well as the follow-up scans showed no new tumour growth in the four months after completing therapy.

The update was shared by Alexander Gintsburg, scientific director of Moscow's Gamaleya Research Institute of Epidemiology and Microbiology.

According to a report published by Kursiv, the patient is undergoing monthly examinations at Russia's National Medical Research Centre for Radiology, including high-resolution CT scans. Doctors are paying attention to the lymph nodes where cancer is most likely to spread.

The patient will remain under medical observation for the next three years. While the early findings are promising, they are based on a single patient's experience, which is a major limitation.

Russia's Personalised mRNA Cancer Vaccine

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The treatment, known as NeoOncovac, is a personalised cancer vaccine developed with the help of messenger RNA (mRNA) technology.

Unlike preventive vaccines that protect people against infections, therapeutic cancer vaccines are designed to help the immune system recognise and attack existing cancer cells.

The vaccine is customised using the genetic characteristics of an individual's tumour. Researchers analyse tumour samples to identify specific mutations that could help distinguish cancer cells from healthy cells.

The mRNA is then designed to instruct the body to produce these targets related to tumour, prompting the immune system to recognise and attack the cancer cells. It aims to make the immune response more specific to the patient's cancer rather than targeting all cancer cells.

Six Patients Received The Vaccine

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According to reports citing Gintsburg, six patients with melanoma have received the personalised vaccine so far. The first has completed the treatment course, while the second is reportedly halfway through a course involving 10 administrations. Four other patients have also begun treatment.

Russian specialists expect to treat around 20 patients at the Herzen Moscow Research Institute of Oncology by the end of 2026. The country's Health Ministry has reportedly allocated funding for the treatment and follow-up of 120 patients during 2026 and 2027.

Even though the findings are promising, they should not be interpreted as evidence of a cancer cure. The current update concerns one patient with melanoma, a type of skin cancer. Although doctors have reported no new tumour growth during the follow-up period, four months is too short to establish whether the response will last or whether the cancer could return.

There are also currently no results from a large controlled clinical trial that could establish the vaccine's effectiveness, long-term safety or survival benefit.

Outcomes across more patients will be essential to determine whether the treatment can consistently produce similar results.

Personalised cancer vaccines are an active area of research internationally. In October 2026, Moderna and Merck reported positive late-stage trial findings for their experimental personalised mRNA melanoma vaccine, used alongside the immunotherapy drug pembrolizumab (Keytruda).

The trial involved more than 1,100 patients and found a reduction in the risk of melanoma recurrence or death compared with Keytruda alone. However, this is a different vaccine and treatment from Russia's NeoOncovac.

In a major milestone in fetal and paediatric neurosurgery in India, doctors at the All India Institute of Medical Sciences (AIIMS), New Delhi, have performed the country's first open fetal surgery to repair myelomeningocele, the most severe form of spina bifida.

The six-hour procedure was carried out at 25 weeks of pregnancy, in which surgeons were able to repair the baby's spinal defect before birth. The surgery, performed on November 12, entailed repairing a cerebrospinal fluid leak in the lower back while the baby was still in the uterus.

According to AIIMS press release, the operation followed more than five weeks of preparation in multiple disciplines, including detailed fetal imaging, counselling, planning anaesthesia and surgical simulations.

The procedure was done by more than 30 clinicians and nurses from neurosurgery, maternal-fetal medicine, obstetrics, anaesthesia, plastic surgery, radiology and neonatology.

Professor PS Chandra, Head of Neurosurgery at AIIMS, who facilitated the entire surgical execution by the neurosurgery team, said that prenatal surgery could help reduce the incidence of hydrocephalus and Chiari malformations linked with spina bifida.

What Is Myelomeningocele?

Myelomeningocele is an open neural tube defect in which the spinal cord and its protective coverings protrude through an opening in the developing spine. It occurs when the neural tube, which eventually develops into the brain and spinal cord, does not close completely during early pregnancy.

The condition can cause permanent nerve damage, muscle weakness or paralysis, loss of bladder and bowel control, and complications involving the brain and spinal cord. Some affected babies also develop hydrocephalus, a condition in which excess cerebrospinal fluid accumulates in the brain.

In many cases, surgery to close the spinal defect is performed after birth. However, exposure of the spinal cord to the surrounding amniotic fluid during pregnancy can contribute to further neurological injury.

India continues to face a burden of neural tube defects. A 2024 review of 27 Indian studies estimated their pooled prevalence at 9.46 per 1,000 births.

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Is Fetal Surgery The Way Forward?

Unlike conventional postnatal surgery, open fetal repair involves operating on the fetus while it is still inside the uterus. The surgeon accesses the uterus, exposes the affected area of the baby's spine and closes the defect, protecting the exposed spinal cord and its coverings. The aim is to limit further damage to the developing nervous system and improve certain neurological outcomes.

Professor Deepak Gupta, who led the neurosurgical part of the procedure, said, “This establishes an important new capability for fetal care and paediatric neurosurgery in India. In rigorously selected cases, prenatal repair seeks to limit ongoing injury to exposed neural tissue, reduce the subsequent need for cerebrospinal-fluid diversion for hydrocephalus, and improve selected neurological outcomes. It is not a cure, and long-term multidisciplinary care remains essential.”

Evidence for prenatal repair comes from the landmark Management of Myelomeningocele Study (MOMS), an international clinical trial. It found that 40% of children who underwent prenatal surgery required a cerebrospinal fluid shunt by 12 months of age, compared to 82% of those who underwent surgery after birth. Prenatal repair also helped with better motor outcomes and a lower incidence of hindbrain herniation linked with Chiari II.

But fetal surgery comes with its risks. It can increase the chances of premature delivery. It also carries risks related to the opening and subsequent healing of the mother's uterus. It is therefore performed only on carefully selected pregnancies at specialised centres equipped with resources.

Milestone In Fetal Surgery

The AIIMS procedure brings a complex fetal intervention, which is already done in other countries, to India's public healthcare system.

Professor Neena Malhotra, who led the maternal-fetal medicine and obstetric part of the surgery alongside Professor K Aparna Sharma, said, “This accomplishment reflects the collective commitment of an exceptional multidisciplinary team.”

Professor Sharma added, “Fetal intervention in this case is a very well-reasoned and planned decision to optimise the outcomes of both the baby and the mother. The safety of both mother and fetus depends on detailed counselling, high-quality anaesthesia, and coordinated surveillance before and after surgery.”

AIIMS said the procedure was performed free of cost under the Government of India's Janani Shishu Suraksha Karyakram (JSSK). The mother and fetus will continue to receive close monitoring throughout the remainder of the pregnancy, delivery and newborn period.

Also read: First Human Spinal Cord Transplant Reported In Russia But Can It Reverse Paralysis?

Can Spina Bifida Be Prevented?

Prevention of spina bifida remains essential even though the option of fetal surgery is available. Neural tube closure takes place within the first 28 days after conception, often before a woman realises she is pregnant.

Adequate folic acid intake before conception and during early pregnancy can significantly reduce the risk of neural tube defects. Preconception counselling, folic acid intake and dietary interventions with folate are therefore important to prevent spina bifida.

The World Health Organization (WHO) has issued its first-ever guidelines for the diagnosis and management of type 1 diabetes in adults. The recommendations aim to improve insulin access and blood glucose monitoring in countries where healthcare resources are limited.

Released on November 14 to mark World Diabetes Day 2026, the guidelines cover insulin treatment, blood glucose monitoring and care in emergency and humanitarian settings. They are meant to help healthcare providers deliver safer treatment, regardless of the resources available.

The guidelines come as the global burden of type 1 diabetes continues to grow. In 2025, 500,000 people were diagnosed with type 1 diabetes, adding to an estimated 9.5 million people living with the condition worldwide in 2025, according to the WHO. Although type 1 diabetes is often diagnosed during childhood, it can develop at any age, including adulthood.

WHO Guidelines On Type 1 Diabetes

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A primary recommendation is intensified insulin treatment through multiple daily injections, along with the doses adjusted according to blood glucose levels. People with type 1 diabetes cannot produce enough insulin and therefore need lifelong insulin therapy to survive.

The guidelines recognise insulin as an effective and affordable treatment option. Insulin analogues, which are modified forms of insulin designed to alter how long the medicine works, may also be used when needed. The guidelines also address how treatment and monitoring can be adapted in low-resource settings and during emergencies.

The recommendations also emphasise regular blood glucose monitoring.

• HbA1c testing: A blood test that provides an estimate of average blood glucose levels over the previous two to three months.
• Finger-prick testing: Allows people to check their blood glucose levels at home at different points during the day.
• Continuous glucose monitoring (CGM): Uses a small sensor worn on the skin to track glucose levels throughout the day.
• Urine glucose testing: May be considered when blood glucose testing is not available.

Importance Of WHO Guidelines

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More than a century after insulin was discovered, access to affordable treatment remains a challenge for many people with type 1 diabetes. Interruptions in insulin supply can be life-threatening because the body depends on externally administered insulin to regulate blood glucose.

Without enough insulin, blood glucose can rise dangerously and lead to diabetic ketoacidosis (DKA), a fatal complication.

“Insulin is a lifesaving treatment, discovered more than 100 years ago. Yet many people with type 1 diabetes do not have access to affordable and high-quality insulin,” said Dr Søren Brostrøm, WHO Director of Noncommunicable Diseases and Mental Health.

“The new WHO guidelines provide evidence-based recommendations to help countries deliver the best possible care, including in settings where resources are limited and health services are disrupted.”

The WHO guidelines aim to reduce these gaps by providing recommendations that can be implemented across different healthcare systems, including those with limited resources. They also support the organisation's bigger target of ensuring universal access to affordable insulin treatment and blood glucose self-monitoring by 2030.

The WHO has encouraged countries to involve people living with type 1 diabetes in designing diabetes programmes, so that they reflect practical challenges patients face.

Type 1 diabetes is an autoimmune condition in which the immune system destroys the insulin-producing beta cells in the pancreas. Unlike type 2 diabetes, it is not primarily caused by insulin resistance or lifestyle factors.

People with the condition need lifelong insulin treatment, alongside regular glucose monitoring and medical follow-up. Without appropriate management, diabetes can lead to complications affecting the eyes, kidneys, nerves and cardiovascular system.