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Effective infant vaccination against pneumonia needed in sub-Saharan Africa (http://www.news-medical.net, 28 May 2010)
Researchers at the University of Warwick, and the Kenya Medical Research Institute, Kilifi, Kenya, have found that respiratory syncytial virus (RSV) appears to be the predominant virus detected among infants and children hospitalized in Kenya with severe pneumonia, according to a study in the May 26 issue of JAMA. The contribution to this severe disease by an individual pathogen stresses the need for effective infant vaccination.
Glaxo Tries a Linux Approach (http://online.wsj.com, 26 May 2010)
A decade ago, the Linux operating system helped spark a revolution in how software is developed. A move by GlaxoSmithKline PLC could test how well similar open-source principles work for developing new drugs.
The pharmaceutical giant last week opened to the public the designs behind 13,500 chemical compounds that it said may be capable of inhibiting the parasite that causes malaria.
Glaxo and others hope that sharing information and working together will lead scientists to come up with a drug for treating the mosquito-borne disease faster than the company could on its own. Other researchers "may look at these structures in quite a different way and see something that we don't," said Nick Cammack, head of Glaxo's Medicines Development Campus in Spain.
... The Glaxo effort builds off earlier open-source drug efforts that included a nonprofit organization called Tropical Disease Initiative and a project started last year that opens compounds from Pfizer Inc. to researchers at a nonprofit called Drugs for Neglected Disease Initiative.
WHA endorses interim targets to eradicate measles as WHO warns disease on the rise (http://www.news-medical.net, 25 May 2010)
"Measles is making a rapid comeback in African, Asian and even some European countries despite being easily avoided through vaccination, the World Health Organization said Friday as countries pledged to sharply cut infections and deaths worldwide by 2015," the Associated Press reports. On the final day of the 63rd Annual World Health Assembly, the assembly endorsed a series of interim targets towards the global eradication of measles.
"These targets are set for 2015 and are to achieve at least 90 percent measles vaccination coverage nationally and 80 percent coverage in every district, reduce measles cases to less than five per million population, reduce measles mortality by 95 percent compared to 2000 levels," said Peter Strebel, medical officer in WHO's Department of Immunization, Vaccines and Biologicals.
Photos: Avatars, virtual doctors and 24/7 telemedicine - the future of healthcare (http://www.silicon.com, 17 May 2009)
Researchers at the Media Labs at Massachusetts Institute of Technology are working on a project which aims to connect patients to their doctor 24/7, known as CollaboRhythm.
The project, run by Dr John Moore, hopes to use mobile devices, touchscreen displays and avatars to give patients more control and understanding of their treatment.
An avatar, or software agent as it's known, asks the patient a series of questions about their care before they see their GP.
H1N1 Vaccines - Global Strategic Business Report (http://www.researchandmarkets.com/, April 2010)
This report analyzes the Global market for H1N1 Vaccines in US$ Million. Annual estimates and forecasts are provided for the period 2009 through 2015.
The report profiles 21 companies including Baxter International, Inc., CPL Biologicals Pvt. Ltd., CSL Limited, GlaxoSmithKline Plc, MedImmune, LLC, Novartis AG, Sanofi Pasteur, SA, Simcere Pharmaceutical Group, Sinovac Biotech Ltd., Solvay SA, and Zydus Cadila.
Market data and analytics are derived from primary and secondary research.
Company profiles are mostly extracted from URL research and reported select online sources.
GSK, EMBL-EBI, NLM and CDD collaborate to apply principles of open source to drug discovery for malaria (http://www.news-medical.net/news, 20 May 2010)
GlaxoSmithKline (GSK) had teamed up with leading public-domain data providers European Bioinformatics Institute (EMBL-EBI), the U.S. National Library of Medicine (NLM) and the U.S.-based informatics service provider Collaborative Drug Discovery (CDD) to make freely available key scientific information on more than 13,500 compounds that could ultimately lead to new treatments for malaria.
The release of this data marks the first time that a pharmaceutical company has made available the structures of so many compounds and is made possible through the collaboration of the web hosts and their specialist research tools, which will be available at no cost to researchers
Using sari cloth to filter water protects household from cholera: Study (http://www.news-medical.net/news, 20 May 2010)
A five-year follow up study in Bangladesh finds that women are literally wearing the answer to better health for themselves, their families and even their neighbors. Using the simple sari to filter household water protects not only the household from cholera, but reduces the incidence of disease in neighboring households that do not filter. The results of this study appear in the inaugural issue of mBio-, the first online, open-access journal published by the American Society for Microbiology (ASM).
'Malaria Kills More Than HIV/Aids' in Nigeria (http://allafrica.com, 20 May 2010)
Malaria kills more than HIV/AIDS in Nigeria, Head of Pediatrics, Usmanu Dan Fodiyo University Teaching Sokoto Dr. Muhammad Jiya has said. ...
Dr. Jiya noted that malaria accounts for the death of two million children annually, stressing the need to prevent the disease.Sokoto State Programme Officer, Malaria control programme, Dr Aminu Shehu, said 30 percent of illnesses handled were malaria related.
Saint Louis University conducts research to find safe, effective vaccination for dengue (http://www.news-medical.net/news, 20 May 2010)
Sponsored by the National Institutes of Health (NIH), Saint Louis University's Center for Vaccine Development is conducting research of an investigational vaccine designed to prevent people from contracting dengue, a potentially lethal virus that has rapidly spread around the world.
"Finding a safe and effective vaccination for dengue is a global health priority," said Sarah George, M.D., assistant professor in the division of infectious diseases at Saint Louis University and principal investigator of the study.
Statue commemorating 30th anniversary of the eradication of smallpox unveiled (http://www.news-medical.net/news, 18 May 2010)
A statue commemorating the 30th anniversary of the eradication of smallpox is being unveiled today in front of the World Health Organization (WHO) headquarters by the Director-General of the World Health Organization, Dr Margaret Chan.
Prior to eradication, smallpox epidemics were common in many countries, leaving death, blindness and disfigurement behind. The eradication of this devastating, infectious disease has been called one of the greatest achievements in public health.
When water becomes a curse (http://www.irinnews.org, 18 May 2010)
A 15-year river blindness immunization programme in the fertile bread-basket of otherwise-arid Borno State in northeastern Nigeria, now in its 11th year, hangs in the balance for lack of funds.
The disease, also known as onchocerciasis, reduced agricultural activities in the past two decades as farmers fled riverine areas, but this flight abated when aid agencies started the immunization programme. Now, two-thirds of the way through, it could flounder.
With up to 36 percent of inhabitants of southern Borno contracting river blindness, the state has the country’s highest prevalence levels, and is considered “hyper-endemic”, according to the Health Ministry’s National Onchocerciasis Control Programme.
“The flowing waters and good vegetation have endowed the southern part of Borno State with a paradoxical curse because these streams and vegetation which are good for cultivation have become breeding grounds for the black flies responsible for high cases of onchocerciasis in the region,” ....
Australian doctors identify new disease and devise its cure (http://www.news-medical.net/news, 17 May 2010)
A team of Australian doctors have identified a new disease and its cure. In their report published in the journal Clinical Infectious Diseases the doctors from The Queensland Institute of Medical Research (QIMR) report a case of a young NSW woman ill for almost a decade with repeated hospitalizations. She is now said to be suffering from a diseases that disabled the signaling processes of her immune system. The diseases is not named yet. Dr Maher Gandhi, head of QIMR's Immunohemotology Laboratory believes there are more cases of this disease. He said this Monday, “I haven't got a name for it other than T-cell signaling defect of which I assume there are quite a few different types… There are no recorded cases of this in the literature. Katie is unique ... I think we're at the tip of the iceberg here.”
Disappearance of drugs undermines Uganda’s fight against malaria (http://www.bmj.com, 17 May 2010)
Efforts to control malaria in Uganda have been undermined by a lack of first line treatments in public health centres, say investigators from a newly established health monitoring unit that has made dozens of arrests in a crackdown on illicit sales of government owned drugs.
Three senior health officials are currently on trial for corruption: Richard Ndyomugenyi, a senior medical officer, Myers Lugemwa, a doctor, and Martin Shibeki, programmes assistant.
Detective Ian Kakuru told a court in Kampala that the case involved the alleged mishandling of more than 625 000 doses of antimalarial drugs worth 1.1 billion Ugandan shillings (£0.35m; 0.41m; $0.51m)
Researchers design new technique to quickly distinguish between people with active and dormant TB (http://www.news-medical.net/news, 17 May 2010)
An emerging technique designed to quickly distinguish between people with active and dormant tuberculosis may help health professionals diagnose the disease sooner, thereby potentially limiting early exposure to the disease, according to a study conducted by researchers at Duke University Medical Center.
"Current blood tests for tuberculosis are reasonably good at distinguishing between uninfected and infected persons, but cannot tell the whether an infected person has active, and possibly infectious, tuberculosis or has latent infection," said senior author Jason Stout, M.D., M.H.S., assistant professor of medicine at Duke University Medical Center. "Generally a culture is required to tell the difference between latent infection and active tuberculosis, but a culture usually requires weeks to deliver a result. A rapid test that could tell the difference between latent and active tuberculosis would be a major step forward."
Safeguarding Healthcare Workers (http://www.expresshealthcare.in, May 2010)
... "The tragic irony of the present situation is that the healthcare workers at greatest risk-those in countries where the prevalence of blood-borne pathogens in patient populations are highest-are afforded the least protection. In resource-limited countries, healthcare workers are not systematically vaccinated against hepatitis B. Although their training is often subsidised by their Governments, the expense of protecting that national investment by providing a life-saving vaccination is most often viewed as optional," opines Dr Janine Jagger, Professor of Research of Internal Medicine and Infectious Diseases at the University of Virginia.
Healthcare staff runs the daily risk of contracting life-threatening infections from blood borne pathogens including HIV, hepatitis B and hepatitis C. In the US, from these sharps injuries there have been 57 documented cases of HIV sero conversion among healthcare personnel through 2001. Two thousand workers a year become infected with hepatitis C, and 400 contract hepatitis B. More than 20 additional types of infectious agents have been transmitted through needle stick injuries, including tuberculosis, syphilis, malaria, herpes, diphtheria, gonorrhea, typhus and Rocky Mountain spotted fever. Exposure to HIV, HBV or HCV also has implications on personal relationships, future employment, and even insurance coverage.
U.S. healthcare practitioners can resume use of Rotarix, says FDA (http://www.news-medical.net, 15 May 2010)
GlaxoSmithKline (NYSE: GSK) announced that the Food and Drug Administration (FDA) has determined that U.S. healthcare practitioners can resume the use of Rotarix® (Rotavirus Vaccine, Live, Oral), effective immediately. This action supersedes the FDA's recommendation from March 22, 2010 and reflects the agency's assessment that the presence of porcine circovirus type 1 (PCV-1) in the vaccine poses no safety risk.
Science Special Issue Reports On Malaria (http://globalhealth.kff.org, 14 May 2010)
This week's issue of Science features news articles focusing on recent progress on malaria control in Africa and discussing future challenges, including drug resistance. Summaries appear below:
"Africa is the key battlefield in the fight against malaria – and in recent years, there have been major successes," Science reports in a that attributes such successes to "the widespread introduction of insecticide-treated bed nets, indoor spraying, and a new generation of drugs called artemisinin-based combination therapies (ACTs)." However, as the article notes, "most of the successful countries were small and peaceful. More than half of all malaria cases occur in Nigeria, the Democratic Republic of the Congo, Sudan, Tanzania, and Uganda – and in some of those, the challenges are far greater."
The article includes a quote from Robert Newman, head of the WHO's Global Malaria Programme, and features a map of Africa, highlighting the countries who have made gains in the fight against malaria and those where challenges remain.
A separate examines how scientists are responding to the call to eradicate malaria: "Nobody believes that [malaria eradication is] possible in the next 10, 20, or even 30 years. But the call for eradication, combined with the plummeting malaria burden, are already reshaping the scientific agenda," Science notes. "Rather than preventing disease and death, there's a new focus on breaking the chain of transmission between host and parasite," according to the article.
Drive to vaccinate children in developing countries faces "acute crisis" because of high costs (http://www.bmj.com, 12 May 2010)
Médecins Sans Frontières and Oxfam International have warned that the global campaign to vaccinate children in poor countries is being hampered by high prices and is facing an acute funding crisis.
A report issued by the charities says that multiple factors make delivering vaccines to children in developing countries difficult. These include "high prices of newer vaccines, the lack of R&D [research and development] for better-adapted and needed vaccines, as well as weak health systems with corresponding health worker shortages."
Fighting malaria with scarves (http://www.bmj.com, 11 May 2010)
Can treating traditional scarves worn by migrant workers along the Thai-Cambodian border with insecticide help reduce the incidence and transmission of drug resistant malaria? This is a question that the researchers David Sintasath, of the Malaria Consortium in Thailand, and Sylvia Meek, former director of the London School of Hygiene and Tropical Medicine, London, and now director of the Malaria Consortium, are about to explore, thanks to a $100 000 grant from the Bill and Melinda Gates Foundation. The project is one of 78 similar ones to receive a grant awarded in the latest round of the foundation’s "grand challenges explorations."
DNA Medicine Institute Receives $100,000 Grand Challenges Explorations Grant for Innovative Global Health Research (http://www.dnamedinstitute.com, 11 May 2010)
The DNA Medicine Institute announced today that it has received a US$100,000 Grand Challenges Explorations grant from the Bill & Melinda Gates Foundation. The grant will support an innovative global health research project conducted by Eugene Y. Chan, M.D. titled "Optomagnetic Finger Scanner for Malaria."
... Current diagnosis of malaria requires invasive blood tests requiring sizable equipment. Using light-emitting diodes, magnets, and electronic components available to do-it-yourself hobbyists, Dr. Chan will develop a non-invasive finger scanner that detects the presence of malarial hemozoin crystals in infected individuals.
"I am pleased to have the opportunity to pursue an idea that pushes the envelope of malaria diagnosis. Malaria is a deadly disease that afflicts up to 500 million people each year. Millions die from it, including many young children in developing countries. My group is developing a tiny device that scans a finger, without any blood, to allow anyone, anytime, and anywhere to check for malaria infection," said Dr. Chan.
At Front Lines, AIDS War Is Falling Apart (http://www.nytimes.com, 9 May 2010)
... Uganda is the first and most obvious example of how the war on global AIDS is falling apart.
The last decade has been what some doctors call a “golden window” for treatment. Drugs that once cost $12,000 a year fell to less than $100, and the world was willing to pay.
In Uganda, where fewer than 10,000 were on drugs a decade ago, nearly 200,000 now are, largely as a result of American generosity. But the golden window is closing.
Uganda is the first country where major clinics routinely turn people away, but it will not be the last. In Kenya next door, grants to keep 200,000 on drugs will expire soon. An American-run program in Mozambique has been told to stop opening clinics. There have been drug shortages in Nigeria and Swaziland. Tanzania and Botswana are trimming treatment slots, according to a report by the medical charity Doctors Without Borders.
Toxic Waste Alert (http://www.gulf-daily-news.com. 9 May 2010)
HEALTH fears have been raised over more than two tonnes of untreated medical waste, which is being mixed in with domestic rubbish on a daily basis.
There are concerns that contaminated syringes, catheters, scalpels, scissors, blood, body fluids and even placentas could find their way into the general rubbish disposal system.
A senior environment expert has warned that serious environmental and public health problems could emerge as a result.
The Health Ministry and other medical facilities in Bahrain generate around seven tonnes of Healthcare Waste (HCW) every day, said Public Commission for the Protection of Marine Resources, Environment and Wildlife senior environmental specialist Rehan Ahmed.
However, Bahrain only has the facilities to treat five tonnes a day - meaning the rest is processed along with other municipal waste.
"While on paper it is not likely that extremely hazardous waste gets into the municipal waste, there is a very high possibility that it does due to the lack of commitment of staff and lack of awareness and control," said Mr Ahmed.
"This is a grave challenge for planners who have to deal with lack of waste segregation facilities at the point of generation, lack of awareness among the staff in waste separation and lack of efficient monitoring and control."
Reflections on the eradication of smallpox (http://www.thelancet.com, 8 May 2010)
A momentous act, regarded as impossible by many, occurred in May, 1980. The World Health Assembly, hosted by WHO in Geneva, certified that smallpox had been eradicated globally. The end of a damaging disease was celebrated in many medical, political, and scientific quarters; it was a recognition of the fact that future generations were now free of the pain, death, and mutilation that variola had inflicted in the past.
The resulting optimism had far-reaching effects, and helped foster several health-care projects during the 1980s. The Expanded Programme on Immunization (EPI) was a major beneficiary and a strong case could be made within WHO's complex frameworks for the organised deployment of immunisation campaigns. This was remarkable considering that powerful elements within WHO, including Halfdan Mahler, the Director General between 1973 and 1987, were pushing for the development of competing schemes of primary health care. It was a testament to the power of a widespread acknowledgment that the natural existence of a dangerous infectious disease had been purged by a series of human interventions.
Malaria elimination in Asia–Pacific: an under-told story (http://www.thelancet.com, 8 May 2010)
An oft-cited story describes how Sri Lanka reduced its incidence of malaria from 2·8 million cases in 1946 to a mere 17 in 1963, only to see the rate resurge in subsequent years. Yet, in the past decade, Sri Lanka has brought its annual caseload down from more than 200 000 confirmed cases in 2000 to just 670 cases in 2008, with no deaths due to malaria in more than 2 years. Similarly, in the Philippines, the past decade has seen nine provinces become malaria free, bringing the total to 22 of 81. Eight of 20 malaria-endemic countries in WHO's Western Pacific and Southeast Asia regions achieved declines in annual cases of more than 50% from 2000 to 2008. Success stories such as these reverberate throughout Asia—Pacific: in this era of renewed commitment to elimination, participants gathered in Kandy, Sri Lanka (Feb 16—19, 2010), for the second annual meeting of the Asia Pacific Malaria Elimination Network (APMEN).
ALMA launches malaria drive on opening day of WEF on Africa (http://www.news-medical.net, 7 May 2010)
The African Leaders Malaria Alliance (ALMA), comprising the heads of 26 countries, on Wednesday at the World Economic Forum (WEF) on Africa "launched a fresh drive to eliminate malaria using a combination of bed nets, insecticides and medication," ...
"ALMA said it has finalized a bulk purchase of 50 million long-lasting insecticidal nets (LLINs) by 12 African countries, which is expected to reduce costs and extend coverage of LLINs for populations threatened by malaria," ...
Tracking H1N1 through the Internet (http://www.technologyreview.in, 6 May 2010)
Next flu season, mining Internet sites such as Facebook, Twitter, and Google news may provide a faster way to track the spread of H1N1 than reports from official agencies like the World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC). That's the idea behind a new generation of disease surveillance tools, including HealthMap, an interactive online system that trawls the Internet for news, both formal and informal, tracking a virus virtually in real-time.
During the global spread of pandemic influenza A (H1N1) last year, HealthMap was able to pick up one of the earliest reports of the disease, well before the outbreak was confirmed by government agencies. Researchers kept the system running throughout the 2009 flu season and found that, on average from country to country, there was a 12-day lag period between informal reports of suspected H1N1 cases and formal confirmations of the virus. After the last wave of H1N1 outbreaks ended, researchers analyzed their data and found that lag periods coincided with a country's gross domestic product (GDP) - the wealthier the country, the faster the response.
Dual Burden of Disease is Addressed at World Malaria Day (http://allafrica.com, 6 May 2010)
On 25 April, World Malaria Day was an opportunity for the United Nations and global health organizations around the world to come together in their efforts to control the disease.
However, organizations are recognizing the need to analyze the relationship between communicable and non-communicable diseases and also the relationship between diseases like malaria and issues of development.
... In the past decade, the overwhelming number of communicable diseases in sub-Saharan Africa has been the priority for aid organizations. However, recent findings suggest that the decline in communicable diseases have led to an increase in non-communicable diseases. While it is uncertain whether there is a definite correlation, health organizations are speculating that the two are related.
Novartis Seeks Payment for Cancelled Orders (http://online.wsj.com, 6 May 2010)
About half of the 15 governments that ordered H1N1 vaccine from Novartis AG ended up cancelling part of their orders, and some are still negotiating with the company over payment, Andrin Oswald, head of Novartis's vaccine business, said in an interview.
Dr. Oswald said Novartis will seek clearer cancellation terms in future pandemic contracts.
"We would need ... more clarity in the contract about what happens in the situation we have right now, if a government feels it has too much vaccine," he said in a phone interview, "because the debates we have right now are not helpful."
... "As late as October, I had phone calls from governments on a high level who were even threatening us that they would take severe consequences against our company if we did not deliver more and quicker," Dr. Oswald said. "Some of these governments, of course, they called four weeks later and said, you know what, now we don't need it," ...
Novartis has still profited handsomely from the pandemic, booking H1N1 vaccine sales of more than $2 billion over the past two quarters.
Nigerian farmers rejoice in pilot insurance plan (http://www.who.int/bulletin, May 2010)
In Kwara state, a poor agricultural district in western Nigeria, health insurance is a rarity. Like 70% of Nigerians, most people survive on less than one dollar a day. If they visit the doctor at all, they have to pay out of their own pockets. However, this grim situation recently changed for one group of farmers.
They are not covered by Nigeria’s National Health Insurance Scheme (NHIS), which despite being set up more than a decade ago, still only serves 3.73% of the population... The 35 000 farmers and their dependents are in fact the beneficiaries of a scheme put together by PharmAccess, a Dutch government-backed, not-for-profit organization that supports HIV/AIDS treatment and what it describes as “general health-care projects” in developing countries.
Indian trial for inhalable measles vaccine offers hope for other diseases (http://news.oneindia.in, 6 May 2010)
A dry powder, inhalable vaccine developed for measles prevention and slated for human clinical trials later this year in India, could also help pave the way for the inexpensive treatment of a range of other illnesses, say researchers.
The vaccine, developed by a team led by Professor Robert Sievers, from University of Colorado at Boulder, involves mixing 'supercritical' carbon dioxide with a weakened form of the measles virus.
The process produces microscopic bubbles and droplets that are dried to make the inhalable powder, which is dispensed into the mouths of patients using a small, cylindrical plastic sack with an opening like the neck of a plastic water bottle.
... With the new technology, the inhaled powder is sent directly into the lungs, a good target since measles attacks through the respiratory tract said Sievers.
New Understanding of Dengue Fever Could Help With Vaccine (http://www.sciencedaily.com, 6 May 2010)
Some of the human immune system's defences against the virus that causes dengue fever actually help the virus to infect more cells, according to new research published in the journal Science.
The researchers behind the work, from Imperial College London, hope their new findings could help with the design of a vaccine against the dengue virus. The study also brings scientists closer to understanding why people who contract dengue fever more than once usually experience more severe and dangerous symptoms the second time around.
Tiny Patch Could Replace Shots (http://www.aolnews.com, 23 April 2010)
... Good news for the needle-phobic: A vaccine delivered by a nanopatch works as well as one delivered with a syringe, but is pain-free and uses 100 times less medication, according to researchers from the Australian Institute for Bioengineering and Nanotechnology.
... the nanopatch is designed to place vaccines directly into the skin, where a "rich body of immune cells are." A needle, by contrast, injects vaccines into muscles with few immune cells. As a result, the vaccines delivered by nanopatch are more effective, he said.
Conditions in Zambian prisons fueling spread of HIV, TB (http://www.news-medical.net, 29 April 2010)
"Conditions in Zambia's prisons are so overcrowded and medical care so inadequate that they are breeding grounds for disease and pose a serious threat to public health, says a new report by Human Rights Watch, produced in association with the AIDS and Rights Alliance for Southern Africa and the Prisons Care and Counselling Association," BMJ News reports. "Researchers report that similar conditions prevail in much of Africa, where prisons risk becoming reservoirs of HIV and drug resistant tuberculosis" ...
Study results from US Military Malaria Vaccine Program announced (http://www.news-medical.net/news, 28 April 2010)
... This study is the US Military Malaria Vaccine Program's first clinical trial of a DNA vaccine in over five years. The Navy selected Bioject's needle-free injection delivery technology for this trial based on its earlier data. The DNA vaccine was administered to healthy adult research volunteers in order to prime their immune responses prior to the administration of a second, adenovirus-vectored vaccine, which has undergone extensive testing by the US Military Malaria Vaccine Program during the past several years. Genetically based vaccines such as DNA plasmids and adenovirus vectors induce strong cell-mediated immunity, which is believed to be important in protection against the hepatic stage of malaria. Study results showed that four of 15 volunteers receiving this DNA prime adenovirus boost vaccine regimen were sterilely protected against malaria, and it appeared that protection was mediated by the cellular responses (as measured by ex vivo IFN-g ELISpot assay) without any contribution from antibody response. ...
Gates Rethinks His War on Polio (http://online.wsj.com, 23 April 2010)
... Is humanity better served by waging wars on individual diseases, like polio? Or is it better to pursue a broader set of health goals simultaneously—improving hygiene, expanding immunizations, providing clean drinking water—that don't eliminate any one disease, but might improve the overall health of people in developing countries?
The new plan integrates both approaches. ...
In Nigeria, Mr. Gates scored a diplomatic triumph. He won commitments from the sultan, and from Nigeria's governors, to take a more active role in polio vaccinations. "We really stand at the threshold of global health success on polio," he told the assembled governors at the close of the trip.
However, just three days later, a new front opened 2,000 miles away in Uganda. There, a woman walked into a hospital to say her son couldn't move his left leg. It was Uganda's first polio case in 12 years.
Cases also popped up in Mali, Togo and Ghana and Cote d'Ivore, which hadn't reported polio for four years. A girl in Kenya became that country's first polio case since 2006.
Polio, which spreads through water contaminated by human feces, paralyzes just one person for every 200 infected. Discovering just a few cases could mean that thousands have been infected. That demands massive vaccination campaigns.
... If approved in May by member nations of the WHO, the new strategy will set ambitious goals for getting close to eradicating polio by the end of 2012. The plan bolsters the core "vertical" approach of polio program but also adds a "horizontal" strategy, including training for health workers on topics such as hygiene and sanitation.
Malaria emergency in northern Burundi (http://www.msf.org.uk/, 24 April 2010)
Burundi has been grappling with a serious increase in the numbers of malaria patients since the start of the year. The MSF teams have been cooperating with Burundi authorities to fight the disease’s spread by treating patients and distributing mosquito nets to prevent new infections.
Malaria is spread through the bite of certain species of mosquito. These particular mosquitoes have been particularly rife in northern Burundi since late 2009. Malaria cases have spread in the provinces of Kayanza, Ngozi and Karusi. The Burundian authorities have asked MSF to help them respond to this emergency situation.
MSF’s emergency teams thus rallied in Kayanza and Ngozi provinces to roll out a three-pronged strategy. The different elements include support to local hospitals, testing and treating patients in the various villages through mobile clinics, and distribution of mosquito nets to avoid new infections. Another MSF team is evaluating the situation in Karusi province.
Africans Advance Quest for a Malaria Vaccine (http://allafrica.com, 24 April 2010)
On World Malaria Day 2010, the international community marks a historic milestone in the fight against malaria. This past year, we launched a Phase III efficacy trial of the world's most advanced malaria vaccine candidate in 11 research centers spanning seven African countries. Phase III is the last big step for a vaccine candidate before submission for approval to regulatory authorities.
Malaria takes a devastating toll on communities in Africa. In Ghana, like many African countries, malaria is the one of the most deadly diseases for children under the age of five. To be sure, we will need to use every tool available, including bed nets, indoor residual spraying and drugs, to fight this disease. A vaccine would complement existing interventions and has the potential to save hundreds of thousands of lives.
WHO Investigates Polio Outbreak in Tajikistan (http://www1.voanews.com, 23 April 2010)
The World Health Organization says it is sending technical experts to Tajikistan to investigate an outbreak of seven cases of polio in the country. It says this is the first importation of polio in the European region since Europe was certified as polio-free in 2002.
... "Planning is already going on for three large-scale vaccination campaigns," Bari (WHO spokeswoman) said. "There are about 864,000 children under the age of five that we will reach with this vaccine. And, surrounding countries, particularly Uzbekistan and Kyrgyztan are being asked to step up their surveillance for acute flaccid paralysis, which is a sign of polio and to look into their immunization rates to make sure that children are adequately protected in those surrounding areas."
Bari says these immunization campaigns are expensive. She says Rotary International has given $500,000. But, additional funding will be needed to buy the vaccines and carry out the campaigns.
She says the polio crisis comes at a time when WHO and other U.N. agencies are struggling to contain a big outbreak in Africa.
Immunization week to kick off in 112 countries (http://www.who.int/mediacentre, 23 April 2010)
For the first time, immunization campaigns are being launched simultaneously tomorrow in 112 countries and territories in the World Health Organization Regions of the Americas, Eastern Mediterranean and Europe, with the goals of expanding immunization coverage and raising awareness of the importance of vaccines
The simultaneous immunization weeks, which began in the Americas in 2003, expanded to the European Region in 2005, and start this year in the Eastern Mediterranean, promote national and cross-border activities in a collaborative effort to prevent disease and save lives. Many countries are working to eliminate measles, and most are expanding vaccination to reach those who have been excluded up to now.
Measles, polio vaccination drive targets Saada children in Yemen (http://www.irinnews.org, 19 April 2010)
A 12-day measles and child polio vaccination campaign began on 17 April in parts of the troubled northern Yemeni governorate of Saada, targeting over 209,000 children, health officials say.
All under fives in seven of the governorate’s 15 districts will be vaccinated against both measles and polio. Those aged 5-15 will be vaccinated against measles, ...
... The campaign began with the vaccination of children in internally displaced persons (IDP) camps in Saada city, he said, adding that eventually all children in the governorate would be vaccinated, "including those living with their families in IDP camps and outside the camps."
Tuberculosis–resistance, funding, and drugs (http://www.thelancet.com,
... The tuberculosis component of Millennium Development Goal 6–halting and reversing the incidence of the disease by 2015–is likely to be achieved; indeed incidence has been falling since 2004. But this target is becoming less relevant. “We are replacing an epidemic of drug-susceptible tuberculosis, with an epidemic of multidrug-resistant tuberculosis”, warns Jaramillo.
There are issues of funding. Affected countries are expected to provide most of the resources to fight multidrug-resistant tuberculosis. WHO envisages 1·3 million cases up to 2015, the worldwide cost of treatment for which would be US$16 billion. $1·3 billion is needed to treat multidrug-resistant tuberculosis just this year, but only $280 million has been made available, despite governments pledging substantially greater amounts. It does not augur well for the increased funding that WHO expects will be necessary to combat drug-resistant tuberculosis over the next few years.
Coordination essential in malaria battle (http://www.thelancet.com, May 2010)
... According to the WHO World Malaria Report 2009, published in December, and the Roll Back Malaria campaign's Malaria Funding and Resource Utilization, the huge funding inputs from organisation such as the Global Fund to Fight AIDS, Tuberculosis and Malaria, the US President's Malaria Initiative, The Gates Foundation, and the Wellcome Trust, to name a few, have spurred on efforts to eradicate malaria through programmes targeting parasite reservoirs, habitat management, treatment of infected people, and prevention of transmission.
... But the good news is belied by the global malaria statistics. In 2008 there were an estimated 243 million cases and 863 000 deaths worldwide; the vast majority, 85% and 89% respectively, were in sub-Saharan Africa. Scale-up in funding, prevention, and vector control is not always matched by reductions in disease burden. Success stories such as Eritrea and Argentina are cancelled out by the picture in large countries with huge numbers of people at risk, such as Nigeria, DR Congo, Kenya, and Brazil, where disease burden has not decreased substantially. Despite enormous success in roll-out of prevention, many countries lack sufficient treatment, and drug resistance compounds this problem. Surveillance is another area of shortfall—but tracking of resistance and monitoring of transmission are essential not only for control, but also for elimination.
Pneumococcal vaccine has cut disease among Navajos (http://www.health.am, 22 April 2010)
The infant pneumococcal vaccine introduced 10 years ago has cut rates of pneumonia, meningitis and other infections among Navajos in the U.S.—but their risks remain higher than average, a new study finds.
The pneumococcal conjugate vaccine, commonly known as PVC7, was licensed in 2000 for protecting young children against several strains of the Streptococcus pneumoniae bacterium. The bug causes a range of infections, including so-called invasive pneumococcal disease (IPD)—pneumonia, meningitis and bacteremia (a blood infection).
Before the vaccine was introduced, Alaskan Natives, Navajos and White Mountain Apaches were known to have rates of IPD up to 20-times greater than that of the general U.S. population.
NanoBio Launches Development Program for a Therapeutic Intranasal Vaccine for the Treatment of Hepatitis B (http://www.merid.org, 21 April 2010)
NanoBio Corporation and the University of Michigan's Michigan Nanotechnology Institute for Medicine and Biological Sciences will work together to develop an intranasal vaccine for the treatment of hepatitis B (HBV). More than 370 million people worldwide are infected with the HBV virus, leading to nearly one million deaths annually. Vaccinations are routinely given to infants to prevent infection, lowering the incidence in recent years, but no vaccine can protect those previously infected. The nanoemulsion-based HBV vaccine developed by the NanoBio and U of M team will undergo preclinical trials to demonstrate its ability to safely induce failure.
New pilot program to boost HPV and Tdap vaccination rates among women (http://www.news-medical.net, 21 April 2010)
Obstetrician/gynecologist offices may be the ideal venue for boosting vaccination rates among women, say researchers at Duke University Medical Center. They reported today on a successful pilot program focused on providing HPV (human papillomavirus) and Tdap (tetanus, diphtheria, pertussis) vaccines to non-pregnant and post-partum women.
The researchers say the program, funded by the U.S. Centers for Disease Control, could be a model for ob/gyn clinics across the country to increase much-needed immunizations among eligible adults.
New species of human malaria recognised (http://www.lshtm.ac.uk/news, 19 April 2010)
Scientists investigating ovale malaria, a form of the disease thought to be caused by a single species of parasite, have confirmed that the parasite is actually two similar but distinct species which do not reproduce with each other, according to research published in The Journal of Infectious Diseases this week.
Researchers from the London School of Hygiene & Tropical Medicine, the Hospital for Tropical Diseases and Mahidol University, Bangkok collaborated last year in order to share their research after noticing that the single parasite Plasmodium ovale, though visible through a microscope, was not detected by forensic DNA tests designed to identify the species.
Carl E Taylor (Public Healthcare Legend) (http://www.thelancet.com, 10 April 2010)
At the age of 88 years, Carl Taylor, who founded and chaired the Department of International Health at the Johns Hopkins University Bloomberg School of Public Health for almost 25 years, moved to Afghanistan. For 2 years he worked there, helping people provide basic health care for their communities. Afghanistan presented an opportunity for Taylor “to put almost nine decades of community-based primary health care research done throughout the world into practice one last time”
...
Taylor worked in more than 70 countries researching community-based health care, mentoring health professionals and community workers, and leading programmes and research projects. He wrote extensively about his field research and issues of health equity. His 2002 book, Just and Lasting Change: When Communities Own Their Futures, written with his son Daniel Taylor-Ide, urged public health programmes to integrate community-level initiatives, support from national government agencies, and expertise from researchers.
Is there an ethical obligation to complete polio eradication? (http://www.thelancet.com/, 17 April 2010)
In May, 2010, the World Health Assembly (WHA) is expected to endorse the aggressive new strategy of the Global Polio Eradication Initiative (GPEI) to stop polio transmission. Earlier this year, the Executive Board of the WHA expressed strong support for finishing the job of polio eradication. They were encouraged by the Independent Evaluation of Major Barriers to Interrupting Poliovirus Transmission which concluded in November, 2009, that “if the managerial, security, and technical issues can be addressed, polio eradication can be achieved”. To supporters of the GPEI this renewed commitment must surely come as a relief—after more than 20 years of effort, the initiative has come under fire for failing to achieve eradication and support for adopting an “effective control” strategy has gained traction.
Those who favour “effective control” (maintaining fewer than 500 polio cases per year indefinitely) question the wisdom of pursuing eradication for diseases such as polio and malaria, given the technical and sociopolitical challenges, costs, and the uncertainty in ascertaining eradication. Although the ethical case against eradication has been articulated, we were surprised to find no explicit ethical justification in support of polio eradication. Ethics discussions about mass immunisation programmes, and polio eradication more specifically, have focused on analyses of risks and benefits, informed consent, transparency, and the tension between the individual and collective good. However, there have been no claims about an ethical obligation to eradicate polio. Why is an ethical argument for disease eradication needed?
Novel instrument may help limit spread of diarrhoea-causing bacteria
(www.news-medical.net/news, 16 April 2010)
New strains of Clostridium difficile are making the diarrhoea-causing bacteria a global health problem. In hospitals especially, the bacteria can be extremely harmful. But a new instrument devised by Professor Chris Probert at The University of Bristol and Norman Ratcliffe from the University of the West of England (UWE) may help limit its spread.
Professor Probert, a gastroenterologist, spent many years dealing with patients with diarrhoea, and he noted that these patients' nurses could tell, 'who has got what kind of diarrhoea by some of the features of the stool. I stored that information away.' Likewise, his patients with Colitis and Crone's Disease often remarked that they knew when, 'they were going to get an attack of colitis or Crone's because the smell is different.'
Swiss epidemiologist calls for more quality studies on malaria control measures (http://www.news-medical.net/news, 15 April 2010)
Despite wide acclaim as a successful policy there is currently almost no quantitative evidence showing how well spraying the walls of people's homes with mosquito-killing insecticide really works against malaria. This is the key finding of a new Cochrane Systematic Review.
The method, known as "Indoor Residual Spraying" (or IRS), has been widely used in the world since 1950. While it clearly works, it is impossible at present to quantify its protective effect. As a result, international agencies, donors and national programmes working on malaria control are not able to compare the benefits of IRS with any other approach.
"At a time of major investments into malaria prevention (over 500 million dollars in 2009) this is of great concern," ...
First Meeting Of WHO H1N1 Response Probe Concludes (http://globalhealth.kff.org, 15 April 2010)
The first meeting of external experts tasked with reviewing the WHO's handling of the H1N1 (swine flu) virus came to a close Wednesday, with health leaders maintaining it was still too early to declare the pandemic over, Agence France-Presse reports.
"John Mackenzie, the head of the panel advising the WHO on flu and pandemic alerts, told the probe [panel] that the alert should not be wound down" until experts had the opportunity to track the progression of the virus "in the south's traditional autumn and winter flu seasons over the coming months," the news service writes. The group is expected to reconvene "in two or three weeks to advise WHO Director-General Margaret Chan on whether the world has moved to a post-peak phase" of H1N1 ...
A Campaign Shows Signs of Progress Against Polio (http://www.nytimes.com, 12 April 2010)
A decade after the world’s original deadline for eradicating polio, the most tenacious bastions of the crippling virus — Nigeria and India — have recently shown remarkable progress in halting its spread, giving even some of the antipolio campaign’s severest doubters hope that it may yet largely achieve its goal.
In Nigeria, Muslim leaders in the north — who had allowed the disease to spread by halting polio vaccinations in 2003-4, based on rumors that the drops were part of a Western plot to sterilize Muslim girls or spread the AIDS virus — now embrace the cause as their own. So far this year, only two children have been paralyzed by wild polio virus in Nigeria, compared with 123 during the same period last year, according to Nigerian and international health officials.
And in India, Uttar Pradesh and Bihar — states that seemed unable to vanquish polio no matter how many times they vaccinated children — for the first time have not had a single case caused by the most virulent polio viral type for four months straight, World Health Organization officials said.
Tech startup's tools to fight malaria (http://www.news-medical.net, 15 April 2010)
Intellectual Ventures uses "Monte Carlo modeling, which requires tremendous computing power and is used widely on Wall Street and in physics." Its employees, some of whom are profiled in the article, "have created a software model that can incorporate thousands of variables to run 'what if' scenarios and simulate outbreaks of malaria on a computer. The idea is to help doctors choose which approaches to take in a given area, so they can use resources more wisely. … Researchers using the model were able to figure out how frequently the disease is spread by mosquitoes that bite people when they're outside and not sleeping. The model even lets researchers see the effect of potential vaccines that don't yet exist, so they can choose which one to develop. Better yet, the software can be applied not only to malaria but also to polio, HIV, and tuberculosis," ...
Antibiotic-resistant pneumococci increase rate of bacterial infections in children (http://www.news-medical.net/news, 13 April 2010)
In the decade since the introduction of pneumococcal vaccination, significant shifts have occurred in the bacterial strains causing serious pneumococcal infections in children, according to a pair of studies in the April issue ofThe Pediatric Infectious Disease Journal ( www.PIDJ.com).
... The two studies—one from Massachusetts and one from Texas—find that the most common cause of invasive pneumococcal infections is now a strain called serotype 19A, which is not prevented by the current pneumococcal vaccine. The studies also document a rising rate of infections caused by antibiotic-resistant pneumococci.
Tracking Pathogens in Real Time to Stop Outbreaks (http://www.amnh.org/news, 12 April 2010)
Supramap, a powerful new web-based application that tracks pathogens in time and space as they evolve, can help public health officials and national security experts predict and respond to outbreaks of infectious diseases. The program was officially announced in a paper in Cladistics.
“This tool has a lot of predictive power,” says Ward Wheeler, curator in the Division of Invertebrate Zoology at the Museum. “If the movement of a pathogen is related to bird flyways, for example, and those routes are shifting because of something like climate change, we can predict where the disease might logically emerge next.”
Operating on parallel programming on high-performance computing systems at Ohio State University and the Ohio Supercomputer Center, Supramap allows any user to input raw genetic sequences of a pathogen’s strains and build an evolutionary tree based on mutations. The branches are projected onto the globe with pop-up windows to show how strains mutate over space and time and infect new hosts.
Micro-insurance plans extend health care in Africa (http://www.google.com/hostednews, 12 April 2010)
... Even as the U.S. debates how best to insure its people against sickness, a type of health care financing is growing more popular in Africa: Micro-insurance. Activists say it can help pay for health care for some of the billions of people in the developing world who cannot afford it.
"Poor people need health insurance, they deserve it and it can be done," Nobel-prize winning economist Muhammad Yunus told The Associated Press this week. His Grameen bank already provides health insurance to around half a million poor Bangladeshis, and Yunus wants to expand further by using the Internet to connect doctors to patients in remote areas.
... Some 14 million Africans use micro-insurance, and the number of African policy holders has increased by 80 percent in the last five years, according to a recent study by the International Labor Organization. The numbers are still a fraction of the potential market but are growing rapidly as more organizations offer insurance products to the poor.
India decodes TB bacteria, paves way for new drug (http://timesofindia.indiatimes.com, 11 April 2010)
Indian scientists have mapped the Mycobacterium tuberculosis genome, a first of its kind achievement that gives hope of discovering a cost effective drug for the disease that kills at least 330,000 Indians every year.
"Our scientists along with over 100 science students from several universities have done this within a few months. We hope within 18-24 months we will be able to take one molecule to the clinical trial stage," Council for Scientific and Industrial Research (CSIR) chief Samir Bramhachari said.
"... We are doing this through open source drug discovery (OSDD) and anyone across the world is free to join the effort," Bramhachari said.
Afghanistan, Pakistan join hands to fight polio (http://www.dawn.com, 10 April 2010)
Pakistan and Afghanistan launched a joint strategy on Friday to stop transmission of polio virus through people frequently crossing the porous border.
The strategy was agreed upon in a two-day ‘Joint Cross-border Meeting’ which concluded here on Friday.
The meeting was informed that over two million children under the age of five crossed the border between Pakistan and Afghanistan during 2009.Both the countries are considered as one epidemiological block with regard to transmission of the polio virus and are in the spotlight being the final frontiers in the global fight against the virus.
Addressing the meeting, Federal Health Secretary Khushnood Akhtar Lashari called upon the World Health Organisation (WHO) in both the countries to develop a focus group which shall be tasked (sic) with ensuring coordination and dealing with cross-border issues.
Effective compound against antibiotic-resistant biofilms (http://www.news-medical.net, 9 April 2010)
Researchers at North Carolina State University have found a chemical compound that, when used in conjunction with conventional antibiotics, is effective in destroying biofilms produced by antibiotic-resistant strains of bacteria such as the Staphylococcus strain MRSA and Acinetobacter. The compound also re-sentsitizes those bacteria to antibiotics.
Pfizer to expand clinical trials in Asia, work on development of antibiotics for drug-resistant TB (http://www.news-medical.net, 9 April 2010)
The pharmaceutical company Pfizer said on Wednesday that it plans to increase the number of clinical trials it's conducting in Singapore by 10 percent as part of an effort "to design drugs for diseases prevalent in the region," Reuters reports.
"Its clinical research unit in Singapore - which had a volunteer list of 14,000 healthy individuals - would be used as a base for Asia-specific research, its research and development (R&D) executives said in Singapore," ...
UNICEF Executive Director, Ann Veneman launches Facts for Life, a guide for healthy childhood (http://www.unicef.org/media, 7 April 2010)
During a visit to Lesotho, a country entirely landlocked by South Africa, UNICEF Executive Director, Ann M. Veneman, today launched Facts for Life, a publication which delivers life-saving information to families and communities on how to prevent child and maternal deaths, diseases, injuries and violence.
“Education is key,” said Veneman. “Through simple messages, Facts For Life aims to bring vital knowledge to parents and caregivers, who are the first line of defense in protecting children from illness and harm.”
Now in its fourth edition, Facts for life has benefitted millions of individuals and communities since its first publication in 1989. Some 15 million copies of previous editions have been circulated worldwide in 215 languages.
Development of a robotic health assistant to the management of malaria among nomads (http://www.hisa.org.au, April 2010)
We received a Grand Challenges Exploration grant (a Gates Foundation initiative) for the development of a robotic health assistant to the management of malaria among nomads whose access to health service has always posed a concern. A robotic health assistant was constructed using aluminum casing. The device has three components: an interactive non-replaceable section that processes information and provides output. A replaceable laboratory containing supplies for qualitatively distinguishing between fevers associated with malaria and those that are non-malaria and a second replaceable component, a dispensary containing analgesics, ant malaria [*] and antibiotics for treating different types of fevers. The user communicates with the device using three buttons and receives feedback in Fulfude the nomadic Fulani language. The device interviews the user, processes the user’s responses and gives instructions. The accuracy of the information provided by the patient (user), and the ability of the user to carry out the instructions are critical to illness outcome. The device is solar-powered, is able to repeat previous instructions as many times as the patient desires, and provides referral.
GLOBAL: Comparing aid efficiency (http://www.irinnews.org, 8 April 2010)
Multilateral donors like the World Bank and the European Commission spend far more than individual country donors on overheads, according to research by New York University.
Multilateral donors spent a third of their aid on overhead costs and one fifth on salaries in 2008, which was respectively three and five times more than bilateral donors, the research indicated.
While the average donor spends 17 percent on overhead costs, Belgium manages to spend only 0.24 percent on overheads.
Building a Better Flu Vaccine: Add Second Strain of Influenza B (http://www.sciencedaily.com, 6 April 2010)
Vaccines likely would work better in protecting children from flu if they included both strains of influenza B instead of just one, Saint Louis University research has found.
"Adding a second influenza B virus strain to the seasonal influenza vaccine would take some of the guesswork out of strain selection and help improve the vaccine's ability to prevent influenza," said Robert Belshe, M.D., lead investigator and director of the Center for Vaccine Development at Saint Louis University.
Experts Raise Red Flag Over Tuberculosis (Uganda) (http://allafrica.com, 24 March 2010)
A strain of tuberculosis that is resistant to normal drug treatment is fast emerging in Uganda and doctors have termed it a time bomb. The new threat of the Multi-drug-Resistant Tuberculosis (MDR-TB) has worried medical experts because it cannot be treated with standard drug regimens.
According to Dr Grace Muzanye, a TB specialist with the Centre for Disease Control, although there are no precise figures on the numbers of drug-resistant TB, at least 10 per cent of the 40,000 new cases recorded in 2008 were found to have strains that are resistant to drugs.
"Most patients who are diagnosed with TB are given drugs and left to go and mix with the community which makes them vulnerable while those who are given drugs are not monitored and some do not continue with the dose," Dr Muzanya said, adding; "this leads to drug-resistant TB which is difficult and very expensive to manage.
Mosquitoes Engineered Into Flying Vaccinators (http://www.technologyreview.in, 19 March 2010)
Researchers in Japan have transformed mosquitoes into vaccine-carrying syringes by genetically engineering the insects to express the vaccine for leishmaniasis--a parasitic disease transmitted by the sandfly--in their saliva. According to a study in Insect Molecular Biology, mice bitten by these mosquitoes produced antibodies against the parasite. It's not yet clear whether the immune response was strong enough to protect against infection.
"Following bites, protective immune responses are induced, just like a conventional vaccination but with no pain and no cost," said lead researcher Shigeto Yoshida, from the Jichi Medical University in JapanYoshida, in a press release from the journal. "What's more continuous exposure to bites will maintain high levels of protective immunity, through natural boosting, for a life time. So the insect shifts from being a pest to being beneficial."
Malaria emergency in northern Burundi (http://www.msf.org.uk, 24 March 2010)
Burundi has been grappling with a serious increase in the numbers of malaria patients since the start of the year. The MSF teams have been cooperating with Burundi authorities to fight the disease’s spread by treating patients and distributing mosquito nets to prevent new infections.
Malaria is spread through the bite of certain species of mosquito. These particular mosquitoes have been particularly rife in northern Burundi since late 2009. Malaria cases have spread in the provinces of Kayanza, Ngozi and Karusi.
Researchers Explain Repeated Infection by Some Viruses (http://www.sciencedaily.com, 2 April 2010)
New research conducted at the Oregon Health & Science University Vaccine and Gene Therapy Institute explains how a virus that has already infected up to 80 percent of the American population can repeatedly re-infect individuals despite the presence of a strong and long-lasting immune response. The research involves cytomegalovirus (CMV), which infects 50 percent to 80 percent of the U.S. population before age 40.
... "When most viruses infect a host, the immune system remembers the disease and protects against re-infection. This is the case with smallpox, seasonal strains of flu and several other viruses. This immune system reaction is also the reason why vaccines made with weakened or dead viruses work against these pathogens. In the case of CMV, the body's immune system is continuously stimulated by ongoing, low-level persistent infection, but yet CMV is still able to re-infect. This research explains how CMV is able to overcome this immune response so that re-infection occurs."
Polio immunization campaign (in Nepal) on April 10 and May 15 (http://www.myrepublica.com, 2 April 2010)
The Ministry of Health is conducting 12th National Polio Immunization Campaign on April 10 and May 15 targeting 4,466,960 children under the age of five.
The campaign that will cost around Rs 276,698,870, most of which will be borne by UNICEF, WHO and USAID, will be conducted through 39,907 centers across the country mobilizing 79,814 volunteers.
"We had managed 83 percent coverage in the 11th campaign immunizing 4,147,817 children and want to go above 90 percent this time around," KB Chand, the chief of Expanded Program on Immunization, said during an advocacy meeting with political parties Friday.
Chand said there will be only one-day campaign this time around unlike the previous 11 where volunteers would go to each home the next day looking for those who missed the polio drops due to budgetary constraints owing to lesser financial grant from the donors due to global financial crisis. "But those who missed on the days of immunization can still be taken to the nearest health center across the country and given their doses," Chand added.
As Cholera Epidemic Looms, Citizens Hope UN Will Not Repeat Past Mistakes, (http://allafrica.com, 1 April 2010)
A cholera epidemic has plagued Zimbabwe for some time, with ongoing outbreaks occurring there sporadically since 2003. The developing country has suffered long-term political instability, intense food shortages, and according to the World Health Organization (WHO), a male average life expectancy of 37 years. The most recent WHO figures from 2009 estimate that there are 79,613 suspected cases of cholera in the country. The organization's representatives have described the outbreak as "out of control."
... However, what is most troubling for the country is the downplaying of the extent of the cholera epidemic in the past, both by President Mugabe's government and by the United Nations. In an interview with The Independent newspaper on 26 November 2008, a senior official in the Zimbabwe Health Ministry claimed under anonymity that he had been prevented from accurately reporting statistics on the number of cholera deaths around Zimbabwe. Additionally in 2008, a number of months after the epidemic began, the UN appealed for aid for a mere 2,000 cases of cholera but just two months later, the death toll had already reached that number.
... The reason for the failure on the part of the UN has been debated. Former UN official Georges Tadonki has been particularity vocal in his condemnation of the UN's response to the epidemic over the last few years. Tadonki headed the UN's humanitarian office in Zimbabwe around the time that the initial outbreak turned into an epidemic. Tadonki spoke to MediaGlobal about the issue. He said that he believes that this is a very clear example of the UN failing to challenge a dictator in order to protect millions of vulnerable people.
National Delay Blamed for Measles Outbreak (http://allafrica.com/stories, 31 March 2010)
Provincial health authorities have blamed the national department for the measles outbreak in the Western Cape, saying that the delayed decision on a national mass immunisation campaign gave the virus a chance to spread here.
Criticising the national department for its "reluctance" to fast-track the campaign, Health MEC Theuns Botha said it was for this reason that the Western Cape had "brought the process forward", immunising about 45 000 children ahead of the official national roll-out.
In addition, Botha announced that the provincial health department was extending its existing measles isolation ward at Tygerberg Hospital in an effort to address the rising number of cases.
Two Groups Push for Health Funds (http://online.wsj.com, 29 March 2010)
Two global health organizations on Friday began an effort to raise as much as $24 billion from members of the Group of 20 nations that will test whether a major push begun a decade ago against infectious diseases can survive the global recession.
The Global Alliance for Vaccines and Immunizations and the Global Fund to Fight AIDS, Tuberculosis and Malaria pressed government representatives at a meeting in The Hague, the Netherlands, to step up global health funding.
The two groups are important barometers of global health finances. While past funding has sustained GAVI and the Global Fund through the worst of the recession, the results of the new fundraising will indicate how deeply the recession's full impact will be felt by the broader global health field.
... The meeting was the first of a series of events where donor nations are expected to commit money to the two groups. Other events will include a G-8 summit in July and a meeting at the United Nations in New York in late September.
PMCTC Projects At Stake (http://allafrica.com/stories, 1 April 2010)
Pregnant mothers who are HIV-positive could soon find it challenging to access life-saving HIV drugs because Kenya was denied 270 million dollars in funding from the Global Fund to Fight AIDS, Tuberculosis and Malaria.
The Global Fund cited the existence of two ministries of health and the jostling between them over control of funds as a major source of concern.
Global Consultation on Community Health Workers (http://www.who.int/workforcealliance, 2010)
The Global Health Workforce Alliance (the Alliance) is organizing a Global Consultation on Community Health Workers (CHW) scheduled to take place from 29-30 April in Montreux, Switzerland.
The objectives of the Consultation are:
GSK offers free vaccines for low income adults without insurance coverage (http://www.news-medical.net/, 29 March 2010)
GlaxoSmithKline (NYSE: GSK) today announced the launch of the GSK Vaccines Access Program, which will provide the company's adult vaccines free of charge to eligible, low income individuals who do not have insurance coverage for vaccines. The program will cover the company's FDA-approved vaccines for Hepatitis A, Hepatitis B, tetanus, diphtheria, and pertussis for eligible persons ages 19 and older. The program also includes GSK's cervical cancer vaccine for women ages 19 to 25 who, due to their age are not covered under the national Vaccines for Children program, and who meet other eligibility requirements.
Statement of the Global Advisory Committee on Vaccine Safety on Rotarix (http://www.who.int/vaccine_safety, 26 March 2010)
On 25 March 2010, WHO’s Global Advisory Committee on Vaccine Safety (GACVS) met by teleconference to review new data on Rotarix ...
Given the extensive clinical data supporting the safety of Rotarix and the benefits of rotavirus vaccination for children, GACVS considers that the benefits of vaccination far outweigh any currently known risk associated with use of Rotarix. GACVS will continue to review data as it becomes available and will update this statement as we learn more.
WHO does not recommend any change to use of Rotarix vaccine (http://www.who.int/immunization, 22 March 2010)
Following announcements today by the United States Food and Drug Administration (FDA) and the European Medicines Agency (EMA) regarding use of the rotavirus vaccine, Rotarix, the World Health Organization (WHO) encourages all countries using the vaccine to carefully consider the significant benefits of continued use of the vaccine in any decisions about further use.
... WHO concurs with the views of the FDA and EMA that the findings do not present a threat to public health. Moreover, rotaviruses are the most common cause of severe diarrhoeal disease in young children throughout the world, with an estimated 527 000 deaths among children under five years old, most of whom live in low-income countries. Therefore, WHO does not recommend any change to use of the vaccine. The vaccine is prequalified by WHO, and the prequalification status remains unchanged.
Cholera outbreak (in Nepal) due to mix of pathogens (http://www.myrepublica.com, 15 March 2010)
Almost one year after the cholera outbreak that killed over 300 people in the far and mid-western districts including Jajarkot, the National Health Research Council (NHRC) on Monday disclosed that the epidemic was caused by a combination of pathogens, and not solely by cholera bacteria.
Disclosing the findings of a high-tech lab test carried out by the Center for Molecular Dynamics of Nepal (CMDN), Dr Chop Lal Bhusal, Chairman of NHRC, said, “The outbreak was the consequence of an amalgamation of various types of dangerous bacteria.”
He said that the government should have resorted to some other medication to contain the outbreak before it became devastating. “The lessons learnt from the Jajarkot outbreak may be useful in fighting forthcoming epidemics,” he said.
The latest lab test found Aeromonos, Shigella, Campylobacter, VTEC and E.Coli O157:H7 bacteria in stool samples collected from patients during the Jajarkot outbreak.
History of Vaccination Week in the Americas (http://new.paho.org)
In 2002, prompted by a measles outbreak in Venezuela and Colombia, the health ministers of countries in the Andean region propose an annual Vaccination Week in the Americas to help prevent such future outbreaks. In the 8 years since VWA was first implemented, over 288 million people have been vaccinated against a wide range of vaccine preventable diseases such as measles, rubella, yellow fever, diphtheria, tetanus, polio, and influenza, as a result of the initiative. Multiple VWA social mobilization campaigns throughout the region have also been undertaken and the initiative has received ever increasing political support.
Researchers made vital discovery in the development of new drug to cure TB (http://www.news-medical.net, 26 March 2010)
This World TB Day (March 24), researchers at Sydney's Centenary Institute announce they have made an exciting discovery that could lead to the first new drug for Tuberculosis (TB) in almost fifty years.
Dr Nick West, Associate Faculty of the Mycobacterial group at Centenary, is looking at the genetics of TB in the hope they will reveal a way to reduce the impact of one of the deadliest diseases in the world.
Dr West, explains, "When someone is infected with TB they either become sick immediately or the disease stays inactive, latent."
"Unfortunately, the antibiotics we use to fight TB aren't effective against latent TB and can only be used when the disease becomes active. This is a major problem as 1 out of 10 people who have latent TB will develop the active disease, becoming sick and contagious."
Dr West and his team have made a vital discovery in the development of a new drug that could cure TB in the latent stage. If the project succeeds, it will be the first new treatment for TB since 1962.
PAHO documents increase in dengue fever cases in Latin America (www.news-medical.net, 26 March 2010)
Countries in Latin America "are bracing this year for a particularly virulent outbreak of the mosquito-borne tropical disease" known as dengue fever, after reports show an increase in the number of cases recorded this year, Agence France-Presse reports. "The Pan-American Health Organization (PAHO) said so far it has logged some 146,000 cases in the first three months of the year, of which 79 have been fatal. This time last year there were some 79,000 cases of dengue reported, with 26 deaths," the news service writes.
Infectious diseases and the colonised mind (www.hindu.com, 25 March 2010)
... The west eradicated polio by the use of clean water, improved sanitation and the oral polio vaccine. India adopted the use of the oral polio vaccine, sans clean water and sanitation. Many arguments were used to support the use of the oral vaccine over its injectable cousin. The policy pursued for over forty years has not made India polio-free.
... The all-persuasive argument for the use of vaccinations as a panacea to prevent diseases is an example of the medicalisation of public health. The elimination of small pox through vaccination was an outstanding example of disease prevention. However, not all infections are similar. The presence of asymptomatic carriers and feco-oral transmission make the polio virus a completely different cup of tea. The eradication of polio will surely also involve the provision of safe water and sanitation in order to prevent the spread of the virus ...
... Financial institutions and the pharmaceutical industry support vaccines, which are profitable, for the prevention of disease over provision of clean water and sanitation. Despite several recent key reports, which emphasise the dramatic health and economic benefits gained from improvements in water and sanitation, such solutions receive low priority in funding.
The Bill & Melinda Gates Foundation Opens Round Five of Grand Challenges Explorations (www.grandchallenges.org, 25 March 2010)
The Bill & Melinda Gates Foundation today announced the opening of Round 5 of Grand Challenges Explorations, a $100 million grant initiative to encourage innovation in global health research. Proposals are being accepted through May 19, 2010 at 12 noon Pacific Time.
Explorations offers researchers the chance to win $100,000 grants to jumpstart unconventional projects that could transform health in developing countries. The initiative focuses on research areas where creative, unorthodox thinking is most urgently needed.
Momentum in fight against tuberculosis must be maintained (www.un.org, 24 march 2010)
Significant advances have been made in the fight against tuberculosis, with nearly 6 million people saved in the past 15 years, Secretary-General Ban Ki-moon said today, calling for the momentum to be maintained in the fight against the deadly disease.
... Thanks to public awareness campaigns, communities are now much more aware of TB, while funding to combat it continues to grow through the United Nations-backed Global Fund to Fight AIDS, Tuberculosis and Malaria, among other mechanisms.
Acclaimed pop star Craig David was named Goodwill Ambassador to give a further boost to efforts to fight TB. He told the UN News Centre that he hopes to use his audience of millions worldwide to raise awareness of TB and minimize the stigma attached to it
Pfizer to supply pneumococcal conjugate vaccines for infants and children
(www.news-medical.net, 24 March 2010)
Pfizer Inc. (NYSE:PFE) today announced it has signed a 10-year Provisional Supply Agreement to supply Prevenar 13* (Pneumococcal Polysaccharide Conjugate Vaccine [13-valent, adsorbed]), the company’s 13-valent pneumococcal conjugate vaccine, for infants and young children in the world’s poorest countries under the terms of the Advance Market Commitment (AMC) pilot project against pneumococcal disease.
The AMC is a novel public-private approach to public health funding designed to create a sustainable marketplace, ensure a stable supply of pneumococcal vaccines and stimulate the development and expansion of manufacturing capacity of vaccines specifically for the world’s poorest countries.
... “I applaud the groundbreaking milestone achieved today by vaccine manufacturers, developing country governments, donors, the World Bank, and the GAVI Alliance that has made the most advanced pneumococcal conjugate vaccines available to the world's neediest young children at affordable prices and faster than ever before,” says Orin Levine, executive director, International Vaccine Access Center at Johns Hopkins University. ”This year, the Advance Market Commitment will begin helping to save lives and improve the health of infants and young children in Africa.”
FDA Recommends Temporary Halt to Use of Rotarix (http://www.aafp.org/online, 23 March 2010)
The FDA is recommending that physicians temporarily suspend use of GlaxoSmithKline's Rotarix rotavirus vaccine because DNA from porcine circovirus 1, or PCV1, has been detected in the vaccine.
FDA commissioner Margaret Hamburg, M.D., said during a March 22 conference call that PCV1 is not known to cause disease in animals or humans. She said the Rotarix rotavirus vaccine, which was approved in 2008, has an excellent safety record, and the recommendation to suspend its use was made out of an abundance of caution.
... It is unclear how PCV1 got into the Rotarix vaccine. It also is unclear whether the material is a DNA fragment or an intact virus. Hamburg said the material was found in the vaccine, cell bank and the viral seed from which the vaccine is derived. That means the material has been present since Rotarix's early development stages, including during clinical trials.
New understanding of cell in immune system may guide creation of effective flu vaccines: Study (www.news-medical.net, 23 March 2010)
A new understanding of a certain cell in the immune system may help guide scientists in creating better flu vaccines, report researchers from the Program in Cellular and Molecular Medicine and the Immune Disease Institute at Children's Hospital Boston (PCMM/IDI). Reporting online March 21 in Nature Immunology, they show, for the first time, that white blood cells known as resident dendritic cells (DCs) capture flu viruses and show them to B-lymphocytes, another white blood cell that recognizes germs and launches an antibody attack. Harnessing this previously unknown function could help activate the immune system more effectively against the flu virus.
Corruption alleged as tainted vaccines kill Chinese children (www.timesonline.co.uk, 21 March 2010)
For Wang Mingliang, the birth of a son should have been the start of a season of joy in his village at the rural heart of northern China.
But his little boy, Xiao’er, lived just seven months before he suffered convulsions and a fever, then died. Wang said Xiao’er fell ill after vaccinations against tuberculosis and hepatitis. “My whole family is plunged in sorrow,” he said.
“Our son was vaccinated by the hospital and they sterilised my wife to conform to the birth control policy. Now my son is dead and my wife can have no more children.”
His son was among thousands of children given tainted vaccines in a scandal that reporters and medical staff allege has left four dead and 74 handicapped.
... In response to public outrage, however, the health ministry has ordered an inquiry after Wang Keqiang, one of China’s top investigative reporters, revealed a web of alleged corruption and incompetence that put many children at risk.
VN stops importing monotype vaccine (http://en.www.info.vn, 12 March 2010)
The HCMC Department of Health said on Tuesday that Vietnam would stop importing monotype vaccine in July this year and would begin importing five-in-one vaccine instead.
The new vaccine protects against five diseases - diphtheria, tetanus, whooping cough, polio and a bacterial infection called haemophilus influenzae type B (Hib), which can cause pneumonia and meningitis.
India TR35: Humanitarian Of The Year (www.technologyreview.in, March 2010)
Medical diagnostic testing is a key component in the efficient delivery of health-care solutions. However, the widespread use of diagnostic tests in developing nations such as India is held back because of their development for and in developed markets. Further, the test results take time to come in from a centralized laboratory, which may be disastrous in a critical care situation.
Dhananjaya Dendukuri, PhD in chemical engineering from Massachusetts Institute of Technology, has developed a novel microfluidic-chip based platform to perform low-cost medical diagnostic tests with a focus on immunoassays (protein tests).
Global classroom
(http://magazine.jhsph.edu, Fall 2009)
... The sessions, which McGready holds weekly, are one of several feedback loops built into the Bloomberg School’s distance education program. Other tools include hours of pre-recorded lectures; direct email contact with faculty; a threaded, content-rich bulletin board discussion system that encompasses polls, private work spaces, document sharing and DED Messenger—a live-streaming audio conferencing capability that allows small groups to work collaboratively on group assignments and faculty to hold virtual “office hours.” Taken all together they represent, not so much a different way of doing the same old thing, but a new and improved way of teaching and learning, say faculty proponents.
... Experts say this expansion of access to top-flight public health pedagogy can’t come soon enough: A critical shortage of public health workers—across the country and around the globe—is looming, due to years of declining public health budgets and an oncoming tidal wave of retirements. (See Public Health’s Looming Workforce Crisis.)
The Association of Schools of Public Health (ASPH) estimates that it will be necessary to find 250,000 more public health workers by the year 2020 in order to return the U.S. to its former ratio of 220 public health workers per 100,000 of population—a not unrealistic goal in the age of global pandemics and a simultaneous explosion in chronic diseases like diabetes and asthma.
... The online learning format is sometimes referred to as the classroom without walls, and the ability to hear from and interact with faculty and fellow students engaged in public health activities around the globe presents unparalleled educational opportunities. But it also offers another, more prosaic advantage that is especially important in an era of critical public health workforce shortages. A classroom without walls is a classroom that can accommodate—theoretically at least—an unlimited number of additional students.ok
Researchers Discover Two New Ways to Kill TB (www.infectioncontroltoday.com, 21 March 2010)
Researchers at Albert Einstein College of Medicine of Yeshiva University have found two novel ways of killing the bacteria that cause tuberculosis (TB), a disease responsible for an estimated 2 million deaths each year. The findings, published in the March 21 online issue of Nature Chemical Biology, could lead to a potent TB therapy that would also prevent resistant TB strains from developing.
"This approach is totally different from the way any other anti-TB drug works," says William R. Jacobs, Jr., PhD, the study's senior author and professor of microbiology & immunology and of genetics at Einstein, as well as a Howard Hughes Medical Institute investigator. "In the past few years, extremely drug resistant strains of TB have arisen that can't be eliminated by any drugs, so new strategies for attacking TB are urgently needed."
WHO recommendation to temporarily suspend procurement and use of all lots of Shan5 (dtwp-hepatitis b-hib) vaccine produced by Shantha Biotechnics, India (forum.dft.nl/posts, 15 March 2010)
As of 12 March 2010 the World Health Organization (WHO) recommends to stop procurement and to suspend use of all lots of the Shan5 vaccine supplied to countries pending ongoing investigations.
Countries are advised to put any remaining vaccine in quarantine until further notice.
If it is confirmed that the country has received shipments of any lot of Shan5 vaccine, the vaccine should not be used, but kept under recommended storage conditions, clearly marked ‘QUARANTINED; NOT TO BE USED OR DISTRIBUTED’ until further direction is provided by WHO.
Experts concerned about vaccination backlash (www.thelancet.com, 20 March 2010)
Vaccination was one of the greatest public health achievements of the 20th century. Its success might now be its undoing, however. Around the world, vaccination rates are dropping, and the unthinkable is happening: children are dying from childhood diseases like measles and pertussis.
This fall in immunisation has coincided with an increasingly vocal anti-vaccination movement. Public health now seems more at threat than ever by anti-vaccination messages, and the reluctance to vaccinate has been affecting rates of uptake for other vaccines such as that for influenza A H1N1. Health experts are now faced with the daunting challenge of fighting these groups.
Another step towards preventing artemisinin resistance (www.thelancet.com, 20 March 2010)
Last year, The Lancet reported that artemisinin-resistant falciparum malaria had been detected on the Thai—Cambodian border. This news is worrying because WHO recommends artemisinin-based combination therapy (ACT) for frontline treatment of uncomplicated and severe falciparum malaria and there are no new drugs in the pipeline to replace artemisinin derivatives in the near future. Work is underway to try to stop the emergence and spread of drug resistance and, on March 9, WHO released new guidelines for malaria treatment that will aid this effort.
New WHO Report Estimates 440,000 MDR-TB Cases Worldwide In 2008 (http://globalhealth.kff.org, 19 March 2010)
There were an estimated 440,000 cases of multidrug-resistant tuberculosis (MDR-TB) around the world in 2008 – one-third of which were fatal, according to a new WHO report on drug-resistant TB, the Los Angeles Times reports (Maugh, 3/19). The WHO report, based on data from 2008, found that almost half of all drug-resistant TB cases were in China and India, Reuters reports (Fox, 3/18).
According to the Associated Press, data was missing from some countries, creating a "gap in the global TB picture." The report said that with current data, it is "impossible at this time to conclude whether the (drug-resistant TB) epidemic worldwide is growing or shrinking," AP reports (Cheng, 3/18).
Roll Back Malaria report confirms aid for malaria is working but predictable long-term funding is essential to achieve Millennium Development Goals (www.rollbackmalaria.org, 18 march 2010)
A new report from the Roll Back Malaria (RBM) Partnership confirms that current investment in malaria control is saving lives and providing far-reaching benefits for countries. But it warns that without sustained and predictable funding, the significant contribution of malaria control toward the achievement of the Millennium Development Goals (MDGs) could be reversed.
Malaria Funding and Resource Utilization is the first in a new series of reports launched by the RBM Partnership to benchmark progress towards RBM targets and the Millennium Development Goals.
... The report reveals that between 2000 and 2009, an estimated 384,000 children's lives were saved in 12 countries through widespread distribution of mosquito nets and other malaria prevention tools. A further 217,000 children's lives could be saved if the same interventions were to reach the target of 80 percent of all populations by the end of this year.
However, total annual global funding, approximately US$2 billion at the end of 2009, including national budgets and other bilateral funding, falls short of the estimated US$6 billion required annually by the Global Malaria Action Plan (GMAP) to ensure universal coverage of malaria control interventions.
Studies examine ways to increase healthcare personnel vaccination rates through social networking (www.news-medical.net, 17 March 2009)
Healthcare personnel influenza immunization rates have remained low, despite recommendations from the Centers for Disease Control and Prevention (CDC) and other leading healthcare organizations that all healthcare personnel receive annual flu vaccines. Experts say these levels are perilous. Increasing vaccination rates substantially improves patient safety, lowering flu deaths by 40 percent.
Three studies presented at the Fifth Decennial International Conference on Healthcare-Associated Infections in Atlanta examine ways to increase healthcare personnel vaccination rates through social networking, declination strategies and mandates.
Measles vaccine contamination may have caused deaths (www.indianexpress.com, 16 March 2010)
The four children who were administered an anti-measles shot died due to mishandling of the vaccine by the health worker, says a four-member team sent by the Union Health Ministry to Madhya Pradesh on Monday to inquire into the deaths.
While the team — comprising Dr R S Gupta from Ram Manohar Lohia Hospital, Dr Vivek Diwan from National Communicable Disease Control (NCDC) and Dr Balwinder Singh along with an official from the Drug Controller General’s office — is yet to give its final report, “preliminary investigations show that they died of toxic shock syndrome”.
Cash crisis looms for vaccine drive (www.nature.com, 16 March 2009)
Up to 4.2 million people, mostly young children, will die needlessly over the next 6 years unless donors fill a looming multibillion-dollar shortfall in the budget of the GAVI Alliance.
The warning from GAVI, which focuses on getting vaccines into low-income countries, is contained in advocacy documents it sent to its donors last weekend, in the run up to an extraordinary meeting due to be held on 25–26 March in The Hague, the Netherlands.
... The fund-raising meeting will focus on soliciting new donors to broaden GAVI's funding base. Around 80% of GAVI cash comes from a handful of country donors (see 'Few funders for vaccines'), which has left the alliance highly vulnerable during the global economic downturn to funding reductions by only a few nations. click for larger image
GAVI is hoping that one of its key financial innovations, the International Finance Facility for Immunisation, will prove particularly recession-proof. The facility does not require countries to put money on the table immediately, but rather to make 10–20-year legally binding commitments, which the facility then borrows against on capital markets. New long-term pledges by countries or foundations could help the alliance to free up cash in the short term, says Joelle Tanguy, a GAVI spokeswoman.
Court will hear case about vaccine side effects (www.washingtonpost.com, 8 March 2010)
The Supreme Court will decide whether drug makers can be sued by parents who claim their children suffered serious health problems from vaccines.
The justices on Monday agreed to hear an appeal from parents in Pittsburgh who want to sue Wyeth over the serious side effects their daughter, six months old at the time, allegedly suffered as a result of the company's diphtheria, tetanus and pertussis vaccine.
iReminder’s white paper highlights key developments in HPV vaccine compliance and marketing efforts (http://www.news-medical.net, 11 March 2010)
Automated reminder and follow-up calls for HPV vaccinations increase adherence rates from 5% to over 20%, according to a new white paper published by iReminder, LLC. The Scotland National Health Service is the leader in HPV vaccination compliance, with rates as high as 92% for the first dose and 87.8% for the second dose. The laggard is Mississippi, USA where HPV vaccination rates are as low as 15.8%.
Health Care Volunteers and Disaster Response (http://content.nejm.org, 11 March 2010)
The human suffering that followed the devastating earthquake in Haiti, and the many survivors in urgent need of lifesaving care, brought an outpouring of support from the U.S. health care community. Many providers looked for effective ways to help, and many were frustrated by their inability to connect with a system that could immediately take advantage of their skills. Unfortunately, such spontaneous volunteerism can overwhelm a response system and, unless coordinated, can make things worse instead of better. Health care volunteers can enhance their effectiveness by preparing for a disaster before it occurs and thinking critically about their ability to respond. Here we provide an overview for health care professionals about how to volunteer to help in public health emergencies and disasters.
WHO to help Bangladesh develop vaccines locally (http://www.dailynews, 11 March 2010)
The World Health Organization (WHO) Tuesday committed Bangladesh to provide technical support for developing vaccines locally and strengthen comprehensive service through one-stop community clinics.
“WHO has sent three teams of experts to Bangladesh last year and gave a roadmap to the Bangladeshi government how to develop vaccines locally,” WHO Director General Margaret Chan said
Malaria In Pregnant Women : A First Step Towards A New Vaccine (http://www.medicalnewstoday.com, 10 March 2010)
By managing to express the protein that enables red blood cells infected with the malaria agent Plasmodium falciparum to bind to the placenta and by deciphering its molecular mechanisms, a team of researchers from CNRS and the Institut Pasteur has taken an important first step in the development of a vaccine against pregnancy-associated malaria. Their work was published in the journal PNAS.
… One of the potential vaccination strategies for (Pregnancy Associated Malaria) PAM is to recreate this protective immunity, by blocking the binding of parasitized erythrocytes to the placenta. Previous work carried out by the team headed by Benoît Gamain, CNRS researcher at the Unité Bases Génétiques et Moléculaires des Interactions de la Cellule Eucaryote (Institut Pasteur), has shown that one of the proteins of the PfEMP1 family, known as var2CSA, plays an important role in PAM. It is thus the prime target for a vaccine. However, the var2CSA protein shows considerable polymorphism, is very large and has a very complex structure. These characteristics have, until now, prevented researchers from reproducing it in the laboratory and studying it to elucidate its structure and its action mechanisms. Only selected "chunks" of proteins involved in these binding areas, known as domains, have been synthesized.
Violence Delays Polio Vaccinations (http://allafrica.com, 9 March 2010)
A polio vaccination campaign in the violence-wracked central Nigerian city of Jos has been delayed until 13 March due to the violence and an on-going health worker strike, aid workers said.
"We needed more time to plan because of the displacement that happened after the previous violence [in January] said Mathew Dabup, the government's polio immunization manager in Plateau State, which includes Jos.
Dabup has been conducting training for health workers who did not join the strike in Plateau State.
… Chris Maher, head of country operations for polio eradication at the World Health Organization (WHO), told IRIN: "Implementing vaccination activities in security-compromised areas is both logistically and operationally challenging, and it is obviously more dangerous for the staff working on the ground."
He said strategies in southern Afghanistan and the conflict-affected areas of Pakistan and Somalia included quick campaigns carried out during "lulls in conflict".
In areas like Jos, where there were "periodic acute flare-ups of civil unrest, rather than the constant levels of insecurity", WHO's strategy was to adjust the timing of vaccinations so as to reach as many children as possible while protecting health workers.
High hopes for oral cholera vaccine (http://www.who.int/bulletin, March 2010)
September 2006: phase III of a clinical trial of a bivalent, oral cholera vaccine was under way in a neighbourhood of Kolkata in eastern India. As in any clinical trial, this was a critical stage: the vaccine was being given to large groups of people to confirm its effectiveness, monitor side-effects and collect information that would allow it to be used safely.
More than 30 vaccination centres had been set up within the city’s slums so that people did not have to go far to take the vaccine.
… The interim results of the phase III trial that started in Kolkata in 2006 were published recently. There were 20 episodes of cholera in the 52 212 people receiving vaccine and 68 episodes in the 55 562 people who received the placebo. “The results of the vaccine trial were 68% protection of all age groups two years after vaccination. Children aged five to 15 years had 88% protection. With a high burden of cholera in several areas of India, this was a very valuable finding,” …
CHAD: Wipe out corruption, wipe out polio (http://www.irinnews.org, 10 March 2010)
It costs more to vaccinate a child in Chad against polio - almost 70 US cents per child - than any other country in the world at risk of an outbreak, according to the World Health Organization (WHO).
It costs half as much to vaccinate a child in violence-wracked Afghanistan, Sudan or Somalia.
WHO polio coordinator Mohammed Mohammedi, who was kidnapped in Somalia in 2001 by militias and held hostage for four days, is now working in Chari Baguirmi, the Chad region with the second highest number of reported polio cases in 2009 after the capital, N'Djamena.
He told IRIN the main reason Chad had not been able to wipe out an outbreak after almost two years was lack of money and corruption.
A Vision for Personalized Medicine (www.technologyreview.com, 9 March 2010)
Individual genomes will become a standard of medical records in 10 years or so, and we will have the power to make inferences [about an individual's health] when combined with phenotypic information. Then we can begin to plan strategies for individual health care in ways we have never done before.
Nanotechnology approaches to protein measurement--such as measuring 2,500 proteins from a drop of blood--will also be important. We want to develop tests to asses 50 organ-specific proteins from 50 organs as way of interrogating health rather than disease.
Vitamin D Crucial To Activating Immune Defenses (http://www.medicalnewstoday.com, 8 March 2010)
Scientists at the University of Copenhagen have discovered that Vitamin D is crucial to activating our immune defenses and that without sufficient intake of the vitamin, the killer cells of the immune system - T cells - will not be able to react to and fight off serious infections in the body.
For T cells to detect and kill foreign pathogens such as clumps of bacteria or viruses, the cells must first be 'triggered' into action and 'transform' from inactive and harmless immune cells into killer cells that are primed to seek out and destroy all traces of a foreign pathogen.
The researchers found that the T cells rely on vitamin D in order to activate and they would remain dormant, 'naïve' to the possibility of threat if vitamin D is lacking in the blood.
… For the research team, identifying the role of vitamin D in the activation of T cells has been a major breakthrough. "Scientists have known for a long time that vitamin D is important for calcium absorption and the vitamin has also been implicated in diseases such as cancer and multiple sclerosis, but what we didn't realize is how crucial vitamin D is for actually activating the immune system - which we know now. "
WHO releases new malaria guidelines for treatment and procurement of medicines (http://www.who.int/mediacentre, March 2010)
The Guidelines for the Treatment of Malaria (second edition) provide evidence-based and current recommendations for countries on malaria diagnosis and treatment. The main changes from the first edition of the guidelines (published in 2006) are the emphasis on testing before treating and the addition of a new ACT to the list of recommended treatments.
Abt Associates receives two new contracts to evaluate effectiveness of H1N1 vaccine (http://www.news-medical.net/news, 6 March 2009)
The Centers for Disease Control and Prevention (CDC) has awarded Abt Associates two new contracts to evaluate the effectiveness of the H1N1 vaccine among health care workers and children under the age of 18. In December 2009 the CDC awarded the company a related contract to evaluate the vaccine's effectiveness among pregnant women. All three groups are considered high risk populations by CDC either because of increased risk for complications or because of increased risk of contracting or spreading the disease. The combined value of all 3 contracts total $12.8 million.
Pneumococcal Vaccine Offers Protection To HIV-infected African Adults In Clinical Trial (http://www.medicalnewstoday.com, 5 March 2009)
A clinical trial of a vaccine against a major cause of pneumonia and meningitis has shown that it can prevent three out of four cases of re-infection in HIV-infected adults in Africa.
The trials, conducted in Malawi and funded by the Wellcome Trust, studied the efficacy of a vaccine against infection with the Streptococcus pneumoniae bacteria. These bacteria are a primary cause of pneumonia and when they invade the blood stream and brain - so called invasive pneumococcal disease (IPD) - they cause the serious and often fatal illnesses of septicaemia and meningitis. In HIV-infected adults, particularly in sub-Saharan Africa, the risk of developing IPD increases between thirty and a hundred-fold.
... The trial, led by Dr Neil French, formerly at the Liverpool school of Tropical Medicine, tested the vaccine on almost five hundred predominantly HIV-infected adults who recovered from IPD after being admitted to the Queen Elizabeth Central Hospital in Blantyre. They found that the vaccine prevented 74% of recurrent cases of IPD in patients with underlying HIV infection.
HCM City public hospitals run out of recognised vaccines (Vietnam) (http://en.www.info.vn/life, 5 March 2009)
Many brand-name vaccines not covered by the national immunisation programme have run out at public hospitals in HCM City despite warnings from suppliers of shortages as early as September last year.
According to Nguyen Tran Hien, director of the Central Institute of Hygiene and Epidemiology, vaccines provided by the national expanded immunisation programme were not in shortage but the more expensive brand name vaccines for the same diseases.
On Monday, the city's Pasteur Institute published a list of vaccines for diphtheria, whooping-cough, tetanus and paralysis produced by Sanofi-Aventis and Glaxo Smith and Kline, that were in short supply.
The HCM City's Paediatrics Hospital No 2 announced similar supply shortages after they ran out of Japanese encephalitis, meningo-encephalitis A + C, measles and rubella vaccines. Paediatrics Hospital No 1 also reported they had exhausted their supplies of Meningo-encephalitis A + C and typhoid vaccines.
Aluminium Adjuvants In Vaccinations: How Do They Really Work? (http://www.medicalnewstoday.com, 4 March 2009)
An imminent publication in Trends in Immunology by a leading researcher in the bioinorganic chemistry of aluminium, Dr Christopher Exley, Reader in Bioinorganic Chemistry at The Birchall Centre, Keele University in Staffordshire, has now gone some way to giving the fullest possible explanation of how aluminium adjuvants work in boosting the immune response to vaccination.
Adjuvants are used in vaccinations to improve the efficacy of the vaccine. They enhance the immune response to the vaccine. For almost 80 years the most common form of clinically approved adjuvant has been aluminium salts. They are used in the majority of vaccines including vaccines against cervical cancer (HPV), hepatitis, polio, tetanus, diptheria and seasonal flu amongst many others.
Researchers From HZI Vaccine Department Examine New Adjuvant To Improve Vaccinations (http://www.medicalnewstoday.com, 4 March 2009)
... Vaccines are one of the most powerful tools against infectious diseases. They protect against an infection by preventing the infection to arise. In a typical vaccine, attenuated or killed pathogens or just some of their sub-cellular components are injected into the body. The immune system responds to those foreign components, producing antibodies and/or killer cells, which are able to fight the pathogen, as well as memory cells. The latter recognize the true pathogen after host infection, thereby promoting a specific and rapid response able to prevent the establishment of a disease.
However, the immune system often reacts only weakly to the attenuated pathogens or their fragments present in a vaccine. Thus, partial or short-life protection is usually stimulated. The adjuvants by themselves do not trigger an immune reaction, but given as components of a vaccine, they modulate and enhance the immune responses elicited, thereby providing a stronger, early and long-lasting protection. While searching for new adjuvants, the vaccine researchers at the HZI have now found the molecule "c-di-IMP".
Genetically Altered Mosquitoes Could Help Fight Dengue Fever (http://allafrica.com/, 4 March 2010)
Last week, the US National Academy of Sciences published a study suggesting that genetically modified mosquitoes could help fight dengue fever.
According to the World Health Organization (WHO), 2.5 billion people in more than 100 countries are at risk of dengue fever. An estimated 50 to 100 million cases occur annually, resulting in 22,000 deaths, most of which are children.
Reported cases of dengue fever have steadily been on the rise since the 1960s, and reached a peek during a pandemic in 1998, with 1.2 million cases.
.... Currently there is no specific treatment or medication for the virus, nor is there a preventative vaccine available. Rest and consumption of fluids is considered the best course of action, though some patients require blood transfusions in cases of dengue hemorrhagic fever, a complication of dengue fever.
The virus is spread by the Aedes species of mosquito, which transfer the virus after biting an infected individual. As such, other forms of prevention, such as removing standing bodies of water where mosquitoes lay eggs, is thought to be the best defense against contracting the illness.
... In the new study released 22 February, a group of scientists bred genetically altered Aedes mosquitoes to produce females, who are the ones that bite and spread dengue, that cannot fly.
According to the study, males were altered, and then bred, and their female offspring were flightless, while the males remained unaffected. Additionally, the genetic modification will be limited only to the dengue-carrying species, as Aedes males cannot mate with other species of mosquito.
Inovio Develops Cordless Electroporation Device For Delivering DNA Vaccines (http://www.medicalnewstoday.com/, 4 March 2009)
Inovio Biomedical Corporation (NYSE Amex: INO), a leader in DNA vaccine design, development and delivery, has unveiled its new CELLECTRA®-SP series of hand-held, cordless electroporation devices at the DNA Vaccines 2010 conference being held in New Orleans, LA.
Existing generations of electroporation systems consist of an electrical pulse generator box the size of a large laptop attached by a cord to a separate needle-electrode applicator. The new CELLECTRA®-SP devices bring together groundbreaking design and engineering advancements to combine all components into a self-contained, easy-to-use portable device the size of a cordless hand tool.
... Delivery of Inovio's SynCon™ DNA vaccines into muscle or skin tissue with Inovio's electroporation systems have generated robust immune responses in disease models including influenza (H5N1 and H1N1), smallpox, and HIV.
Mumps spike reveals risk in one-dose vaccinations (www.thespec.com, 4 March 2010)
... Mumps, an acute viral infection of the salivary glands, hadn't been reported in Hamilton since 2006.
There are only five cases in the city since January, but that's a big increase because there are usually none or just a few in a year, Tran (an associate medical officer of health) said.
... Twenty-year-olds are vulnerable to getting the highly contagious viral disease because they were born around the 1990s, when two doses of vaccine were just starting to be recommended, he said.
“Five-in-One Vaccine” to be tested in two provinces in Vietnam (http://en.www.info.vn, 4 March 2009)
Phu Tho province north of Hanoi and Dong Thap province south of HCM City will start using a new kind of vaccine against whooping-cough, diphtheria, tetanus, hepatitis B and meningitis caused by virus Hib in their expanded vaccination programme this May.
Dr. Nguyen Tran Hien, chairman of the National Expanded Vaccination Program, said that after proving its worth in the two above provinces, the vaccine will be used nation-wide.
Study indicates climate change plays a role in malaria transmission
(http://www.news-medical.net, 4 March 2010)
Climate change is one reason malaria is on the rise in some parts of the world, new research finds, but other factors such as migration and land-use changes are likely also at play. The research, published in The Quarterly Review of Biology, aims to sort out contradictions that have emerged as scientists try to understand why malaria has been spreading into highland areas of East Africa, Indonesia, Afghanistan and elsewhere.
"We assessed - conclusions from both sides and found that evidence for a role of climate in the dynamics is robust," write study authors Luis Fernando Chaves from Emory University and Constantianus Koenraadt of Wageningen University in the Netherlands. "However, we also argue that over-emphasizing a role for climate is misleading for setting a research agenda, even one which attempts to understand climate change impacts on emerging malaria patterns."
Mosaic vaccines show promise in reducing HIV spread (http://www.news-medical.net, 4 March 2010)
Two teams of researchers-including Los Alamos National Laboratory theoretical biologists Bette Korber, Will Fischer, Sydeaka Watson, and James Szinger-have announced an HIV vaccination strategy that has been shown to expand the breadth and depth of immune responses in rhesus monkeys. Rhesus monkeys provide the best animal model currently available for testing HIV vaccines.
... HIV is an extremely variable virus. One of the most daunting challenges for developing an effective HIV vaccine is designing one that stimulates immune responses that will protect an individual from the highly diverse spectrum of strains of the circulating virus. The mosaic vaccine design uses computational methods developed at Los Alamos to create small sets of highly variable artificial viral proteins. These proteins, in combination, provide nearly optimal coverage of the diverse forms of HIV circulating in the world today.
Polio eradication within 5 years now a real possibility (http://www.thelancet.com, March 2010)
Last year was a significant one for polio eradication. Real progress was made simultaneously in northern Nigeria, on the Afghanistan—Pakistan border, and in the remaining pockets in Bihar and Uttar Pradesh in India, cutting the number of cases worldwide to 1597 (correct as of Feb 2, 2010). The new bivalent oral polio vaccine (bOPV), which targets type 1 and type 3 polioviruses, was licensed in late 2009 and has been in use since December. Starting in February, March, and April, 2010, multiple mass immunisations are planned in all four remaining countries where polio is endemic, at the start of a 3-year intensive effort to finally halt polio transmission worldwide.
... Polio eradication in India is a more daunting challenge because of the competition that any live polio vaccine faces from the plethora of other intestinal infections present in the population. “In northern India, vaccine coverage is very high, confirmed by serology studies showing greater than 99% immunity against type 1 poliovirus among infants, despite a huge monthly birth cohort. And yet, transmission of type 1—prioritised for eradication by the programme—is at a tipping-point. The programme is tantalisingly close to eradicating this serotype in India, but the virus has bounced back from very low case numbers before”, notes Nicholas Grassly (Imperial College, London, UK). “We know that we need to further understand the factors that are still allowing transmission to persist in these pockets and additional options to overcome those challenges”, ...
Gates Foundation's decade of vaccines (http://www.thelancet.com, March 2010)
The GAVI Alliance celebrated the tenth anniversary of its foundation on Jan 29 this year. During its 10 years GAVI has overseen the delivery of vaccines to around 250 million children in the world's poorest countries, a programme that has probably averted around 5 million deaths.
To mark GAVI's birthday, the Bill and Melinda Gates Foundation announced that it will commit US$10 billion over the next 10 years to a so-called decade of vaccines—ie, research and development and delivery of vaccines to the world's poorest. As an agency whose role is vaccine delivery, rather than research and development, it is not clear how much of the Gates billions will be coming to GAVI. However, GAVI is already the foundation's largest grantee, having received $1·5 billion in its 10 year history.
One-Third of Antimalarial Medicines Sampled in Three African Nations Found to be Substandard (http://allafrica.com, 10 February 2010)
Rockville, Maryland, U.S. — The first results from a large-scale study of key antimalarial medicines in ten Sub-Saharan African countries reveal that a high percentage of medicines circulating on national markets are of substandard quality and thus may contribute to the growth of drug-resistant strains of Plasmodium falciparum, the most virulent form of malaria.
The findings, released today by the Promoting the Quality of Medicines (PQM) Program, a USAID-funded program implemented by the US Pharmacopeial Convention (USP), are for three countries surveyed in the study - Madagascar, Senegal and Uganda.
Cape Measles Outbreak (http://allafrica.com, 26 February 2010)
The Western Cape Department of Health has set up isolation wards to deal with a measles outbreak that has affected more than 500 children in the province over the past few months.
It has also officially declared a measles outbreak in the province.
Yesterday the department said that as a result of an increased number of confirmed measles cases, children's health services across the province were operating under "significant pressure" to curtail the disease ...
"As at February 22, 2010, 422 confirmed measles cases were reported in the Western Cape, with an additional number of serologically unconfirmed cases," the department reported.
However, according to the National Institute for Communicable Diseases there were at least 517 people infected with measles in the province, including the 70 newly confirmed cases.
Making public policies on vaccination with limited information (http://www.news-medical.net, 26 February 2010)
How might policymakers make reasonable decisions when they have limited information?
That's the question Northwestern University's Charles F. Manski explores in his new paper, "Vaccination With Partial Knowledge of External Effectiveness." The paper is published online by the Proceedings of the National Academy of Sciences (PNAS)
"Let's say you're a public health official from the Centers for Disease Control, and you don't really know how much disease is going to be averted by vaccinating different fractions of the population," said Manski, the Board of Trustees Professor in Economics in the Weinberg College of Arts and Sciences. "Then how should you choose a policy? That's really what the paper tries to address."
Phones, paper 'chips' may fight disease (http://www.cnn.com, 25 February 2010)
A chemistry professor at Harvard University is trying to shrink a medical laboratory onto a piece of paper that's the size of a fingerprint and costs about a penny.
George Whitesides has developed a prototype for paper "chip" technology that could be used in the developing world to cheaply diagnose deadly diseases such as HIV, malaria, tuberculosis, hepatitis and gastroenteritis.
The first products will be available in about a year, he said.
... Patients put a drop of blood on one side of the slip of paper, and on the other appears a colorful pattern in the shape of a tree, which tells medical professionals whether the person is infected with certain diseases.
... Since people in remote parts of Africa and Asia often have to travel great distances by public transit or foot to reach a medical clinic, patients simply can take photos of the chips with cell phones and then send them to larger cities for diagnosis. And Whitesides said his group is also working with a cell phone maker to develop apps that would tell patients the results of their tests automatically if doctors aren't available.
Japan commits $2 million to boost immunization in Haiti (http://www.unicef.org, 23 February 2010)
The Government of Japan committed US$2 million (JPY180 million) to UNICEF to reinforce immunization services for children and women in Haiti. The timely contribution provides UNICEF with the much-needed equipment for the cold-chain system and funds for vaccines and immunization activities.
Since before the earthquakes, the Government of Haiti, UNICEF, PAHO/WHO (Pan American Health Organization / World Health Organization) and other partners have been collaborating to immunize children against infectious diseases including polio, tuberculosis and measles in order to reduce the under-five mortality rate as part of the efforts to achieve the Millennium Development Goals. According to the statistics, in 2008, 72 children out of 1,000 died before they reach the age of five.
Bangladesh to vaccinate 20 million children against measles (http://www.unicef.org, 13 February 2010)
Bangladesh will vaccinate more than 20 million children against measles during a two-week measles campaign starting tomorrow and ending on February 28, 2010. All children aged 9 months to less than 5 years will be given measles vaccine, while all children aged 0 to 5 years will be given two drops of polio vaccine.
More than 50,000 health staff, 600,000 volunteers and NGO workers have been mobilized in order to carry out the campaign. They will work in 120,000 vaccinations sites spread across the country. In each site, a vaccination team will be deployed consisting of two skilled vaccinators and three volunteers.
A Jewel for Disease Tracking (http://magazine.jhsph.edu, Fall 2009)
In Pakistan, the centuries-old tradition of encircling a baby’s ankle or wrist with a beaded bracelet is meant to protect the child, to ward off the “evil eye”.
But the custom has gone high-tech in a Bloomberg School study designed to document the need for a pneumococcal vaccine in Pakistan, where pneumonia is the second leading cause of death in children under five.
Threaded among the black beads of the study-issued bracelets that adorn more than 4,500 babies in a low-income Karachi neighborhood is a button-size radio frequency identification (RFID) tag. The device can use radio waves to transmit real-time surveillance data via cell phones to a central computer server. The jewelry is at the heart of an innovative, disease-tracking system that Bloomberg School researchers hope will yield persuasive data on childhood pneumonia incidence to share with Pakistan’s government.
... The system has virtually eliminated paper from the disease-tracking process in this study, allowing for greater accuracy of data and making it possible for researchers to address problems and identify data trends ...
Masters Degree programme with a focus on health workforce development (http://www.who.int)
Competent leaders are needed to tackle the critical shortage of health workers and to spearhead the planning, production and management of the health workforce for years to come.
To generate these leaders in Sub-Saharan Africa, WHO is supporting a pioneering initiative with networks of educational institutions applying a distance-learning approach to deliver a Masters Degree with a focus on Health Workforce Development.
AFRICA: Early arrival of meningitis "alarming" (www.irinnews.org, 22 February 2010)
A meningitis epidemic has struck earlier than usual and is spreading across sub-Saharan Africa's "meningitis belt" from Senegal to Ethiopia, according to health ministries in the region. The disease occurs during the dry season, with most cases reported in mid-April.
As of 7 February, health ministries in high-risk countries reported 2,298 cases, with a 13-percent fatality rate. Burkina Faso has reported the highest number of cases, but Togo has experienced the highest fatality rate, where 25 of 108 infected people died.
... Mamoudou Harouna Djingarey, a WHO epidemiologist and meningitis expert, told IRIN it was still not clear why infections were spreading earlier than expected. "This [timing] is a sign of a major epidemic risk if no action is taken," he warned. Extensive meningitis outbreaks tended to occur every eight to 10 years, he said, but were now occurring about every four years.
FIFA: 2010 war on malaria, TB and HIV (www.buanews.gov.za, 21 February 2010)
The 2010 FIFA World Cup will present a unique platform to mount the fight against malaria, tuberculosis (TB) and HIV in the African continent.
The pledge was made by Michael D'Hooghe, chairman of the FIFA Medical Committee at the third International Football Medicine Conference in Rustenburg.
"We must use this Soccer World Cup to fight the big three in Africa. We must fight against malaria, TB and HIV.
ZAMBIA: Cervical cancer screening saves lives (www.plusnews.org, 18 February 2010)
New research presented this week at the 17th Conference on Retroviruses and Opportunistic Infections (CROI) in San Francisco has shown that cervical cancer screening among HIV-positive women prevented one death for every 32 women screened.
Presented by Dr Groesbeck Parham of the University of Alabama at Birmingham, the research originated from a pilot study of about 6,600 HIV-positive women examined as part of the Cervical Cancer Prevention Programme in Zambia (CCPPZ), an ongoing low-cost screening project.
... the programme had helped propel cervical cancer onto the national health agenda, and had prompted high-level discussion about the possible introduction of the HPV vaccine in the public health sector.
Screening by the programme's service costs about US$1 as compared to pap smears that cost about $15 and remain prohibitively expensive even in richer countries like South Africa. To keep costs this low, the programme enables health workers and nurses to carry out screening and treatment, allowing doctors - already in short supply - to perform other tasks.
Upp Technology adds Vaccine Provider Registration System to irms software suite (www.news-medical.net, 18 February 2010)
Upp Technology, a leader in public health software solutions, announced today at the Public Health Preparedness Summit, that it has enhanced its suite of irms software with the addition of the irms Vaccine Provider Registration System. The new provider management solution is already running in multiple states and the company expects to announce the deployment of this system in another four states within the first quarter of 2010.
... Vaccine providers can electronically approve orders through the irms Web portal with the option to accept the allocations or adjust quantities. Approved orders are sent electronically to vaccine distributors directly or via the CDC's VACMAN system. Providers can also use the online Web portal to record the doses administered and destroyed for easy and accurate reporting back to the CDC.
Phase III data reveals potential of Merck’s GARDASIL in preventing HPV and HPV-related cancers (www.news-medical.net, 18 October 2010)
Merck & Co., Inc. announced today that in new Phase III data, GARDASIL® [Human Papillomavirus Quadrivalent (Types 6, 11, 16 and 18) Vaccine, Recombinant] was 77.5 percent (95 percent CI: 39.6, 93.3) efficacious against anal intraepithelial neoplasia (AIN) associated with human papillomavirus (HPV) types 6, 11, 16 and 18 in 16-to-26 year-old men who have sex with men.
'No post-jab paracetamol' advice (news.bbc.co.uk, 16 October 2009)
Giving paracetamol to babies after vaccinations as a precaution against fever may lower the effectiveness of the immunisation, say researchers.
A trial of 450 infants having vaccines found that paracetamol doses over the next 24 hours did indeed reduce fever.
However, the Czech researchers also found a significantly lower vaccine response with the painkiller.
A UK doctor said the Lancet study backed advice not to use medicines in children without good cause.
Concerns raised, five-in-one vaccine will have to wait (www.indianexpress.com, 12 February 2010)
The ambitious plan of the Union Health Ministry to introduce a pentavalent vaccine — to fight five diseases — in the National Immunisation Programme early this year has received a setback.
With doubts being raised about the “need” of the vaccine, the ministry has now asked the Indian Council of Medical Research (ICMR) to “re-confirm” the decision to introduce it.
Mumps outbreak in NY, NJ tops 1,500 cases (seattletimes.nwsource.com, 11 February 2010)
A mumps outbreak among Orthodox Jews in New York and New Jersey has now surpassed 1,500 cases and shows no sign of ending soon, health officials said Thursday.
... In the new outbreak, the first identified case was an 11-year-old boy who got sick in late June. He had just returned from the United Kingdom - where vaccination rates are lower and mumps is more common - before going to the camp in Sullivan County in upstate New York. About 25 campers got sick.
Since then, hundreds of cases have been diagnosed in Orthodox Jewish enclaves in the New York City borough of Brooklyn, in nearby Orange and Rockland counties and in four counties in New Jersey.
Orthodox Jews account for more than 97 percent of the cases, which most likely has to do with the insular nature of their community, said Dr. Guthrie Birkhead of the New York State Department of Health.
Whooping cough vaccine may be losing its punch: study (www.news-medical.net, 10 February 2010)
Vaccination programs against whooping cough may not be fully effective because the bacteria that cause the disease have evolved new strains, a new study has found.
A team of Australian scientists has shown for the first time that two of the most common strains of the Bordetella pertussis bacteria in Australia have undergone significant genetic changes since 1997, according to a report of the study published in the journal Emerging Infectious Diseases.
Inovio Biomedical announces additional immunogenicity data from therapeutic cervical cancer vaccine trial (www.news-medical.net, 8 February 2010)
Inovio Biomedical Corporation (NYSE Amex: INO), a leader in DNA vaccine design, development and delivery, announced today additional interim safety and immunogenicity data from its therapeutic cervical cancer vaccine (VGX-3100) trial. VGX-3100 is a DNA vaccine targeting the E6 and E7 proteins of human papillomavirus (HPV) types 16 and 18 and is delivered via in vivo electroporation. Similar to previously reported data from the initial lowest dose cohort of this phase I trial, the vaccine was found to be generally safe and well tolerated. While previously reported data showed significant cellular and humoral immune responses, data from this second, intermediate dose group highlighted a significantly increased and dose-related immune response specific to the antigens targeted by the vaccine.
... “While recent HPV preventive vaccines have been successful in protecting against infections that may lead to cervical cancer, Inovio’s therapeutic vaccine targets the millions of women already infected with HPV and is intended to treat pre-cancerous cells and cervical cancer caused by this virus. Current vaccines do not serve this group of women,” Dr. Kim added
For obese, vaccine needle size matters (www.reuters.com, 8 February 2010)
In a new study, the researchers report that using a standard 1-inch needle to immunize obese adolescents against hepatitis B virus produced a much weaker effect than using a longer needle.
"As obesity rises in the US, we need to be aware that the standard of care may have to change to protect obese youth," study co-author Dr. Amy Middleman of Baylor College of Medicine in Houston told Reuters Health.
Over three years her team vaccinated 22 young women and two young men in the shoulder, randomly assigning them to be injected with either a 1-inch or a 1.5-inch needle.
... The two groups turned out to have different antibody counts depending on the needle used. In those injected with the short one, the number was almost halved.
KARACHI: Shrinking budgets hit anti-hepatitis project (www.dawn.com, 1 February 2010)
Shrinking budgets for the health delivery system may hamper the ‘Chief minister’s initiative for hepatitis-free Sindh’, say sources in the provincial health department.
The programme was announced by Sindh Chief Minister Syed Qaim Ali Shah in the middle of 2008 in response to the inadequacies found in the existing national programme on hepatitis to ensure rapid screening of people against hepatitis C, uninterrupted supply of medicines to patients suffering from viral diseases and provision of preventive facilities to the people.
However, the funds released for the project have been less than half of the amount originally allocated for it in PC-1, a health official said.
It is feared that the targets set for the three-year programme, including treatment of 70,000 hepatitis C and 7,500 hepatitis B patients, and vaccination of 4.2 million newborns, 58,000 children and adults, prisoners and other high-risk groups, might remain unachievable due to limited release of funds.
Cell-Phone Medicine Brings Care To Patients In Developing Nations (content.healthaffairs.org, February 2010)
... Sitting at a white plastic table near the pharmacy, an HIV-positive man—we’ll call him Carlos—is recruiting other patients to use a system called VidaNET (LifeNET). It’s a cell phone–based system that sends text messages and e-mail to patients, reminding them to take their anti-HIV drugs, keep their doctors’ appointments, and stay up to date on their lab tests. The system also sends messages about mental health and alerts patients to supplementary resources on a Web site explaining side effects from anti-HIV medications. Carlos, a skinny man sporting an Abercrombie and Fitch baseball cap, gives the system a ringing endorsement. "I like the cell phone because texts just arrive" from VidaNET, says Carlos, who takes his medicine twice daily. "It’s really easy to use." A banner hanging across his makeshift information booth underscores the point: "VidaNET is a technological platform that helps you self-manage your health."
Even if people worldwide miss their medications, however, they are increasingly addicted to their cell phones. An estimated 55 percent of the world’s citizens have one, and it’s projected that there will be on average one cell phone for every person in the world by 2018. Strikingly, 80 percent of Mexicans now own at least one cell phone; in fact, the country has more mobile phones than people. A cell phone can be bought for less than the equivalent of $30, and minutes can be bought in increments of as little as $2.50. That’s not exactly cheap in a country with annual per capita gross domestic product (GDP) of roughly $14,000, and where 40 percent live in poverty—but it’s still low enough to put calls and texting within the reach of many. And although only 9.1 percent of Mexicans have an Internet connection at home, through Internet cafes or shared computers, about one-quarter of Mexicans are using the Web today—a 500 percent increase since 2000.
As many countries or regions leapfrog over the land-line stage of telecommunications and go directly to cellular, they are tapping mobile technologies to transform their health systems.
Pakistan: 2,100 displaced children vaccinated against measles (www.msf.org.uk, 21 January 2010)
On Tuesday, 12th January in Munda, Lower Dir district of the North West Frontier Province, Pakistan, MSF and Department of Health staff started a measles vaccination campaign for the displaced people under 15 years of age. In three days, 2,100 children were vaccinated by three teams located in different areas around Munda camp. The vaccines and cold chain were provided by the Department of Health and MSF teams conducted the vaccination.
Haiti Hospital’s Fight Against TB Falls to One Man (www.nytimes.com, 5 February 2010)
At a fly-infested clinic hastily erected alongside the rubble of the only tuberculosis sanatorium in this country, Pierre-Louis Monfort is a lonely man in a crowded room.
Haiti has the highest tuberculosis rate in the Americas, and health experts say it is about to drastically increase.
But amid the ramshackle remains of the hospital where the country’s most infected patients used to live, Mr. Monfort runs the clinic alone, facing a vastness of unmet need that is as clear as the desperation on the faces around the room.
... In normal times, Haiti sees about 30,000 new cases of tuberculosis each year. Among infectious diseases, it is the country’s second most common killer, after AIDS, according to the World Health Organization.
The situation has gone from bad to worse because the earthquake set off a dangerous diaspora. Most of the sanatorium’s several hundred surviving patients fled and are now living in the densely packed tent cities where experts say they are probably spreading the disease. Most of these patients have also stopped taking their daily regimen of pills, thereby heightening the chance that there will be an outbreak of a strain resistant to treatment, experts say.
UNICEF and partners launch immunization campaign in Haiti quake zone (www.unicef.org, 3 February 2010)
UNICEF, the Haitian Ministry of Health, the World Health Organization and other partners have organized the immunization drive to reach those, like Magalie and her children, who survived the quake but are now living in cramped, makeshift camps.
Conditions in the camps are rife for the spread of disease. And while the campaign is mainly focused on protecting the health of young children, a number of vaccines are also available for older children and adults.
... The first phase of the immunization campaign kicked off at Sylvio Cator Stadium in downtown Port-au-Prince. ... The first phase of the immunization campaign kicked off at Sylvio Cator Stadium in downtown Port-au-Prince.
For Some Survivors, Polio Won’t Fade Into the Past (www.nytimes.com, 2 February 2010)
... Post-polio syndrome, first recognized by science in the 1980s, is not technically a disease — no bacteria or virus causes it, for example, like polio itself. Rather it is more like a car’s transmission breaking down after too many years of wear and tear on the gears: battered muscles and nerves that are pushed through a lifetime of strain to overcome and compensate for polio’s debilitating effects simply wear out sooner, doctors say.
Cholera kills at least five, with scores infected (www.irinnews.org, 2 February 2010)
In Benin cholera has killed five people in the past two weeks in a rare dry-season outbreak.
Health officials detected the first cases of the diarrhoeal disease on 13 January in the town of Bonou – 90km east of the economic capital Cotonou – where 66 cases and four deaths were recorded up to 29 January, according to the Health Ministry’s director of sanitation Laurent Assogba.
Three cases, one resulting in death, have also been recorded in Cotonou, he said.
WHO pneumonia expert honored with PACE Global Leadership Award (www.news-medical.net, 31 January 2010)
WHO pneumonia expert Dr. Thomas Cherian will be honored by a group of the world’s leading infectious disease experts today for his pivotal work to accelerate access to vaccines preventing pneumococcal disease, the world’s leading vaccine-preventable killer of children under age five.
... Over the course of a 25-year career that began at Christian Medical College in Tamil Nadu, India, Dr. Cherian, who currently serves as coordinator of the Expanded Programme on Immunization at the World Health Organization, has made significant contributions to the fight against pneumonia and pneumococcal diseases. His work includes helping to accelerate the development pneumococcal vaccines, evaluating their efficacy against pneumonia, and informing the development of the WHO protocols that today guide treatment of pneumonia and other respiratory infections in community settings around the globe.
Certification, corruption, and cost: The fight for a vaccine production policy (http://infochangeindia.org, December 2009)
India has used vaccines -- for smallpox and typhoid -- since the early part of the 20th century. Vaccination against smallpox heralded the development of the Expanded Programme on Immunisation in 1978. Then, in 1985, India pushed forward the Universal Immunisation Programme (UIP) to reduce mortality and morbidity from certain vaccine-preventable diseases. The programme today mandates that vaccines for six diseases – for tuberculosis, diphtheria, tetanus, pertussis, polio and measles – be provided free of cost to children less than a year old. Hepatitis B is being planned as well, with considerable controversy: Opponents argue that it is pointless trying to include new vaccines. They also point out that the country has dismal vaccine coverage. “At present there is only 50-54% coverage of the UIP,” ...
... Vaccine production in India has gone through significant changes within the last few years. Till about the end of 2007, three public sector units (PSUs) – BCG Labs in Chennai, Pasteur Institute in Coonoor, and Central Research Institute (CRI) in Kasauli -- provided much of the country’s essential vaccines. For instance, BCG Labs in Chennai produced more than 500 lakh doses of BCG vaccine annually by the end of 2002 (India now needs about 760 lakh doses this year, and BCG Labs was planning to gear up for 800 lakh doses to fulfil the requirements, according to statistics seen at its Chennai office).
But in January 2008, after a WHO-led team found that the labs were not compliant with the latest manufacturing norms, the Ministry of Health and Family Welfare agreed to suspend the licenses of these PSUs. Private players stepped up their production soon after, and currently a majority of vaccines) come from private manufacturers.
And with that, we could say, the dust settled, if it were not for a proposed Vaccine Park in Chennai, run by HLL Lifecare, another government-owned establishment. The Vaccine Park is supposed to function by 2012 and provide 100% of the country’s vaccines.
... SII’s chief managing director, Dr Cyrus Poonawalla, feels that any move to revitalise the manufacturing at the PSUs is a political move to “sympathise with a few hundred incompetent employees.” Poonawalla says that these PSUs have clearly failed the GMP norms, and are a burden on the country’s resources. The Vaccine Park project too is a waste of money and time, he feels. “The Vaccine Park is one more attempt by the government to waste public funds,” he said...
... Cost comparisons may be vague too. “Cost is in the long run an indicator of efficiency,” said Srinivasan. “But costs are to be compared with risks and benefits.” The true cost of producing a vaccine needs to include the cost of manufacturing and enterprise, and also the intangible cost of outsourcing manufacturing. A government enterprise may only be marginally cheaper than a private one since there is a reduced profit motive.
... The problem is actually one of policy and ethics. To implement a policy requires clout, as much as clarity. What does the government wish for, and how do we want to secure our nation’s essential health needs?
Bill and Melinda Gates Pledge $10 Billion in Call for Decade of Vaccines (www.sciencedaily.com, 30 January 2010)
Bill and Melinda Gates announced that their foundation will commit USD10 billion over the next 10 years to help research, develop and deliver vaccines for the world's poorest countries.
The Gateses said that increased investment in vaccines by governments and the private sector could help developing countries dramatically reduce child mortality by the end of the decade, and they called for others to help fill critical financing gaps in both research funding and childhood immunization programs.
"We must make this the decade of vaccines," said Bill Gates. "Vaccines already save and improve millions of lives in developing countries. Innovation will make it possible to save more children than ever before."
... "Vaccines are a miracle -- with just a few doses, they can prevent deadly diseases for a lifetime," said Melinda Gates. "We've made vaccines our number-one priority at the Gates Foundation because we've seen firsthand their incredible impact on children's lives."
New Vaccine Effective in Preventing TB in African Patients With HIV Infection (www.sciencedaily.com, 29 January 2009)
Investigators from Dartmouth Medical School (DMS) have reported results of a clinical trial showing that a new vaccine against tuberculosis, Mycobacterium vaccae (MV), is effective in preventing tuberculosis in people with HIV infection. The DarDar Health Study, named for Dartmouth and Dar es Salaam, Tanzania, found that MV immunization reduced the rate of definite tuberculosis by 39 percent among 2,000 HIV-infected patients in Tanzania.
... The 7-year, randomized, placebo-controlled trial was conducted in Tanzania with collaborators at the Muhimbili University of Health and Allied Sciences (MUHAS) in Dar es Salaam, and was supported by a grant from the National Institutes of Health (NIH) in the United States. According to Kisali Pallangyo, M.D., the senior collaborator at MUHAS, "The study confirms that University institutions from the northern and southern hemispheres can establish partnerships to perform quality clinical research work with global importance.
UK medical panel rules against doctor over vaccine (http://seattletimes.nwsource.com, 28 January 2010)
A British doctor who claimed links between a common children's vaccine and autism failed in his duties and acted against the interest of the children in his care, a medical panel ruled Thursday.
The General Medical Council ruling against Dr. Andrew Wakefield regarded research that he and other doctors conducted in the late 1990s, purporting to show that the combined measles-mumps-rubella (MMR) injection could put children at risk of autism or bowel disease.
That research, published in The Lancet medical journal in 1998, and media coverage of it that followed, led many parents in the U.K. to refuse to vaccinate their children with the injection, which is administered around the world.
Ten of the study's 13 authors have since renounced its conclusions. The Lancet said it should not have published the study and that Wakefield's links to litigation against the manufacturers of the MMR vaccine were a "fatal conflict of interest."
Options to sustain and improve healthcare (www.kuenselonline.com, 28 January 2010)
The health ministry could start charging non-Bhutanese for health services and Bhutanese who come to referral hospitals even when not referred as a means to generate more revenue to sustain the health system.
These were two recommendations made by experts, to generate revenue without having to do a study, at a meeting in Paro yesterday where health officials explored options for more revenue and improving efficiency of the health system.
Selectively introducing private participation, initially in the non-clinical sector and then in the clinical sector, was another alternative suggested. But health officials said this needed caution. “Many countries are trying to get out of the grip of private health care practice because patients have become customers and hospitals, five star hotels,” said the health secretary, Dasho (Dr) Gado Tshering.
WHO slams swine flu critics as 'irresponsible' (www.etaiwannews.com, 25 January 2010,
The World Health Organization on Monday slammed as "irresponsible" critics who claim swine flu is a fake pandemic created for the benefit of drug companies.
The U.N. health agency said the outbreak of a new strain of H1N1 influenza in North America last year had all the scientific characteristics of a pandemic, adding the WHO was never improperly influenced by the pharmaceutical industry that has benefited from huge government orders for vaccines and anti-viral drugs.
"The world is going through a real pandemic. The description of it as a fake is wrong and irresponsible," the WHO said in a strongly worded statement Monday.
Pentavalent vaccine suspended (www.kuenselonline.com, 28 October 2009)
Two months after being introduced nationwide, the health ministry has alerted all hospitals to immediately stop vaccinating infants with the pentavalent vaccine, because it may have side effects.
The circular, which was sent on October 23, states, “… the use of pentavalent vaccine should be stopped immediately due to some side effects. All adverse events following on immunisation (AEFI) must be strengthened, reported and investigated.”
The ministry’s media spokesperson, Kado Zangpo, said that, while the investigation is on, health centres will continue to immunise infants the way it was done before the introduction of pentavalent vaccine.
Threat of Hepatitis Underestimated (www.time.com, 26 January 2010)
How's this for an unsettling statistic: up to 1 in 50 Americans are living with chronic viral hepatitis, but most of them don't know it. A new report released by the Institute of Medicine in January describes hepatitis as a "major public-health problem" in the U.S. and calls for greater funding for prevention and treatment, increased vaccination, and a public awareness campaign to curb the threat of hepatitis B and C. "It's long overdue," says Dr. Douglas Dieterich, a professor in the Division of Liver Diseases at the Mount Sinai School of Medicine.
... Some 800,000 to 1.4 million Americans are currently living with hepatitis B, and 2.7 million to 3.9 million suffer from chronic hepatitis C.
... In tandem with more aggressive vaccination programs, the report suggests educational programs for prisoners and other at-risk populations, including immigrants from areas like East and Southeast Asia, where hepatitis B circulates widely. Some 40,000 to 45,000 people legally emigrate to the U.S. every year from such countries, where in some cases, stigma — such as in China, where infected individuals face job discrimination — may make people wary of seeking testing or medical attention in the U.S.
Vaccine plant may be shelved (www.winnipegfreepress.com, 24 January 2010)
The federal government has sparked concerns it is reconsidering a plan to build an $88-million vaccine-manufacturing facility that was touted as Canada's principal contribution to the global effort to find an HIV vaccine.
The facility is the central focus of the $139-million Canadian HIV Vaccine Initiative (CHVI), Ottawa's signature contribution to the global search for a HIV vaccine, first announced in February 2007.
... Ottawa had grown concerned there was too much private-sector vaccine manufacturing capacity to make the CHVI facility viable, and had convinced Gates to reallocate the money to another project. However, Sekaly said there is a critical need for independent facilities to ensure no private drug company corners the market on HIV vaccine.
Global cervical cancer market to grow up to $4.1 billion by 2016 (www.news-medical.net, 21 January 2010)
GlobalData has estimated the global cervical cancer market to be valued at $1.8 billion in 2009. It is expected to grow to $4.1 billion by 2016, at a Compound Annual Growth Rate (CAGR) of 11.9% between 2009 and 2016. This growth is primarily attributed to increased competition among the existing cervical cancer vaccines in the market. The vaccines will be primarily responsible for the growth of the market with the predicted increase in their uptake and sales. The success of these vaccines has driven a lot of companies into research activity.
Prompt Vaccination Reduces Chickenpox Risk After Exposure (www.infectioncontroltoday.com, 21 January 2010)
For people who haven't had chickenpox and are exposed to an ill family member, getting vaccinated within five days can reduce the risk of developing chickenpox—or at least reduce the severity of disease, reports a study in the January issue of the Pediatric Infectious Disease Journal.
"Available varicella vaccines administered within five days after exposure to chickenpox are effective in preventing chickenpox and highly effective in attenuating the disease," concludes the study by Dr. Maria Brotons and colleagues of Hospital Universitario Vall d'Hebron, Barcelona.
Promising Candidates for Malaria Vaccine Revealed (www.sciencedaily.com, 19 January 2010)
Dr James Beeson, Dr Freya Fowkes and Dr Jack Richards from the institute's Infection and Immunity division, along with Dr Julie Simpson from the University of Melbourne, have identified proteins produced by malaria parasites during the blood-stage that are effective at promoting immune responses that protect people from malaria illness.
Their findings are published in the international journal PLoS Medicine.
Drs Fowkes and Beeson identified these proteins by reviewing and synthesising data from numerous scientific studies that had looked at the relationship between antibodies produced by the human immune system in response to malaria infection and the ability of these antibodies to protect against malaria.
Vi typhoid vaccine is highly effective in young children (http://www.ivi.int, 22 December 2009)
Typhoid fever remains an important cause of illness and death in the developing world, killing an estimated 216,000 to 600,000 people annually. Multidrug-resistant Salmonella Typhi has spread to many parts of the world, limiting the ability to treat typhoid fever with available antibiotics. Typhoid is both a waterborne and foodborne gastrointestinal infection, with incidence approaching one percent of the population annually in certain endemic areas. Experts say that in the absence of affordable programs to assure safe water and better sanitation, short and medium-term efforts need to be directed towards prevention through vaccines.
Safe and effective vaccines against typhoid fever exist but they are used primarily for affluent travelers to developing countries, rather than for the poor residing in these countries, who account for the majority of the global burden of typhoid morbidity and mortality. One of these vaccines, Vi polysaccharide, is ideally suited for use in developing countries because it is cheap (about $0.50 per dose) and requires only a single dose.
First Steps Taken Toward the Development of a Malaria Transmission-Blocking Vaccine (www.jhsph.edu/publichealthnews, 15 January 2010)
The PATH Malaria Vaccine Initiative (MVI) today announced a new collaboration to initiate development toward a vaccine that may eventually help eliminate and eradicate malaria. This collaboration with the Johns Hopkins Bloomberg School of Public Health (JHSPH) and the Sabin Vaccine Institute (Sabin) marks MVI's first investment in transmission-blocking vaccines (TBVs). This vaccine approach aims to stop the malaria parasite from developing in the mosquito, effectively blocking transmission of malaria from mosquitoes to humans. Malaria kills nearly 900,000 people per year, most of them children younger than age five.
Public awareness campaign needed to curb health threats posed by hepatitis B and hepatitis C (www.news-medical.net, 12 January 2010)
Stepped-up vaccination requirements, a boost in resources for prevention and treatment, and a public awareness campaign similar to the effort that dispelled the stigma of HIV/AIDS are needed to curb the health threats posed by hepatitis B and hepatitis C, says a new report from the Institute of Medicine. ...
An estimated 800,000 to 1.4 million Americans have chronic hepatitis B and between 2.7 million and 3.9 million have chronic hepatitis C. The majority of infected individuals are not aware of their condition until they develop symptoms of liver cancer or liver disease. Few among the populations most at risk -- immigrants from countries where the diseases are endemic, non-Hispanic black men, injection-drug users, and people who had blood transfusions before 1992 -- seek testing or information on how to protect themselves from infection. Moreover, health care and social service providers' knowledge about hepatitis B and C is generally poor, and many fail to follow guidelines for screening patients and providing prevention, treatment, and follow-up services.
... Steps need to be taken to eliminate the stigma associated with viral hepatitis. Negative attitudes about hepatitis B in some cultures may contribute to immigrants' reluctance to seek testing. In China, for example, people with chronic hepatitis B face job and social discrimination. In addition, negative perceptions about illicit-drug users, who make up the greatest percentage of those with hepatitis C, can affect the care they receive or their willingness to seek care.
Who’s Afraid of the HPV Vaccine? (www.nsf.gov, 10 January 2009)
A new study concludes that people tend to match their risk perceptions about policy issues with their cultural values, which may explain the intense disagreement about proposals to vaccinate elementary-school girls against human-papillomavirus (HPV). The study also says people's values shape their perceptions of expert opinion on the vaccine.
... An online experiment involving more than 1,500 U.S. adults reveals that individuals who have cultural values that favor authority and individualism perceive the vaccine as risky, in part because they believe it will lead girls to engage in unsafe sex. But individuals with cultural values that favor gender equality and pro-community/government involvement in basic health care are more likely to see the vaccine as low risk and high benefit.
Poverty's Researcher (www.technologyreview.in, 21 December 2009)
A few years ago, economist Esther Duflo, PhD '99, found a problem that threatened to stump her. In the rural villages of Udaipur, a district in northern India with one of the worst child mortality rates in the world, parents were spurning health clinics' offer of free immunizations against deadly diseases such as measles and tuberculosis. Only 2 percent of local children were being immunized by age two.
Duflo, MIT's Abdul Latif Jameel Professor of Poverty Alleviation and Development Economics, specializes in finding unorthodox ways to help the world's poor. So she concocted an experiment with MIT-based collaborators Abhijit Banerjee and Rachel Glennerster, along with officials from Seva Mandir, a local nongovernmental organization. In some villages, they offered parents about two pounds of free lentils when they brought their children in for shots. Before long, families started streaming into these clinics. About four in 10 children got immunized where free lentils were available.
... According to mainstream economic thinking, the success of the lentil giveaway made no sense. The shots were already free. The lentils, a cheap staple of the Indian diet, added little value. "The standard theory of human capital accumulation cannot explain why you go from a few percent to 38 percent," says Duflo. "The fact that there is huge responsiveness to such a small thing is contrary to theory."
But that is precisely why she likes to perform experiments. Duflo, 37, a native of France, has gained renown for using the world as a laboratory to see why aid programs succeed or fail. In so doing, she has not just tweaked conventional wisdom but helped revitalize global antipoverty efforts.
H1N1 vaccine goes from scarce to plentiful (www.cbsnews.com, 10 January 2010)
Sixty million people have been vaccinated so far against the H1N1 flu (also known as swine flu). And the Centers for Disease Control says that 136 million doses are still there for the taking. But while the current outbreak has peaked, Americans are being urged not be become complacent ...
A spoonful of ingenuity (The Economist, 7 January 2010)
In the old days, the job of eradicating disease fell to governments and inter-governmental bodies. Then charities, often led by celebrities or entrepreneurs, joined in. Finally, in the Western world at least, governments accepted the need to pool their efforts with those of private donors, big and small. The effort still seems unequal to the task. Every year, nearly 11m children die before the age of five because of a mixture of poor nutrition and preventable disease. Many of the United Nations’ Millennium Development Goals (calling, for example, for a plunge in child and maternal mortality by 2015) look unattainable.
The good news is that more imaginative ways of raising and spending money are now on the horizon. How well they do will depend on many details—like the quality of information flowing between poor places and the governments, firms and individuals that want to help.
The change in funding is already dramatic. In 1990 more than two-thirds of the $5.6 billion spent on global health assistance came from governments (see chart 1). By 2007, when total funding for health reached nearly $22 billion, government spending still made up the lion’s share. Look closer, though, and it emerges that the yeast which leavened this bread was “non-traditional” financing. ...
As a case of the new sort of money-raising, take UNITAID, an agency founded by France, Brazil and three other countries, which is hosted by the World Health Organisation in Geneva and calls itself a “facility” for the purchase of drugs to fight important diseases. UNITAID’s main income comes from a charge on air tickets, levied by a dozen states; combined with cash contributions from other countries, this has raised $1.5 billion in the past four years.
Mongolia receives first batch of swine flu vaccines (www1.voanews.com, 1 January 2010)
The World Health Organization says Mongolia became the first developing country to receive doses of donated H1N1 swine flu vaccines. A WHO spokeswoman tells VOA more vaccines will be distributed for use in 95 poor countries during the next few months.
The World Health Organization has divided the 95 developing countries into three groups. Mongolia is the first country in the first group of countries to receive the H1N1 vaccine donations.
"So, for now, we are just saying that the three countries that seem closest to receiving-well Mongolia, which did receive," said WHO spokeswoman, Nyka Alexander. "Azerbaijan, which should receive within a few days and Afghanistan as well, looks pretty likely to be next on our list, next of the countries able to receive. So, there is that. The other countries on this first cluster of 35, there are several in our Western Pacific region and there are also Pacific island countries."
She says health care workers will be the first to be immunized, followed by people most at risk, such as pregnant women and very young children.
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WHO use of advisory bodies in responding to the influenza pandemic (3 December 2009)
WHO is aware of some concerns, expressed in the media, that ties with the pharmaceutical industry among experts on the Organization’s advisory bodies may influence policy decisions, especially those relating to the influenza pandemic.
WHO has historically collaborated with the pharmaceutical industry for legitimate reasons. Efforts to improve health depend on better access to high-quality and affordable medicines, vaccines, and diagnostics. Medical interventions, including antiviral drugs, vaccines, and diagnostic tests, have long been recognized for their role in mitigating the health impact of an influenza pandemic. Pharmaceutical companies play an essential role in this regard and WHO has engaged with them to pursue its public health objectives.
New systems for rapid flu testing developed (igovernment.in, 31 December 2009)
Researchers have developed an automated system to test and differentiate flu strains.
In pandemic infection, such as the present Influenza A (H1N1) outbreak, rapid automated tests are needed in order to make quick and effective public health decisions.
Real-time reverse transcriptase polymerase chain reaction (real-time RT-PCR) is a sensitive and specific method for identifying flu substrains.
A group led by Kelly J Henrickson of the Medical College of Wisconsin (MCW), has developed rapid semi and fully-automated multiplex real-time RT-PCR assays to detect influenza A, influenza B, and respiratory syncytial virus (RSV), reports IANS
Indian-made vaccine for swine flu by March (http://www.expressbuzz.com, 4 January 2010)
Indigenous vaccine for swine flu will be available by March along with testing kits at just 25 per cent of the cost of its foreign counterpart, according to Dr V M Katoch, secretary, Department of Health Research and Director General of Indian Council of Medical Research.
He said that five Indian companies were working on it and had made good progress.
France sells off surplus swine flu vaccine (http://news.bbc.co.uk, 3 January 2010)
France is selling off millions of surplus swine flu vaccine doses to other countries, officials say. They say the move was decided after health authorities found they had more than enough to deal with the outbreak.
Germany and The Netherlands announced similar sales late last year. The H1N1 virus appears to have peaked in North America and parts of Europe.
However it remains active elsewhere. More than 11,500 people worldwide are believed to have died from swine flu.
A French health ministry official told AFP on Sunday: "We started with a plan for two-dose vaccinations but since one dose is sufficient we can start to resell part of the stock."
How vaccines became big business (http://www.globeinvestor.com, 29 December 2009)
... In a matter of a few years, flu shots have gone from being a marginal, money-losing business to a massive profit generator for a small number of global companies, as governments and the public hasten to protect themselves from getting sick.
Between 2004 and 2007, vaccine sales across the industry soared an average of 32 per cent each year, with flu vaccine leading the way. That is roughly four times faster than any other pharmaceutical product.
... In a year that will be remembered for widespread public worry about the H1N1 virus, or swine flu, vaccines have become a $24-billion business. Analysts predict the global vaccine industry will top $40-billion by 2012. For companies like Glaxo, Sanofi-Aventis, Merck & Co., Novartis AG and Pfizer Inc., the fear of a pandemic has translated into a financial windfall that has been years in the making. Worldwide, nearly 1 billion doses of H1N1 vaccine have been ordered in 2009.
Fewer school children receiving immunization over vaccine doubts (http://www.etaiwannews.com, 28 December 2009)
A fatality allegedly due to an inoculation against influenza A(H1N1) involving a 7-year-old in Taichung has caused panic among parents in Taiwan leading to a sharp decline in the number of school children receiving A(H1N1) immunization over the past week.
Pediatricians at major medical institutions confirmed yesterday that the number of school children receiving A(H1N1) vaccine shots has declined sharply over the past week, primarily due to concerns over the safety of the vaccine after the 7-year-old boy died several weeks after being immunized.
The doctors, however, still recommended that parents should get their children immunized because the benefits far outweigh the risks.
Low immunization levels in Uttar Pradesh causing concern: UNICEF (The Hindustan Times, 26 December 2009)
Low levels of immunization in Uttar Pradesh are resulting in the resurgence of diseases like diphtheria and whooping cough in children, a Unicef sponsored study says.
This was disclosed during a Unicef presentation titled "Routine Immunisation - Bitter Facts".
While immunization levels were less then 20 percent in 36 districts of the state, they were estimated at between 20-40 percent in 39 districts, the study said.
"Sadly, it is only in five districts of Uttar Pradesh that routine immunization touched 40 percent," said Yogesh Govil, professor in paediatrics at the King George's Medical College here.
UNICEF Chief To Step Down After Term Ends In 2010 (http://globalhealth.kff.org, 24 December 2009)
UNICEF Executive Director Ann Veneman will not seek a second term as head of the agency after her term expires in a few months, U.N. Secretary-General Ban Ki-moon announced "with great regret" on Wednesday, Xinhua reports. In a statement, Ban said that Veneman "fulfilled her mandate with immense dedication, and I have been impressed by her extraordinary energy and determination to improve children's health, education and well-being around the world.
What Ukrainians think about introduction of immunization record cards—telephone survey results (http://unian.net/eng/news, 2 November 2009)
According to the press release passed by Gorshenin Institute to UNIAN, Ukrainians oppose the introduction of Immunization Record Cards. Those are the results of the phone survey “Immunization in Ukraine” conducted by Gorshenin Institute on 26/10/09-28/10/09.
Gorshenin Institute experts note that majority of Ukrainians (61.5%) do not support passing by Verkhovna Rada of the law that provides for the implementation of “National Immunization and Infectious Disease Control Program for 2009-2015” requiring every Ukrainian to get vaccinated.
First Case of Highly Drug-Resistant TB found in US (http://abcnews.go.com, 27 December 2009)
... Doctors say Juarez's incessant hack was a sign of what they have both dreaded and expected for years — this country's first case of a contagious, aggressive, especially drug-resistant form of tuberculosis. The Associated Press learned of his case, which until now has not been made public, as part of a six-month look at the soaring global challenge of drug resistance.
Juarez's strain — so-called extremely drug-resistant (XXDR) TB — has never before been seen in the U.S., according to Dr. David Ashkin, one of the nation's leading experts on tuberculosis. XXDR tuberculosis is so rare that only a handful of other people in the world are thought to have had it.
... This April, the World Health Organization sounded alarms by holding its first drug-resistant TB conference in Beijing. The message was clear — the disease has already spread to all continents and is increasing rapidly. Even worse, WHO estimates only 1 percent of resistant patients received appropriate treatment last year.
New WHO guidelines on antiretrovirals welcomed worldwide (The Lancet Infectious Diseases, 2010)
As the latest figures indicate that new HIV infections and AIDS deaths are starting to fall globally, WHO has released guidelines that recommend earlier initiation of antiretroviral treatment and prolonged use of antiretrovirals to prevent mother-to-child (vertical) transmission. These measures are intended to further reduce the epidemic in high-burden countries, says WHO. Now, the challenge is encouraging more people to come earlier for HIV testing, says Teguest Guerma, acting director of WHO's HIV/AIDS division.
More H1N1 vaccines available in U.S., many Americans don't want it (www.news-medical.net, 24 December 2009)
While an increasing number of H1N1 (swine flu) vaccines are available in the U.S., "more than half of American adults say they still don't want it, and one-third of parents say they don't want their children to get it either, according to two surveys," the Washington Post reports. "As of this week, 111 million doses of vaccine against the pandemic strain of H1N1 flu have been released to states and cities. Not all have been used. There have been no unusual or unexpected vaccine side effects reported" ...
Health Canada approves Prevnar 13 vaccine for invasive pneumococcal disease (www.news-medical.net, 24 December 2009)
Following a Priority Review, Health Canada has approved Prevnar 13 (Pneumococcal 13-valent Conjugate Vaccine (Diphtheria CRM197 Protein)) for children aged six weeks through five years for active immunization against invasive pneumococcal disease, a bacterial infection that can include meningitis (inflammation of the coverings of the brain and spinal cord), sepsis (bloodstream infection), bacteremic pneumonia, pleural empyema (accumulation of pus in the cavity surrounding the lungs) and bacteremia (bacteria in the blood).
Prevnar 13 is designed to provide the broadest coverage of any pneumococcal conjugate vaccine. The new vaccine includes the seven strains in Prevnar (4, 6B, 9V, 14, 18C, 19F and 23F) as well as six additional strains (1, 3, 5, 6A, 7F and 19A) responsible for the greatest remaining burden of invasive disease in young children worldwide.
Doctors query ability of Tamiflu to stop severe illness (The Guardian 8 December 2009)
Roche, the manufacturer of Tamiflu, has made it impossible for scientists to assess how well the anti-flu drug stockpiled around the globe works by withholding the evidence the company has gained from trials, doctors alleged today.
A major review of what data there is in the public domain has found no evidence Tamiflu can prevent healthy people with flu from suffering complications such as pneumonia.
Tamiflu may shorten the bout of illness by a day or so, the investigators say, but it is impossible to know whether it prevents severe disease because the published data is insufficient. Roche has failed to make some of the studies carried out on the drug publicly available, the scientists say.
The final push to end polio in India (The Guardian, 27 December 2009)
... Calliper and crutches were a common sight in the 1950s, when the UK had 45,000 cases. The arrival of the polio vaccine in the 1960s wiped out the disease in developed countries and triggered a remarkable aspiration – to eradicate it from the world. The job was supposed to have been finished at the turn of the millennium, but nearly a decade and $7bn on, polio eludes us still. Last year, there were 1,500 cases in the world – a tiny fraction of the 350,000 in 1985, but a real and present danger not only in India, Pakistan, Nigeria and Afghanistan, where polio is still endemic, but also to other countries where migrants and travellers can so easily take it. The numbers have hardly shifted in five years. But can it be defeated now?
Afghanistan first in world to use new vaccine against polio (The Lancet, 15 December 2009)
A new vaccine against polio will be used for the first time today in polio immunization campaigns in Afghanistan. The bivalent oral polio vaccine (bOPV), recommended by the Advisory Committee on Poliomyelitis Eradication, the global technical advisory body of the Global Polio Eradication Initiative as a critical tool to eradicate polio, can provide the optimal concurrent protection needed by young children against both surviving serotypes (types 1 and 3) of the paralysing virus. This will vastly simplify the logistics of vaccination in the conflict-affected parts of this country. This sub-national immunization campaign, from 15-17 December, will deliver bOPV to 2.8 million children under five in the Southern, South-Eastern and Eastern Regions of Afghanistan.
... The bOPV allows countries to simplify vaccine logistics and to optimize protection using a mix of the available polio vaccines according to local needs. In southern Afghanistan, where access to children can be limited depending on the security situation, using bOPV helps maximise the impact of each contact with a child.
Malaria progress shows development aid for health works (http://www.who.int, 15 December 2009)
Significant progress has been made in delivering life-saving malaria nets and treatments over the last few years, but the coverage of malaria programmes needs to be stepped up drastically in order to meet the Millennium Development Goals (MDGs), according to a report released today by WHO.
The World malaria report 2009 found that the increase in international funding commitments (US$ 1.7 billion in 2009 compared to US$ 730 million in 2006) had allowed a dramatic scale up of malaria control interventions in several countries, along with measurable reductions in malaria burden. However, the amounts available still fall short of the US$ 5 billion required annually to ensure high coverage and maximal impact worldwide.
Wild poliovirus reaches more African countries in 2009 (www.news-medical.net, 15 December 2009)
Cases of polio have been reported in some African countries that have eradicated the disease, Luis Gomes Sambo, the WHO's Africa regional director, said Monday at the opening of a child immunisation conference in Zimbabwe, Agence France-Presse reports (12/14). It is the WHO's first annual regional conference on immunization, according to VOA News. Sambo said the conference will review the status of immunization in the 46-country sub-Saharan region ...
"Several polio-free countries have suffered setback in polio eradication," Sambo told the 150 delegates. "The number of countries with polio outbreaks following wild poliovirus importations has increased from 13 to 19 in 2009," he said, AFP reports. According to the WHO, Angola, Chad, the Democratic Republic of Congo and Nigeria are some of the countries that have seen more polio cases, mainly because of a lack of immunization ...
Disease eradication: Yesterday's ambition (www.guardian.co.uk, 14 December 2009)
If ever there was a single moment of lost innocence in global medicine, it came with the triumph of disease over the best efforts of rich nations to transfer their knowledge and expertise to the rest of the world. Yet – as veterans of the campaign to eradicate smallpox will remember at commemorative events next spring – 30 years ago they believed that soon other major infectious diseases would be similarly defeated. Instead they persist to devastating effect, particularly in sub-Saharan Africa, where malaria remains the biggest killer of children under five and where polio, although much reduced, is back on the march even in countries like southern Sudan where it once was under control, while TB kills more than HIV/Aids. And the bigger the challenge, the hotter the politics.
Glaxo Reaches Deal On Vaccine Patches (http://online.wsj.com, 12 December 2009)
GlaxoSmithKline PLC struck a deal with an Austrian firm to develop needle-free vaccines delivered through a patch, a technology that could broaden vaccine use by eliminating irksome needle jabs and the need for vaccine to be refrigerated.
Glaxo, based in Brentford, England, said it will make an initial payment of €33.6 million ($46 million) to Vienna-based Intercell AG to gain access to both the patch technology and the marketing rights to experimental patch vaccines for traveler's diarrhoea and pandemic flu.
Vaccination push as polio re-emerges (IRIN, 11 December 2009)
Health officials and aid agencies in Guinea will mount the fifth polio vaccination drive this year from 12 to 16 December. The once polio-free country has recorded 37 cases since April.
"The strategy is to reach all under-five children, wherever they are and whatever their immunization status," the World Health Organization and UN Children's Fund said in a joint communiqué on 11 December. "Isolated zones, border villages and islands [off the capital, Conakry] will get particular attention."
More than 11,000 health workers will go door-to-door, immunizing children. The effort is part of a region-wide vaccination push to stem a resurgence of polio. The disease has struck a number of long-uninfected countries, particularly in West Africa, since 2008. According to WHO, polio cases in northern Nigeria were blamed for the reinfection.
Appeal for aid as malaria "emergency" looms in Sierra Leone (IRIN, 11 December 2009)
Malaria deaths in children under five have increased "significantly" in the past four months in Sierra Leone, where this preventable disease kills a child every 30 minutes. Aid agencies are urgently appealing for medicines and other supplies to stem the trend.
"This current trend of one in five children in Sierra Leone dying before the age of five due to easily preventable diseases is unacceptable, and calls for immediate and concerted action," said a joint communiqué by the World Health Organization (WHO) and the UN Children's Fund (UNICEF) on 10 December.
The two agencies are "urgently" appealing for 1.3 million bednets, as well as anti-malaria drugs, at a cost of US$16.9 million. "The situation is now considered as constituting a potential emergency," said the statement.
Pfizer's Prevenar 13 granted European marketing authorization (www.news-medical.net, 11 December 2009)
The European Commission has granted Pfizer Inc. (NYSE: PFE) a European marketing authorization for its pneumococcal conjugate vaccine, Prevenar 13 (Pneumococcal Polysaccharide Conjugate Vaccine [13-valent, adsorbed]). Prevenar 13 is indicated for active immunization for the prevention of invasive disease, pneumonia, and acute otitis media caused by 13 Streptococcus pneumoniae serotypes in infants and children from 6 weeks to 5 years of age. Invasive pneumococcal disease includes sepsis, meningitis, bacteremia, bacteremic pneumonia, and empyema.
Advocacy for Immunization Program receives a three-year grant from the Bill & Melinda Gates Foundation (www.news-medical.net, 8 December 2009)
The Agence de Médecine Préventive (AMP) has received a three-year grant from the Bill & Melinda Gates Foundation to implement a program to support immunization advocacy in West Africa.
The program, called ADVocacy for IMmunization (ADVIM), is a collaborative effort involving the World Health Organization (WHO), the United Nations Children's Fund (UNICEF), and local finance, health, and planning ministries. ADVIM's advocacy platform will be developed by AMP and members of the EPIVAC international network, a group of 400 health professionals involved in immunization in 11 sub-Saharan African countries. The participating countries will be selected among those meeting the requirements for GAVI Alliance funding ...
Vaccination key to stemming rotavirus, say experts (IRIN, 8 December 2009)
African health experts are calling on governments to vaccinate children against rotavirus, to end an “unacceptable” yet preventable situation in which the virus kills some 1,400 children in developing countries daily.
The West African Rotavirus Advisory Board on 3 December held a meeting in the Senegalese capital, Dakar, as part of efforts to advance the vaccine’s use after the World Health Organization recommended its inclusion in national immunization programmes worldwide.
George Armah, professor and rotavirus expert at Ghana’s Noguchi Memorial Institute for Medical Research, told IRIN the evidence is clear and must be used to push policymakers to act. “Rotavirus is one of the major causes of diarrhoea deaths and hospital admissions. There are vaccines that are very effective and can radically reduce mortality and morbidity from rotavirus infection.”
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GLOBAL: Integrated health systems "boost the fight against HIV" (IRIN, 7 December 2009)
If universal access to HIV prevention, treatment and care is to be achieved, experts recommend an inclusive approach to healthcare, rather than narrow HIV programmes.
"Governments and their development partners ought to adopt a health development approach with a long-term perspective in which HIV is a component," Jonathan Quick, chief executive officer of a public health NGO, Management Sciences for Health (MSH), told IRIN/PlusNews.
"For countries [where] the epidemic is generalized but stabilizing, it is no longer necessary to have special budgets for HIV but rather development budgets in which HIV is included in all aspects."
GAVI honours 15 countries for excelling in immunisation and child survival (www.gavialliance.org, 19 November 2009)
Fifteen health ministers from low-income countries today received awards from the GAVI Alliance for their outstanding performance in improving child health and immunisation.
At a ceremony at the GAVI Alliance Partners’ Forum in Hanoi, GAVI Board Chair Mary Robinson, GAVI Immunize Every Child Board member, La Infanta Cristina of Spain, and GAVI CEO Julian Lob-Levyt presented the ministers with an engraved plaque to recognise their success. UNICEF Goodwill Ambassador Yvonne Chaka Chaka, a South-African singer, moderated the event.
... Vietnam, the host country of the GAVI Partners’ Forum, and Nepal received awards for the highest average annual rate of reduction of child mortality among all of the 72 GAVI countries since 1990.
“We recognise that effective and sustainable programmes require careful attention to a variety of factors,” Dr Lob-Levyt said.
“You have to ensure that the vaccines are available; that stocks are well managed, and your staff is well trained. You also need to put in place a workable delivery system for reaching every child, and you must have adequate resources to sustain the introduction of new vaccines. This is why we gave awards in different categories.”
To control or eradicate malaria? (www.scidev.net, 18 November 2009)
Lately, malaria scientists have once again begun talking about eradication. It is not a word they use lightly. The last attempt, in the 1950s, failed miserably. Millions of people died because, far from disappearing, the disease came back stronger than ever.
Since then, the global health community has focused on reducing the number of cases and severity of the disease and lowering death tolls.
But ridding the world of this disease, which kills more than a million people every year, was a hot topic at the fifth Multilateral Initiative on Malaria (MIM) meeting earlier this month (November) in Nairobi, Kenya.
Several high-profile international groups, most notably the Gates Foundation, are pushing elimination and eradication. At first glance, these are unquestionably positive goals.
Yet some researchers fear that health infrastructure in regions like Africa is ill-equipped to roll out eradication tools, and are nervous that the shift will divert funds from much-neededbasic control measures.
Fighting resistance. An interview with John Crofton (WHO Bulletin, 12 December 2009)
A pioneer in the early identification of drug resistance in tuberculosis patients, Sir John Crofton and his colleagues’ seminal research into multidrug therapy for tuberculosis patients in the 1950s laid the groundwork for the WHO-recommended tuberculosis treatment today. This is one of the last interviews he gave before he passed away on 3 November at the age of 97, after a career that spanned three-quarters of a century.
Spanish health district tests a new public–private mix (WHO Bulletin, 12 December 2009)
Faced with ballooning deficits in its health-care budget in the late 1990s, the Spanish regional authority of Valencia decided it was time to look for new ways to fund and run its hospitals. Starting with the health district of Alzira, the authority invited a private consortium led by Adeslas, a leading Spanish private health insurance company not only to build a brand new hospital, but to run it as well. Hospital de La Ribera, built at a cost of €61 million in 1999 (US$ 91 million on 17 November 2009), was managed by a new kind of corporate entity known as a public–private investment partnership (PPIP). PPIPs are just one way of involving the private sector in publicaly-funded health services, as most districts in Spain rely on a public–private mix of one kind or another.
... But where the Alzira PPIP really stands out is in its tight control of costs. Funded by the regional health ministry on a pre-agreed per capita basis, La Ribera spends 20–25% less than comparable publicly managed institutions, according to Juan Alfonso Bataller, the Valencia Regional Health Ministry Undersecretary. Bataller says that operational improvements, such as the digitalization of medical records and the sourcing of supplies based on competitive tender rather than established relationships, account for a good deal of these savings, but it’s clear that the Valencia region also benefits from the Adeslas consortium’s serious approach to investing in health.
... “I don’t think that any of the enterprises involved in the administrative concessions will become rich, because here we have an obligation to invest nearly everything that we earn,” says Marín (director of Hospital de La Ribera). The Alzira contract in fact stipulates that profit generated by the hospital be limited to 7.5% per annum, any amount in excess of that being subject to obligatory re-investment. This is slightly below the 8% return on assets that Feachem considers to be typical and acceptable for the private partners in a PPIP, but is way above the 1.6% profit that Marín says the Alzira consortium actually makes. According to Marín the consortium has never cleared more than that, while the rest is being ploughed into local projects, including new health centres and improvements to the hospital itself. So doesn’t the consortium care about profits? Marín explains that Adeslas gets a “non-tangible benefit” in the form of good publicity for its business model, from “people knowing that a private system can provide a public service and manage a public service”. It also hopes its model will be taken up in other parts of Spain.
Hepatitis C Drug Targets RNA (www.technologyreview.com, 4 December 2009)
An experimental drug developed by Danish startup Santaris effectively controls the hepatitis C virus in chimpanzees without creating drug-resistant forms of the virus--a major advantage over other compounds in clinical development. The compound, a synthetic nucleic acid that binds to a microRNA molecule required for viral reproduction, is now in early-stage clinical trials. It is the first microRNA-targeting drug to be tested in humans.
Approximately 170 million people across the globe are infected with the hepatitis C virus, a chronic infection that can lead to cirrhosis, liver cancer, and the need for a liver transplant. While drugs exist to treat the virus, they carry serious side effects and work in fewer than half of all infected patients. ...
Existing drugs suppress the virus by boosting the patient's immune system. The Santaris drug targets the hepatitis C virus more directly by binding to a short piece of RNA called a microRNA, which the virus needs to replicate.
Caterpillar Flu Vaccine Delayed (www.technologyreview.com, 1 December 2009)
A new method of making flu vaccines is faster, more efficient, and more robust than the one that has been in use for the last 50 years. It has the potential to scale up rapidly, to deal with new strains of influenza such as this year's H1N1, and to help stem a pandemic tide. However, a U.S. Food and Drug Administration advisory panel voted in late November not to approve the technology, which involves growing key vaccine ingredients inside caterpillar cells instead of in chicken eggs, as is currently done. The FDA says that the company behind the new approach, Protein Sciences, based in Meriden, CT, needs to test it further before the method can be approved for use in the United States.
... Today's egg-based vaccine technology is slow and unwieldy, requiring at least six months' of production time and millions of eggs to supply enough doses for a regular flu season.
Positive results from NanoBio's recombinant H5N1 flu antigen-nanoemulsion vaccine combination study (www.news-medical.net, 3 December 2009)
NanoBio Corporation today announced positive results from studies in mice in which immune responses were evaluated following administration of 5µg doses of recombinant H5N1 pandemic flu antigen combined with the company’s novel nanoemulsion vaccine. These studies are unique because the adjuvant was administered for the first time by subcutaneous (SC) and intramuscular (IM) injections.
Phase 1 study of preventive HIV vaccine testing a novel delivery mechanism completed (www.news-medical.net/news, 1 December 2009)
A Phase 1 study of a preventive HIV vaccine testing a novel delivery mechanism known as electroporation – the use of electrical pulses to increase the immune responses elicited by DNA vaccines – was recently completed in New York City. The results show that TriGrid™, a technology developed by Ichor Medical Systems, Inc., helped to enhance the immunogenicity of the vaccine tested.
Conducted by Drs. Sandhya Vasan and David Ho of the Aaron Diamond AIDS Research Center (ADARC) at the Rockefeller University Hospital in New York City, with technical support from the International AIDS Vaccine Initiative (IAVI), this randomized, placebo-controlled trial is the first systematic evaluation of an HIV DNA vaccine delivered with electroporation ever conducted in healthy human volunteers. In addition to evaluating the safety and tolerability of the vaccine candidate, the clinical trial also assessed the frequency, magnitude and breadth of human immune responses to ADVAX, a DNA-based AIDS vaccine candidate.
Americans with hepatitis C are at increased risk of developing liver cancer (www.news-medical.net, 24 November 2009)
New peer-reviewed data finding that fewer than one-fifth of the nearly 4 million Americans infected with chronic hepatitis C virus have received anti-viral therapy in recent years should be a wake-up call that Congress needs to move urgently on bipartisan legislation to support new state-based detection, research, and surveillance efforts, the National Viral Hepatitis Roundtable (NVHR) said today.
Among the key findings:
WHO Investigates Cases Of H1N1 Drug Resistance In U.S., Britain (globalhealth.kff.org, 25 November 2009)
The WHO is looking into reports that patients with "severely suppressed immune systems" in Britain and the U.S. developed resistance Tamiflu, which is used to treat the symptoms of H1N1 (swine flu), a spokesman for the organization said Tuesday, Reuters reports.
"Britain's Health Protection Agency (HPA) said five cases have been confirmed in Wales of patients infected with H1N1 resistant to oseltamivir – the generic name of Roche and Gilead Sciences Inc's antiviral drug Tamiflu," the news service writes. Last week, the CDC reported four cases of Tamiflu-resistance in patients with H1N1 at a hospital in North Carolina.
According to WHO spokesman Thomas Abraham, both sets of patients experiencing Tamiflu resistance involved "people with severely compromised immune systems," Reuters writes.
Novartis Opens Vaccine Plant In U.S.; Production Of Flu Vaccine Years Away ((globalhealth.kff.org, 25 November 2009)
... Swiss drug maker Novartis opened a vaccine-manufacturing plant in North Carolina "designed to make influenza vaccines without relying on decades-old technology that employs millions of chicken eggs to grow viruses," the Wall Street Journal reports. "However, under the current timeline, the plant still needs to be licensed by the Food and Drug Administration and likely won't be producing flu shots for the U.S. market until at least 2013. But Novartis officials said the plant could be brought online in two years if licensed under emergency procedures," ...
Global Fund to give $47 mn for HIV awareness among gays (http://www.thaindian.com, 25 November 2009)
The Global Fund will give a $47-million grant to NGOs based in South Asia to launch a community-based programme for gays to reduce the spread of HIV among them.
The first-ever regional grant, which has been approved in principle, will focus on gays and transgenders in seven south Asian countries, said a statement issued here by the Global Fund to Fight AIDS, Tuberculosis and Malaria, which is an international financing institution that invests money to save lives against the three diseases.
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Women's, kids' health declining in Zimbabwe (http://www.news24.com, 24 November 2009)
The health of Zimbabwe's children and women, particularly in the poorer parts of the country has worsened sharply, with 100 children under five dying of mostly preventable diseases each day, the UN said on Tuesday.
A survey carried out jointly with the Zimbabwe Health Ministry since May also revealed the mortality rate of children under five had increased by 20% since 1990, the UN Children's Fund (Unicef) said in a statement.
Zimbabwe's health, education and other basic systems went into freefall during the latter years of autocratic President Robert Mugabe's 28-year monopolistic rule.
Swine Flu - African Countries Meet to Discuss Vaccine Deployment (http://allafrica.com, 23 November 2009)
Worried over the rapid spread of the influenza A, H1N1 virus in the African regions, representatives of African countries under the auspices World Health Organization (WHO) are meeting in Abuja to discuss the procurement and deployment of the vaccines.
Speaking during the opening ceremony, WHO Policy Adviser on Vaccine Security Peter Cerrasco said all African Countries will receive free vaccines to cover 10% of the population.
Nigeria with a population of about 140 million people will receive about 14 million doses of vaccine.
The WHO policy adviser on vaccine safety said the donation by WHO was small contribution to help countries access the vaccines, while looking for ways to assist African acquire plants to manufacture the vaccine.
Drugmakers rush back into market for vaccines (http://www.newsobserver.com, 20 November 2009)
... Vaccines are no longer a sleepy, low-profit niche in a booming drug industry. Today, they're starting to give ailing pharmaceutical makers a shot in the arm.
The lure of big profits, advances in technology and growing government support has been drawing in new companies, from nascent biotechs to Johnson & Johnson. That means recent remarkable strides in overcoming dreaded diseases and annoying afflictions likely will continue.
Vaccine safety: informing the misinformed (The Lancet Infectious Diseases, December 2009)
At the time of going to press, the first major vaccination campaigns to prevent pandemic H1N1 are getting underway. The vaccine might not have been ready in quite the volume hoped; nonetheless, for the production of vaccine in any substantial quantity in such a short time while still providing seasonal vaccine, those involved—the scientist, the pharmaceutical companies, and the chickens that laid the millions of eggs used—should be applauded.
Whereas most people are concerned about if and when they will be able to access the vaccine for themselves, their children, or their vulnerable loved ones, a small but vociferous minority seek to undermine the efforts of vaccine production and distribution by playing on fears over vaccine safety.
... Immunisation has saved millions of lives worldwide since the introduction of smallpox vaccine more than 200 years ago. But programmes are undermined by people choosing not to vaccinate, thus decreasing herd immunity, and reported outbreaks of vaccine-preventable infectious diseases, such as measles and pertussis, are becoming more common both in the USA and western Europe.
Safety of pandemic vaccines (www.who.int, 19 November 2009)
To date, WHO has received vaccination information from 16 of around 40 countries conducting national H1N1 pandemic vaccine campaigns. Based on information in these 16 countries, WHO estimates that around 80 million doses of pandemic vaccine have been distributed and around 65 million people have been vaccinated. National immunization campaigns began in Australia and the People’s Republic of China in late September.
Vaccination campaigns currently under way to protect populations from pandemic influenza are among the largest in the history of several countries, and numbers are growing daily. Given this scale of vaccine administration, at least some rare adverse reactions, not detectable during even large clinical trials, could occur, underscoring the need for rigorous monitoring of safety. Results to date are encouraging.
Pentavalent price drops: the GAVI effect (www.news-medical.net, 18 November 2009)
Following the increasing impact of the GAVI Alliance on the vaccine market, the price of one of the major combination vaccines, the pentavalent, is falling considerably, enabling GAVI’s partners to vaccinate millions of more children in the developing world.
News of the unprecedented progress was announced in Hanoi, Vietnam just before the GAVI Partners’ Forum, which unites some 400 participants from all over the world including ministers of health, donors, civil society and industry representatives, researchers and development experts.
“This is the GAVI effect at work: encouraging and pooling growing demand from countries, attracting new manufacturers and increasing competition to drive down prices,” said GAVI CEO Julian Lob-Levyt. “The price drop has come later than we had hoped and it needs to fall further. But this is a clear indication that our market-shaping efforts work.”
... GAVI’s business model is based on the expectation that rising demand for immunisation in developing countries induces more companies to produce vaccines, thus creating competition and driving prices down. Through the new data, success becomes evident. Whereas in 2001, there was only one company producing the pentavalent vaccine, now there are four. Two are Indian companies, whose products came on the market in 2008. Today, 50% of the vaccines funded by GAVI are from developing country manufacturers.
... “Our Alliance is not providing charity but rather securing a basic human right, which is the right to equal access to basic standards of health,” said the former UN High Commissioner for Human Rights, noting that this week the world is celebrating the 20th anniversary of the Convention on the Rights of the Child. “It is time to recognise that the availability of life-saving vaccines for children worldwide, regardless of where they live, is not a luxury but a fundamental right.”
Report calls for refocusing health spending in developing countries to save children's lives (www.news-medical.net, 17 November 2009)
"More than 24,000 infants die daily from preventable diseases in developing countries," and child deaths have fallen in countries where governments "have shown a high level of political leadership on child health," World Vision International said in a new report .
... Sub-Saharan Africa and South Asia are noted as the "epicenter of the child health emergency," the AP/San Francisco Chronicle writes. According to the report, half of all child deaths occur in five countries: the Democratic Republic of Congo, Ethiopia, India, Nigeria and Pakistan. Diarrhea, malaria and pneumonia are the leading causes of child deaths and are the cause of 45 percent of the deaths, ...
India to conduct human trials for malaria vaccine (Hindustan Times, 15 November 2009)
For the first time, human trials for the malaria vaccine and drug development programme will be conducted in India.
This was revealed by Dr Virander Singh Chauhan, Director, International Centre for Genetic Engineering and Biotechnology (ICGEB), New Delhi, during the 21st National Congress of Parasitology at Panjab University here on Saturday.
“Almost all human trials of malaria are being conducted in South Africa as the country is most affected by the disease in the world. The ICGEB is aiming to conduct the trials in India, where states like Orissa, Jharkhand, Chhattisgarh and Madhya Pradesh, besides coastal areas, are affected by malaria on a large scale,” he said.
Agreement for donation of pandemic H1N1 vaccine signed (www.who.int, 10 November 2009)
GlaxoSmithKline (GSK) is to donate 50 million doses of pandemic H1N1 vaccine to the World Health Organization (WHO) under an agreement signed at WHO headquarters in Geneva by the WHO Director-General, Dr Margaret Chan, and the Chief Executive Officer of GlaxoSmithKline, Mr Andrew Witty.
FRANCE: Top Designers Make Dolls to Fund Darfur Vaccinations (www.ipsnews.net, 9 November 2009)
From small beginnings six years ago, the "Frimousses de Créateurs" (Designers’ Dolls) project has grown to include about a hundred designers as well as prominent artists such as Damien Hirst and Jeff Koons, who are known for their provocative and controversial artwork.
Entertainers, too, have joined the cast, with French singer France Gall and outspoken actress Isabelle Adjani making dolls out of fabric and decorating them in their own fashion.
Last year, the doll project, coordinated by the United Nations Children’s Fund (UNICEF), financed polio vaccinations for more than 160,000 children and tuberculosis shots for 183,000 newborns in Darfur, a conflict-ridden region of Sudan.
... Despite the economic crisis, the amount gained could be even greater this year because of the higher number of participants and corporate sponsors - who cover the operating costs of the project. UNICEF says it expects to inoculate at least 260,000 infants in 2010 as well as 195,000 pregnant women who will receive anti-tetanus vaccines.
... The "Frimousse" project does not stop with designers, however. To help fund vaccinations in other countries besides Sudan, thousands of schoolchildren in France take part in a similar but separate venture. They make rag dolls which are then sold to adults for 20 euros each. This amount is enough for a full cycle of childhood vaccinations, says Valerie Metzger, a UNICEF projects coordinator who started the scheme in France, following a similar venture in Italy known as "Pigotta".
AMFm Subsidized Malaria Drugs To Be Delivered Soon (globalhealth.kff.org, 4 November 2009)
Subsidized artemisinin-based combination therapies (ACTs) under the Affordable Medicines Facility - malaria (AMFm) program will be available in select countries "in two week's time," SABC News reports. The announcement came Monday at the 5th Multilateral Initiative on Malaria (MIM) Pan-African Conference in Nairobi, Kenya.
SABC News writes: "According to latest research information, at least 97% of people in sub-Saharan Africa cannot afford the life saving artemisinin-based combination therapies. ACTwatch’s Desmond Chavess says as a result of lack of affordability, most children presenting malaria symptoms fail to get treatment or end up receiving ineffective drugs" (Kimani, 11/2).
The program, announced in April, is being launched in Benin, Cambodia, Ghana, Kenya, Madagascar, Niger, Nigeria, Rwanda, Senegal, Tanzania and Uganda, all of which applied to the program through the Global Fund to Fight AIDS, Tuberculosis and Malaria, New Times/allAfrica.com reports. AMFm will reduce the price of malaria drugs to 40 cents from $6 per dose, according to the article (Nambi, 11/4). The Clinton Foundation's Oliver Sabot said AMFm is able to lower the cost of malaria drugs by through negotiations and bigger payments directly to manufacturers, SABC News writes (11/2).
AFRICA: Drug Subsidy Key to Anti-Malaria Effort (www.ipsnews.net, 5 November 2009)
Nine hundred thousand people die worldwide every year as a result of malaria, 90 percent of them in Africa.
A survey done by Population Services International (PSI) and the London School of Hygiene and Tropical Medicine reveals that only three percent of children access effective malaria treatment within 24 hours.
Speaking to IPS at the Fifth Multilateral Initiative on Malaria Pan-African Malaria Conference, Dr Desmond Chavasse, vice president malaria control and child survival at PSI (a global health organisation with programmes targeting malaria, child survival, HIV and reproductive health), equates the lack of access to effective malaria drugs to being tantamount to a death sentence for African children who are under five.
"Artemisinin-based Combination Therapies (ACTs) are currently the most effective form of treatment against malaria and over 80 countries have adopted these as first-line treatment, as recommended by WHO. However, a survey done by PSI and London School of Hygiene and Tropical Medicine reveals that despite being effective, ACTs are not being sold in the market," Chavasse says.
The stumbling block is simple: the cost of ACT is far beyond the means of a typical family in Sub-Saharan Africa.
Anxiety Persists Over Safety of Rubella Vaccine (www.ipsnews.net, 4 November 2009)
Sudarma Senevirathana’s teenage daughter is at an age when she can already be given the ‘rubella’ vaccine, administered free of charge by government health officials at schools.
But Senevirathana refuses to subject her twelve-year-old daughter to the injection. "She can take it when she is nearer to getting married," says the mother from Kurunegala, about 100 kilometres east of the capital Colombo, "I don’t want to risk my daughter’s life."
The rubella vaccine is given to girls between the ages of 12 and 13, the period medical experts say the body’s immune system is at its strongest to fight any rubella infection. It is administered to prevent still births and other birth defects commonly associated with the rubella virus, which triggers a disease known by its name, or commonly called German measles.
India: State injects life with safe syringe (Express News Service, 4 November 2009)
“The Karnataka government is setting a precedent by becoming the only state in the country to use autodisable (AD) syringes in all the government hospitals for past three years, which helps in preventing the spread of HIV, hepatitis and other deadly diseases caused by reusable syringes,” said Marc Koska, CEO of UKbased SafePoint Trust.
... according to WHO, 1.3 million people die a year due to unsafe medical injections.
New Journal of Infectious Diseases special edition outlines compelling rotavirus burden data and critical need for access to vaccines in high-burden regions (www.path.org, 5 November 2009)
The Journal of Infectious Diseases has released a special edition, Global Rotavirus Surveillance: Preparing for the Introduction of Rotavirus Vaccines. This special edition provides a significant contribution to the understanding of rotavirus disease burden and the impact of rotavirus vaccines, which have the potential to save an estimated 228,000 lives annually.
... As the leading cause of severe diarrheal disease, rotavirus exacts a tremendous toll on health systems, particularly in the world’s poorest countries. In addition to compiling data on rotavirus incidence from around the globe, this collection of scientific articles also covers strain diversity, the need for continued disease surveillance, and vaccine cost-effectiveness.
... “As these articles demonstrate, the burden of rotavirus is felt worldwide,” said Marc-Alain Widdowson, epidemiologist at the U.S. Centers for Disease Control and Prevention and lead author of the introductory article in the special edition. “The global health community must work together with public and private sector partners to help every country use available interventions—including vaccines—to stop child diarrheal disease deaths.”
Experts advise WHO on pandemic vaccine policies and strategies (http://www.who.int, 30 October 2009)
The Strategic Advisory Group of Experts (SAGE) on Immunization, which advises WHO on policies and strategies for vaccines and immunization, devoted a session of its 27–29 October meeting to pandemic influenza vaccines. The experts reviewed the current epidemiological situation of the pandemic worldwide and considered issues and options from a public health perspective.
Items on the agenda included the status of vaccine availability, results from clinical trials on vaccine immunogenicity, and early results from safety monitoring in countries where administration of the H1N1 pandemic vaccine is currently under way.
... The experts noted that a variety of pandemic vaccines, including live attenuated and both adjuvanted and non-adjuvanted inactivated vaccines, have now been licensed for use by regulatory authorities. SAGE recommended the use of a single dose of vaccine in adults and adolescents, beginning at the age of 10 years, provided such use is consistent with indications from regulatory authorities.
Data on immunogenicity in children older than 6 months and younger than 10 years are limited and more studies are needed. Where national authorities have made children a priority for early vaccination, SAGE recommended that priority be given to the administration of one dose of vaccine to as many children as possible. SAGE further stressed the need for studies to determine dosage regimens effective in immunocompromised persons.
Promising Malaria Vaccine Being Tested Across Africa (VOA, 3 November 2009)
Researchers behind the world's leading malaria vaccine candidate announced a major clinical trial involving thousands of children in seven African countries is well underway and on schedule. Top experts are converging in Nairobi from around the globe this week to attend the largest malaria conference in four years.
The vaccine, known as RTS-S, is the first malaria vaccine to ever reach Phase III testing. RTS-S is designed primarily to fight malaria in Africa, where 91 percent of children killed by the virus are found.
The critical vaccine trial is expected to enroll up to 16,000 African children, 5,000 of which have already been recruited.
Spreading the testing across a variety of sub-Saharan nations was necessary in order to ensure a diversity of malaria breeding grounds were represented. In some areas malaria is a seasonal threat, whereas in others transmission can happen year-round.
Hammocks could be added to malaria control arsenal (18 October 2009)
Insecticide-treated hammocks could cut malaria rates in remaining pockets of high transmission in the forests of South-East Asia, researchers say.
Hammocks made from nylon, ropes and an insecticide-treated bednet were given to 7,000 people in Ninh Thuan province in central Vietnam. Researchers then noted new malaria cases in both the study group and a hammock-free control group. ...
New cases of malaria in Vietnam dropped by more than 90 per cent between 1991 and 2007 but the disease persists in remote forested areas in the central highlands and along the country's borders. Vietnamese forest workers often use hammocks, and spending time — particularly sleeping — in the forest is known to be a risk factor for malaria.
In the forested areas of South-East Asia, bednets alone cannot control malaria, as the local vector — Anopheles dirus — feeds and rests outdoors, and bites early in the evening. By contrast, the African Anopheles mosquito feeds and rests indoors, and bites at night, making bednets far more effective at reducing transmission.
Study indicates possibility of a vaccine to prevent Group B Streptococcus infection (www.news-medical.net, 31 October 2009)
Scientists supported by the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health, have completed a Phase II clinical study that indicates a vaccine to prevent Group B Streptococcus (GBS) infection is possible. GBS is the most common cause of sepsis and meningitis in newborns in the United States, according to the Centers for Disease Control and Prevention (CDC). It can also cause severe illness in pregnant women, the elderly and adults with chronic illnesses. Colonization of the genital or gastrointestinal tract is a critical risk factor for infections due to GBS.
Global health organizations observe World Pneumonia Day; urge governments to take steps to fight pneumonia (http://www.news-medical.net, 2 November 2009)
Nearly 100 leading global health organizations from around the world joined forces to recognize the first-annual World Pneumonia Day on November 2 and urge governments to take steps to fight pneumonia, the world’s leading killer of young children. The first steps in this fight are outlined in the Global Action Plan for the Prevention and Control of Pneumonia, released today by the World Health Organization (WHO) and UNICEF.
.... Pneumonia takes the lives of more children under 5 than measles, malaria, and AIDS combined. The disease takes the life of one child every 15 seconds, and accounts for 20% of all deaths of children under 5 worldwide. While pneumonia affects children and families everywhere, it has the most deadly impact in South Asia and sub-Saharan Africa, where 98% of pneumonia deaths occur. It can be prevented with simple interventions, and treated with low-cost, low-tech medication and care.
... Safe and effective vaccines exist to provide protection against the primary causes of pneumonia, Streptococcus pneumoniae (pneumococcal disease) and Haemophilus influenzae type b (Hib). However, use of Hib vaccine has only recently expanded to low-income countries and pneumococcal vaccine is not yet included in national immunization programs in the developing world, where children bear the highest risk for pneumonia and where most pneumonia-related child deaths occur.
As the result of collaborative efforts by WHO, UNICEF, the GAVI Alliance, academia, foundations, vaccine manufacturers, and donor and developing country governments, low-income countries can now access existing and future pneumococcal vaccines with a small self-financed contribution of as little as US $0.15 per dose. To date, 11 countries have received GAVI Alliance approval for support to introduce pneumococcal conjugate vaccine (PCV) and 12 additional countries have submitted applications.
New strategy to eliminate and eradicate malaria unveiled (http://www.news-medical.net, 4 November 2009)
Marking its tenth anniversary year, the PATH Malaria Vaccine Initiative (MVI) today unveiled a new strategy that sets the stage for an aggressive push targeting the long-term goal of eliminating and eradicating malaria. Malaria is one of the world's deadliest infectious diseases, killing nearly 900,000 people a year, most of them children in sub-Saharan Africa.
Released at the Fifth Multilateral Initiative on Malaria Pan-African Malaria Conference, the MVI strategy represents a multi-pronged approach to developing the next generation of malaria vaccines. The international community in 2006 set a long-term goal of having a malaria vaccine by 2025 that is at least 80 percent effective against clinical disease and lasts longer than four years.
"The malaria community has made impressive strides in reducing deaths in the last ten years, but malaria still incurs a crushing global burden," said Dr. Christian Loucq, Director of MVI. "History has shown us that a vaccine would add a powerful, cost-effective way to save lives and help eliminate this disease."
H1N1 Widespread in 46 States as Vaccines Lag (The New York Times, 24 oct. 2009)
President Obama has declared the swine flu outbreak a national emergency, allowing hospitals and local governments to speedily set up alternate sites for treatment and triage procedures if needed to handle any surge of patients ...
The declaration came as thousands of people lined up in cities across the country to receive vaccinations, and as federal officials acknowledged that their ambitious vaccination program has gotten off to a slow start. Only 16 million doses of the vaccine were available now, and about 30 million were expected by the end of the month. Some states have requested 10 times the amount they have been allotted.
.... Mr. Obama’s declaration was necessary to empower Kathleen Sebelius, the secretary of Health and Human Services, to issue waivers that allow hospitals in danger of being overwhelmed with swine flu patients to execute disaster operation plans that include transferring patients off-site to satellite facilities or other hospitals.
Ecuador to make cheap versions of patented drugs (www.forbes.com, 28. October 2009)
Foreign pharmaceutical companies accepted on Wednesday Ecuador's decision to bypass patents in order to produce less expensive generic versions of some patented drugs.
President Rafael Correa issued a decree Monday giving Ecuadorean officials the power to grant local laboratories "compulsory licenses" to bypass patents and produce generic versions of designer drugs.
A new vaccine adverse event reporting system website has been launched (IAC Express, 26 October 2009)
A new website for the Vaccine Adverse Event Reporting System (VAERS) has been launched. VAERS is a national program co-managed by CDC and FDA to monitor the safety of all vaccines licensed in the United States.
VAERS is a passive surveillance system that collects and analyzes important information from reported adverse events that occur after vaccination. The system relies on reports from healthcare providers, vaccine manufacturers, and the general public. You may report to VAERS electronically, by mail, or fax. You can also search the VAERS database, via the website, for information and summaries on particular adverse events reported for specific vaccines. Please note that VAERS cannot determine if an adverse event was caused by a vaccine, but can help determine if further investigations are needed.
Marc Koska: 1.3m reasons to re-invent the syringe (www.exchangemagazine.com, 23 October 2009)
Reuse of syringes, all too common in under-funded clinics, kills 1.3 million each year. Marc Koska clues us in to this devastating global problem with facts, photos and hidden-camera footage. He shares his solution: a low-cost syringe that can't be used twice.
... In 1984, Marc Koska read an article that predicted HIV would spread widely through unsafe injections. He writes, "Appalled at the prospect of such an avoidable catastrophe, I decided there and then to try and do something about it." The prediction, sadly, turned out to be true: syringe reuse now accounts for 1.3 million deaths -- more than malaria.
Developing countries swamped in healthcare rubbish (www.eht-forum.org, 16 October 2009)
Half the world’s population could be at risk from exposure to mounting volumes of improperly disposed medical waste, according to a review published this month in Tropical Medicine and International Health.
“The documented growth in and poor disposal of health care waste appears to represent a real threat to the health of at least 40… low and middle income nations,” write Michael Harhay, from the University of Pennsylvania, USA, and colleagues.
To better understand how many people could be affected by poor waste management practices in low- and middle-income countries, Harhay and colleagues reviewed the available literature. Looking at 82 reports from 37 countries, they found that medical workers are under-trained in waste disposal, not provided with sufficient information, and have no access to systems that segregate medical rubbish. There is also widespread confusion over who is responsible locally for the sorting and disposal of medical waste, a task that is under-funded, they add.
A black market of used medical products also exists in some countries. ...
Six of the world’s most populated countries — China, India, Brazil, Pakistan, Bangladesh and Nigeria — have problems with the management of healthcare waste, according to the report. The authors say this puts around 50% of the global population at risk from the environmental, occupational, and public health consequences of improper disposal.
Has routine immunisation in Africa become endangered? (The Lancet, November 2009)
The broad picture of immunisation in Africa is one of excellent progress and enthusiastic energy, with amazing advances having been made since the turn of the century. There has been a large drop in mortality due to measles, and about a third of countries now use a three dose regimen of diphtheria-tetanus-pertussis triple vaccine (DTP3), which provides coverage of at least 80% in all districts. However, a review of immunisation in Africa found that all is not well.
Despite many African countries reporting increased routine immunisation coverage between 2005 and 2007, the ambitious coverage goals of the Global Immunization Vision and Strategy remain elusive and many children continue to be unimmunised. These goals include that by 2010 or earlier countries will reach at least 90% national vaccination coverage and at least 80% coverage in every district or equivalent administrative unit. The goals also include the reduction of measles mortality—worldwide, mortality due to measles will have been reduced by 90% compared with that in 2000. The countries worst affected in this respect are still the so-called big four—Angola, Democratic Republic of Congo, Ethiopia, and Nigeria.
News outlets examine challenges with expanding global child immunization campaigns
Wednesday's release of the WHO, UNICEF and the World Bank joint report on childhood vaccines highlighted gains in recent global vaccination campaigns and also found that nearly 24 million infants worldwide don't get the recommended first-year vaccination.
"The Global Immunization Vision and Strategy (GIVS), co-sponsored by WHO and UNICEF, estimates that by vaccinating 90 percent of the world's children against 14 illnesses for which there are vaccines (diphtheria, pertussis, tetanus, measles, polio, tuberculosis, hepatitis B, Hib disease, rubella, meningococcal disease, pneumococcal disease, rotavirus, and, where applicable, Japanese encephalitis and yellow fever), … two million child deaths could be prevented ...
"[S]aving lives does not come cheaply," Scientific American writes, noting the increased per-child costs of immunizations," from "a few dollars on average" in the 1980s to today's cost of $18. "To meet the GIVS target, that figure would increase to $30, due to the sheer number of vaccines required and the complexity of newer formulas. Such per-child costs may not sound like much in today's expensive U.S. health care market, but for many developing countries, that is more than 10 percent of annual per capita income,"
Childhood vaccines at all-time high, but access not yet equitable (WHO, 21 October 2009)
Reversing a downward trend, immunization rates are now at their highest ever and vaccine development worldwide is booming, according to a new assessment released today by the World Health Organization (WHO), UNICEF and the World Bank.
The State of the world’s vaccines and immunization reports that more infants are being immunized today than ever before - a record 106 million in 2008 - according to new data. At the same time, its authors are calling on donor nations to address a funding gap that leaves millions of children still at risk, particularly in the poorest nations and communities, where preventable diseases take their deadliest toll.
Bill & Melinda Gates Foundation's initiative to transform health in developing countries (http://www.news-medical.net, 21 October 2009)
The Bill & Melinda Gates Foundation today announced 76 grants of US$100,000 each to pursue bold ideas for transforming health in developing countries. The grants support researchers across 16 countries, including nine in Europe and Africa with ideas as diverse as using the power of sunlight to kill malaria-causing mosquito larvae and developing a device that repels mosquitoes without insecticides.
"Some of the biggest stumbling blocks in global health are now being overcome with promising new vaccines and treatments," said Dr. Tachi Yamada, president of the Gates Foundation's Global Health Program. "Grand Challenges Explorations will continue to fill the pipeline with possibilities and hopefully produce a breakthrough idea that could save untold numbers of lives."
Swine flu vaccination under way (in the UK) (The Guardian, 21 October 2009)
Seriously ill hospital patients and the health staff caring for them will be the first of 14m people in the "priority group" to be given the jab.
From next week GPs will begin inviting people with health problems, damaged immune systems and pregnant women to come forward for immunisation.
Medical chiefs urged everyone in the priority group to have the vaccine.
The government has yet to decide whether the rest of population will be immunised, although enough doses have been ordered.
So far just over 100 people with swine flu have died in the UK out of the 500,000 who have been infected.
Possible harms of oseltamivir—a call for urgent action (The Lancet, 17 October 2009)
Oseltamivir is a successful drug: between July, 2004, and June, 2009, more than 11·5 million new prescriptions were issued in the USA, and nearly all influenza pandemic plans recommend antiviral drugs as a mainstay of containment on a population basis and treatment on an individual basis, with oseltamivir preferred because of ease of administration and storage. Because 75% of the world production of oseltamivir has been used in Japan, this is where to look for any serious harms the drug might cause.
Since 2005, the Japanese Ministry of Health, Labour, and Welfare has funded two prospective cohort studies, and subsequently advised against oseltamivir's use in children and adolescents aged 10—19 years. The first study was in 2846 children in the winter of 2005—06. This study found evidence of unusual behaviour in recipient children within the first day of infection.The second, larger (>10 000 children) cohort study done the following winter failed to find any positive association. However, the analysis was criticised. A detailed independent review of eight serious cases concluded that three sudden deaths during sleep and two near-deaths, as well as two deaths from accidents resulting from abnormal behaviour in older children and adolescents shortly after taking oseltamivir, were probably related to the central depressant action of oseltamivir.
... The FDA dataset includes 2275 initial adverse event reports from postmarketing surveillance generated worldwide from December, 1999, to July, 2009 (the date of granting our request). Breakdown by setting and even country is difficult, because most reports do not indicate these variables and the only date consistently recorded is the date the FDA received the report (which could be several months or even years after the event). The data do not allow standardisation by doses sold or by level of circulating influenza, which prevents estimates of reporting rates or seasonal trends. Despite these limitations, many (607/1781, 34%) serious harms were reported in people younger than 20 years. Abnormal behaviour, convulsion, delirium, and hallucinations were more common in the young, while other adverse effects (diarrhoea, headache, nausea, loss of consciousness, pyrexia, and vomiting) were not.
Malaria in Africa: The net gains of keeping mosquitoes at bay (The Telegraph, 5 October 2009)
Atong Deng put on her finest clothes today and walked for two hours to receive a household item that could save her life and the lives of her four children. Mosquito nets impregnated with insecticide are being distributed for free in the remote village of Riang Aker in the state of Northern Bahr el Gazal, Southern Sudan. It will be the first time Atong Deng has ever had a bed net.
... A 2006 survey by the Government of Southern Sudan found that just over half of all children under five suffered from fever, thought to be malaria, in the two weeks before the survey.
Young children are vulnerable because they have not yet developed enough immunity to fight the infection, as are pregnant women. If patients don't receive effective malaria drugs within 24 hours of the onset of symptoms, the disease can quickly progress and damage the kidneys, liver, lungs, and brain. Severe cases can rapidly cause coma and death.
Cheap drugs, such as chloroquine, are rarely effective across Africa because the malaria parasite has become resistant. There is an excellent life-saving drug called artemisinin-based combination therapy (ACT), ... but it is expensive and often in short supply.
... If Atong Deng's children sleep under an insecticidal net, they will cut their risk of contracting malaria in half. Their risk of dying from the disease will fall by around 20 per cent. The net works in two ways; serving as a mechanical barrier, it repels mosquitoes and prevents them from biting, and it will also kill them provided the mosquitoes are susceptible to the insecticide in the net's fibres.
... The newest type of mosquito nets last up to five years, and some experts consider these to be one of the few "magic bullets" in global health. The World Health Organization's (WHO) malaria programme has set an ambitious target. It wants everyone at risk of malaria in Africa to sleep under a long-lasting insecticidal net by the end of 2010, which they hope will cut deaths by one half.
... Another major threat to the WHO goal is that nets are not always used. Some people say they experience a sense of suffocation or discomfort under their net. Across East Africa, there is also a rich variety of cultural explanations for why nets go unused. In Uganda, malaria nets have been sewn together for use in fishing or turned into bridal veils. Some villages in Uganda and Kenya have been afraid to use white nets out of their belief that white is the colour of death. On the Kenyan coast, people mention "the talking nets" – some communities were convinced that their malaria nets were speaking to them. In pockets of Kenya, people believed nets were medicated with a drug that would make them infertile.
Deploying the Power of Music to Save Lives (http://www.malarianomore.org, June 2009)
World-famous singer Youssou Ndour has a voice that is recognized across the globe. Now he's using that voice to amplify the fight against malaria in his home country of Senegal with a new song "Xeex Sibbiru" ("Fight Malaria" in Wolof) and a multi-year partnership with Malaria No More, designed to get Africa singing a different tune—one of a country where no child dies of malaria. "Xeex Sibbiru" raises awareness about malaria prevention and treatment as Senegal prepares for a mass distribution of mosquito nets kicking off in late June.
... "Surround Sound: Senegal" strives to help communities and families embrace a new and enduring tradition of mosquito net usage and malaria treatment. The world has the tools to end malaria deaths and international support has skyrocketed in recent years. Youssou Ndour is showing how, by surrounding the country with a message that no child need die of malaria, Senegal can become the next success story in the fight against malaria.
WHO, UNICEF Publish Plan To Reduce Childhood Diarrhea Deaths (http://globalhealth.kff.org, 15 October 2009)
The WHO and UNICEF have released a seven-point treatment and prevention plan to reduce the number of children around the world who die from diarrhea, the BBC reports (10/14). BMJ News writes, "Every year 1.5 million children aged under 5 years die from diarrhoea, more than 80% of them in Africa and south Asia" (Zarocostas, 10/14). This amounts to more annual childhood deaths than from AIDS, malaria and measles combined, according to the BBC (10/14).
"According to the report, just 15 countries account for almost three-quarters of diarrhea deaths among children under five years of age — India, Nigeria, Congo, Afghanistan, Ethiopia, Pakistan, Bangladesh, China, Uganda, Kenya, Niger, Burkina Faso, Tanzania, Mali and Angola," writes Associated Press/GMA News (10/15). The Times of India reports that "88 percent of diarrhoeal deaths worldwide are attributable to unsafe water, inadequate sanitation and poor hygiene" (10/15).
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Panel Discusses Future Of USAID, QDDR (http://globalhealth.kff.org, 15 October 2009)
While the "long wait for an appointment of" a USAID administrator continues, the agency's future "was the main topic of interest" at a U.S. Global Leadership Coalition conference Wednesday in Washington, D.C., Foreign Policy's blog, "The Cable," reports. Deputy Secretary of State Jack Lew, Director of Policy Planning Anne-Marie Slaughter and acting USAID Administrator Alonzo Fulgham participated in a panel at the conference (Rogin, 10/14).
About 400 people "jammed" in to hear the panel "explain the Quadrennial Diplomacy and Development Review [QDDR] process," Politico's Laura Rozen reports. According to Politico, "The team also found themselves dealing with another rumor - that the QDDR process is cover for State to absorb USAID" (10/14).
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In 1918 Pandemic, Another Possible Killer: Aspirin (12 Oct. 2009, The New York Times)
The 1918 flu epidemic was probably the deadliest plague in human history, killing more than 50 million people worldwide. Now it appears that a small number of the deaths may have been caused not by the virus, but by a drug used to treat it: aspirin.
Dr. Karen M. Starko, author of one of the earliest papers connecting aspirin use with Reye’s syndrome, has published an article suggesting that overdoses of the relatively new “wonder drug” could have been deadly.
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Swine flu fears grow as NHS staff shun vaccine (The Guardian, 11 October 2009)
The Department of Health has ordered NHS bosses across England to ensure that frontline staff get immunised against swine flu amid growing signs that many doctors and nurses intend to shun the vaccine.
Chief executives and boards who run hospitals, primary care trusts and strategic health authorities have been told to urgently maximise the number of workers having the jab. Leading DH figures including Sir Liam Donaldson, the chief medical officer, have written to them six times in the last five weeks stressing the need for action before the second wave of the pandemic causes major problems.
... A poll by Nursing Times magazine last week showed that the proportion of nurses who do not intend to get vaccinated has risen from 31% in August to 47%, while those who definitely will has fallen from 35% to 23%.
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Where to Get Flu Shot Is Big Worry of Season (The New York Times, 11 October 2009)
As a small fraction — some 2.4 million doses — of the nasal spray version of the new swine flu vaccine began arriving last week at local health departments, plans for limited distribution were being formulated on the fly or dusted off from earlier in the decade, when fears of an avian flu pandemic sparked a rush of emergency preparedness.
... In large part, chaos seems to have been averted, at least initially. Many people seem to be more eager to receive the injectable form of the vaccine, which is not yet available. And the nasal spray, called FluMist, has some limits on who may use it. It is not recommended for infants, the elderly or pregnant women.
... The Centers for Disease Control and Prevention has embarked on an extensive immunization drive, and, by later in the flu season, there will be enough vaccine for the general population. But, to date, the 50 states have received only part of the available stock based on their populations. At the moment, demand is far outstripping supply — and patience.
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Allergic reaction to vaccines should be investigated (Los Angeles Times, 9 October 2009)
Some people have an allergic reaction after having an immunization, an experience that often -- and quite naturally -- leads to an avoidance of any future immunizations. But new guidelines published this week state that any allergic reaction to a shot should be investigated to understand the cause, rather than just giving up on vaccinations.
About 235 million doses of vaccines are given each year in the United States, and about 235 cases of anaphylaxis, a serious medical reaction, occur. Milder reactions to vaccines, such as redness and soreness at the injection site and fever are common and should not deter people from getting future immunizations ...
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Suspected Ebola kills 23 in Sudan (www.newvision.co.ug, 7 October 2009)
A haemorrhagic disease suspected to be Ebola has killed at least 23 people and infected dozens more in Southern Sudan, the spokesman of the Southern Sudanese army (SPLA) said yesterday.
Most of the dead are SPLA soldiers. Army spokesman Kuol Diem Kuol said blood samples of soldiers had been sent to laboratories for testing but doctors suspected it was Ebola.
“So far, from the SPLA, there are 20 killed and three wives (of soldiers) also died,” Kuol told Reuters.
“There is a huge number of the population affected that we don’t have the (exact) number of.”
Kuol said symptoms included vomiting blood and bleeding from the ears and nose, adding it was widespread in the Western Bahr al-Ghazal state.
A UN official in the south said they had attempted an assessment but needed more information from the local government to be able to assess the situation.
Health officials say there is still no known cure for the disease, which is spread through bodily fluids, including blood.
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Google Flu Trends includes 14 European countries (Eurosurveillance, 8 Oct. 2009)
Google Flu Trends, a tool that estimates the level of influenza activity in near real-time using aggregated search queries, has been released for 14 countries in Europe on 8 October 2009 by Google.org, the philanthropic arm of Google [1]. In total Google Flu Trends covers information for 20 countries worldwide and it is available in 37 languages. It aims to complement traditional influenza surveillance systems used by the public health community such as the European Centre for Disease Prevention and Control’s (ECDC) European Influenza Surveillance Network (EISN).
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Measles outbreak in Styria, Austria, March-May 2009 (Eurosurveillance, 8 October 2009)
In the last week of March 2009, five measles cases among students of an anthroposophic school were reported to the public health authorities in the Austrian province of Styria where only five cases had been reported in the whole of 2008. A descriptive epidemiological investigation of the measles outbreak was performed. Between 2 March and 10 May 2009, 37 cases of measles were identified in Styria: 33 confirmed outbreak cases and four probable outbreak cases. The measles outbreak spread from the general population (12 cases) to an anthroposophic community (25 cases). Cases outside of the anthroposophic community were mostly over 10 years of age (10/12). Thirty-five cases were unvaccinated, and two of the 37 had received one dose of measles, mumps, rubella vaccine. Following a measles outbreak in Salzburg in 2008 with 394 cases, this outbreak reemphasises the continued need for additional vaccination campaigns in population groups over the age of 10 years.
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The World Health Summit: intentions and expectations (The Lancet, 2 October 2009)
As Angela Merkel emerges victorious from the German election and is busy forming a new coalition government, preparations for the World Health Summit, to be held in Berlin on Oct 14—18, are in their final stages. The summit is under the patronage of Merkel and the French President Nicolas Sarkozy and is intended as a global forum to discuss future challenges in health and health care. The organisers want it to go further. Their aim is to present a document with key messages from workshops, recommendations, and a call to action, which will be published after the October meeting.
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Hepatitis C emerges as Egypt’s top health crisis (The National, 2 Oct. 2009)
According to the ministry of health’s last comprehensive study in 1996, some 15 to 20 per cent of Egyptians tested positive for hepatitis C antibodies. The study linked the epidemic directly to Egypt’s otherwise laudable bilharzia treatment campaign, which ended only a few years before the hepatitis C virus was discovered in 1989.
About one-third of Egyptians aged 50 and older – those who were more likely to have been injected with the tartar emetic shot during the therapy’s heyday – tested positive for hepatitis C.
“I can tell you that those who have [hepatitis] C now, a very high percentage of them are the kids who were given this tartar emetic in the late [19]60s and ’70s and probably until the early ’80s. Because they were all infected with [hepatitis] C,” said Dr Shahin.
... To fight the scourge, the ministry of health convened the National Committee for the Control of Viral Hepatitis in 2006, charging its seven-member board with evaluating the problem and halting the epidemic’s spread.
Before that, Egypt’s broken public health system, stymied by the epidemic’s daunting size, allowed the problem to metastasise for more than a decade. Only about half of Egyptians have health insurance, and the poorest people in rural areas were unable to pay for the costly Interferon protein therapy.
... The committee launched an awareness-raising campaign in 2007, which focused on universities in the hope that educated youth would spread the word about hepatitis C in their home villages. After targeting about 150,000 students in 11 universities, 80 per cent of rural Egyptians now say they have heard about hepatitis C, according to the committee’s surveys.
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ECDC in collaboration with the VAESCO consortium to develop a complementary tool for vaccine safety monitoring in Europe (2 October 2009)
A consortium of researchers aiming for development of vaccine safety monitoring through linkage of large computerised clinical databases and immunisation registries (VAESCO-project) has recently signed a contract with the European Centre for Disease Prevention and Control (ECDC). This new tool will complement the routine monitoring of adverse events through National Regulatory Agencies reporting to the large European Medicines Agency (EMEA) EudraVigilance database.
The consortium with participants from eight European Union Member States will utilise common software (the Jerboa Vaccine module) to look for possible events in each participating database.
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Ancient Chinese anti-fever cure becomes panacea for malaria. An interview with Zhou Yiqing (WHO Bulletin, October 2009)
Q: What made you and your team think of using artemisinin to treat malaria?
A: Project 523 included two groups engaged in antimalarial drug development: one to devise chemical medicines, another to examine traditional Chinese medicines. The latter group included researchers as well as traditional Chinese medicine doctors, who, as part of Chairman Mao’s barefoot scheme, scoured the nation to collect folk remedies. By the time Project 523 had got under way, the Cultural Revolution had started and the research provided shelter for scientists facing political persecution. From 1970, the focus of the project shifted to traditional Chinese medicine because producing antimalarials became less of a priority after China produced chemical combination antimalarials and provided them to North Viet Nam. Experts screened a list of herbs and folk remedies, a few of which were found to have a curative effect against malaria. In the end, the Artemisia annua plant was chosen for further research. In the early 1970s, a Project 523 team first isolated artemisinin from the plant. Clinical trials confirmed its antimalarial effects. Between 1976 and 1978, the molecular structure of artemisinin was identified and more artemisinin derivatives were developed.
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Can private equity deliver on equity? (WHO Bulletin, October 2009)
In June 2009, a new Health in Africa Fund was launched by the International Finance Corporation (IFC), the branch of The World Bank group mandated with supporting and expanding the private for-profit sector. This Fund will be managed by Aureos Capital, a private equity fund manager focusing on emerging markets. Through investment in small- and medium-sized private providers, the Fund will attempt to“[help] low-income Africans gain access to affordable, high-quality health services.” The Fund, currently supported by the IFC, the African Development Bank, the Bill & Melinda Gates Foundation and the German development finance institution DEG, is a key component of the IFC’s US$ 1billion Africa health strategy and it targets initial commitments of US$ 100–120 million.
The Fund’s establishment was inspired by the IFC’s health strategy, which entails harnessing private capital and private sector providers to improve quality and coverage of health services.
... The new Fund is unlikely to improve access or quality of care unless it is complemented by initiatives to strengthen the public sector capacity to regulate, train, oversee and sub-contract (where appropriate) private providers, interventions that, according to a recent systematic review,8 have the potential to improve the impact of private sector provision in poor communities. In addition the Fund would also require the development of risk-pooling and subsidy mechanisms, so that privately-provided services can be offered free at the point of delivery. If it fails to do so, there is a concrete risk that the Fund, contrary to its objectives, will contribute to the entrenchment of two-tier health-care systems and to a further concentration of human and financial resources in services catering to affluent urban dwellers.
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Mass vaccination of health workers in Peru (WHO Bulletin, October 2009)
“Peru has intermediate endemicity of hepatitis B, with areas of both high and low endemicity that have left the country with high rates of liver cirrhosis and liver cancer,” says Dr Manuel Peña, the Pan American Health Organization (PAHO) representative in Peru. “The annual mortality rate from liver cirrhosis is 10.45 per 100 000 population and mortality rate from liver cancer is 0.98 per 100 000 population. In endemic areas, about 7% of deaths from liver disease are related to hepatitis B infection, including liver cancer, cirrhosis and fulminant hepatitis.”
... The campaign kicked off in 2008, making Peru the first country in the world to start working towards the goal of full hepatitis B vaccine coverage for health-care workers under the Global Plan of Action on Workers' Health, which was set at the 2007 World Health Assembly. The World Health Organization (WHO) estimates that occupational exposure to hepatitis B – mainly from needlestick injuries – accounts for some 37% of the disease burden among health-care workers worldwide and that 95% of this fraction of the burden can be prevented with immunization.
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Catching outbreaks wherever they occur (WHO Bulletin, October 2009)
.. Communicable diseases have no respect for boundaries. As pandemic influenza A (H1N1) swept the globe this year, WHO’s Member States could take comfort in the legal requirements of the International Health Regulations (IHR), which were updated in 2005 to require countries to report certain disease outbreaks to the World Health Organization (WHO).
But not all parts of the world are or may be parties to the IHR, and where there is a gap in surveillance there is always the possibility that an outbreak can slip through the net. For example, the West Bank and the Gaza Strip – though not party to the IHR – are covered by the Middle East Consortium on Infectious Disease Surveillance (MECIDS). This coordination mechanism of Israeli, Jordanian and Palestinian health officials shares information and takes coordinated action to help detect and respond to infectious disease outbreaks.
It is one example of how regional disease surveillance can be achieved in difficult political environments ...
... WHO’s mediating role between Israel and Palestinian health authorities has become even more critical due to the tensions between the two. “WHO brings supplies, notifies about disease and advocates for the need of the health authorities in Gaza,” he added.Despite the political divide, there have been extraordinary cases of cooperation between Israel and the health authorities in the Gaza Strip with WHO assistance. With the outbreak of avian flu in the Gaza Strip three years ago, WHO initiated contact with the Israeli authorities to coordinate intervention activities and the provision of equipment and anti-viral drugs for the coastal strip. “We managed to hold a meeting between senior professionals from Gaza and Israel to talk about surveillance. They understand that communicable diseases don’t respect borders and they work in accordance with the situation,” ...
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Pandemic influenza: the new wave (The Lancet, October 2009)
... The vaccination programme might come into its own if the peak of the pandemic could be delayed by a month or two. But is this possible? Children seem to act as mixing vessels for the dissemination of influenza. So school closures have been suggested as a way of buying time, as was discussed by Simon Chauchemez and colleagues in the August issue of the journal. However, closing of schools is socially disruptive because carers are obliged to take time off work, it interrrupts children's education, and arguments for the effectiveness of the intervention are based on poor quality evidence.
Perhaps the way forward is to make children the highest priority group for receipt of the first batches of vaccine. However, the WHO Strategic Advisory Group of Experts on Immunization (SAGE) have defined the priority groups for receipt of vaccine in the following order: health-care workers, pregnant women, individuals aged more than 6 months with chronic medical conditions, healthy young adults aged 15—49 years, healthy children, healthy adults aged 490—65 years old, and healthy adults aged more than 65 years. With most governments likely to follow this advice, school children are a long way back in the queue.
So has there been scaremongering about the possible effects of the influenza pandemic? And is the effort devoted to producing a vaccine misplaced? The work that has gone into pandemic planning over the past few years has clearly had an effect in minimising the severity of the current pandemic. Therefore, there are good grounds for congratulating global and national health authorities for not allowing worst-case scenarios to come to pass. Even if vaccine is available too late to alter the number of people infected, it might still reduce the number of admissions to hospital and deaths.
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Pneumococcal campaign foreshadows wider initiatives (The Lancet, October 2009)
In late August, the Gambian Ministry of Health launched the first national pneumococcal vaccination programme in west Africa, following a similar immunisation initiative in Rwanda launched in April. The two countries are sharing 3·1 million doses of seven-valent pneumococcal conjugate vaccine (PCV7) donated by Wyeth Pharmaceuticals and made available through an agreement with the GAVI alliance. According to WHO, one in six deaths in children under 5 years of age in The Gambia is caused by pneumonia.
Problems with PCV7 storage and disposal of the glass syringes have prevented additional countries from starting use of this vaccine, says Tido von Schoen-Angerer, director of the Médecins Sans Frontières Campaign for Access to Essential Medicines. Julian Lob-Levyt (GAVI Alliance) states that “while Prevenar, PCV7, is widely used in Europe and the United States, it is not optimal for developing countries. In developing countries other serotypes are common, so a vaccine providing broader coverage, including these additional serotypes is needed.”
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Health systems in Africa: learning from South Africa (The Lancet, October 2009)
The Series on South Africa in The Lancet is a crucial analysis of how the country's health-care system has performed since the end of apartheid. The Series examines: the health-care system, maternal and child health, HIV infection and tuberculosis, the rising tide of non-communicable disease, violence and injuries, and the Millennium Development Goals (MDGs) as they apply to the country. Despite increased investments and improved social policies, South Africa has not adequately addressed health disparities.
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More than four million HIV-positive people now receiving life-saving treatment (www.who.int, 30 Sept. 2009)
More than 4 million people in low- and middle-income countries were receiving antiretroviral therapy (ART) at the close of 2008. This represents a 36% increase in one year and a ten-fold increase over five years, according to a new report released today by the World Health Organization (WHO), the United Nations Children's Fund (UNICEF) and the Joint United Nations Programme on HIV/AIDS (UNAIDS).
Towards Universal Access: Scaling Up Priority HIV/AIDS Interventions in the Health Sector highlights other gains, including expanded HIV testing and counselling and improved access to services to prevent HIV transmission from mother to child.
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International Medica Foundation sponsors rotavirus vaccine trial in Ghana (http://www.intl-medica.org, 29 Sept. 2009)
... To combat rotavirus, the International Medica Foundation is sponsoring a Phase II clinical trial of its oral rotavirus vaccine, RotaShield®. The trial is being conducted in more than 1,000 infants in Ghana, Africa, in association with the Noguchi Memorial Institute for Medical Research.
... “Our approach will not only cost less, but our strategy is to make this an economically sustainable vaccine by ultimately providing the manufacturing know-how and assistance to developing countries with the infrastructure to produce vaccines. Even with discounting or subsidies by healthcare-related organizations, I believe that affordability of the two existing rotavirus vaccines is not economically sustainable long-term in developing countries.”
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Schoolgirl dies after cervical cancer vaccination (The Guardian, 29 Sept. 2009)
An urgent investigation has been launched after a 14-year-old girl died shortly after receiving a cervical cancer vaccination at her school.
Natalie Morton was a pupil at the Blue Coat Church of England School in Coventry, where she was given the human papilloma virus (HPV) jab yesterday. She was taken to Coventry University hospital, where she died at lunchtime.
A letter to parents posted on the school's website by the headteacher, Dr Julie Roberts, said a girl had suffered a "rare but extreme reaction" after being given the vaccine. The precise cause of her death remains unknown.
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Vaccines 2009: World Market Analysis, Key Players, and Critical Trends in a Fast-Changing Industry (Report Linker, May 2009)
The global market for human vaccines has experienced strong growth through 2008 and this is expected to continue through the forecast period. Growth will be fueled by new product introductions and rising usage in all regions.
This report, Vaccines 2009: Key Players, and Critical Trends in a Fast-Changing Industry, examines the market for vaccines used in humans to previous various types of disease. Sales estimates for each market segment represent global revenues and are expressed in current dollars. Estimates are provided for the historic 2008 period and forecasts are provided through 2013.
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Investigational Vaccine Shows Modest Potential For Protecting Against HIV Infection (http://globalhealth.kff.org/ 24 Sept. 2009)
For the first time, scientists say an investigational vaccine has modest potential for protecting people against HIV infection, the Associated Press reports. “The vaccine — a combination of two previously unsuccessful vaccines — cut the risk of becoming infected with HIV by ... 31 percent in the world's largest [HIV] vaccine trial of more than 16,000 volunteers in Thailand, researchers announced Thursday in Bangkok. ...
... BBC reports, “'This result is tantalisingly encouraging. The numbers are small and the difference may have been due to chance, but this finding is the first positive news in the AIDS vaccine field for a decade,' said Dr. Richard Horton, editor of the Lancet medical journal. 'We should be cautious, but hopeful. The discovery needs urgent replication and investigation’.” BERMANA.com reports that the study "will form an important foundation for further HIV vaccine development in Thailand in the future," Paijit Warachit, deputy health permanent secretary in Thailand.
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Merck, Qiagen Pledge Cervical Cancer Tools At CGI (http://globalhealth.kff.org/ 24 Sept. 2009)
Drugmaker Merck & Co. announced on Wednesday at the Clinton Global Initiative's (CGI) annual meeting in New York that it will "donate more than $500 million of its Gardasil cervical cancer vaccine" with the goal of improving women's health in developing countries, Bloomberg reports. The vaccine works by preventing strains of the human papillomavirus (HPV) that cause 70 percent of cervical cancer cases. The Netherlands-based company Qiagen NV said it "will donate tests to screen patients to determine if they have certain strains" of HPV, according to the news service.
Reuters/Forbes reports that "Merck will provide up to 5 million free doses of Gardasil and Qiagen intends to add to its existing 1 million test donation program by providing HPV DNA tests to screen an additional 500,000 women. The companies said they plan to seek other partners to set up public sector cervical cancer programs, provide treatment, and support improvements in laboratory and vaccine delivery".
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WHO Asia-Pacific Countries Pledge To Use Artemisinin With Drugs By 2015 To Prevent Drug-Resistance Other (http://globalhealth.kff.org/ 24 Sept. 2009)
On Wednesday, nine of the 10 countries in the WHO's Asia-Pacific region "that suffer most" from malaria pledged to phase out the use of artemisinin-only to treat malaria and use it in combination with other drugs by 2015, Reuters reports.
At the annual general meeting of the Regional Committee for the Western Pacific in Hong Kong, Shin Young-soo, WHO regional director for the Western Pacific, warned that a strain of malaria, present on the Cambodian-Thai border, is becoming increasingly resistant to artemisinin and could evolve into a significant global health threat if countries don't prevent it from spreading to other regions.
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Pandemic influenza vaccines: current status (http://www.who.int, 24 Sept. 2009)
Regulatory authorities have licensed pandemic vaccines in Australia, China, Hungary and the United States of America, soon to be followed by Japan and several countries in Europe. ...
... Last week, donations of pandemic vaccines for use in developing countries were announced by the United States of America, in concert with Australia, Brazil, France, Italy, New Zealand, Norway, Switzerland and the United Kingdom. Similar support from additional countries is anticipated and warmly welcomed.
WHO will be coordinating the distribution of these donated vaccines. Earlier this year, WHO conducted surveys with its regional and country offices to identify countries that will not have pandemic vaccines unless supplies are donated.
... WHO advises all countries administering pandemic vaccines to conduct intensive monitoring for safety and to report adverse events.
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Mist version of swine flu vaccine to be ready soon (The Los Angeles Times, 19 Sept. 2009)
At least 3.4 million doses of vaccine against the pandemic H1N1 influenza virus will be available at the beginning of October, and about 20 million doses per week should become available soon after that, federal officials said Friday.
The first vaccine available will be MedImmune's FluMist intranasal vaccine, but injectable vaccines should be distributed a week or two later, Dr. Jay Butler, chief of the Centers for Disease Control and Prevention's 2009 H1N1 vaccine task force, said at a morning news conference. The intranasal vaccine has not been approved for children younger than 2, adults older than 49 or pregnant women, so it may go primarily to healthcare providers.
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Benefit and Doubt in Vaccine Additive (The New York Times, 21 Sept. 2009)
Are Americans obligated to use an unproven vaccine to help protect people in other countries from the flu pandemic?
That is the crux of a debate over adjuvants — a class of substances that somewhat mysteriously increase the potency of vaccines. Early studies suggest that adjuvants (pronounced AD-joo-vants) could allow four times as many people to be immunized against the H1N1 pandemic influenza with a given amount of vaccine. So with the world facing possibly severe shortages of vaccine, the World Health Organization and some health experts have been calling for the use of adjuvants to stretch the vaccine supply.
... That is the crux of a debate over adjuvants — a class of substances that somewhat mysteriously increase the potency of vaccines. Early studies suggest that adjuvants (pronounced AD-joo-vants) could allow four times as many people to be immunized against the H1N1 pandemic influenza with a given amount of vaccine. So with the world facing possibly severe shortages of vaccine, the World Health Organization and some health experts have been calling for the use of adjuvants to stretch the vaccine supply.
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Merck, Wellcome Trust To Launch Vaccine Center In India To Produce Vaccines For Developing Countries (http://globalhealth.kff.org, 17 Sept. 2009)
Pharmaceutical company Merck and the Wellcome Trust have joined together to create a non-profit, £90-million (about $150 million) research center in India to facilitate the development of new vaccines, "including [those for] neglected diseases for which inadequate or no vaccines exist," Nature News reports. "The move marks the first time that a major medical-research charity and a pharmaceutical company have directly partnered to create vaccines aimed at low-income countries," according to the journal (Butler, 9/16).
... Reuters adds that the center "will focus on fields relevant to low-income countries, such as the production of heat-stable vaccines that do not require refrigeration and the development of a vaccine against Group A streptococci," (Hirschler, 9/17) which causes more than 500,000 deaths per year worldwide.
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Asian Countries Race to Produce Vaccine for H1N1 Virus (http://www.ipsnews.net, 10 Sept. 2009)
India and Thailand are among the countries working on such vaccine doses. The demand for immunisation measures comes at a time when public health authorities are warning that Asia, like other developing regions, is in dire need of vaccines to respond to the rapid spread of the Type A (H1N1) influenza pandemic.
"All three countries have received the seed virus for vaccine production," Dr Thapa said during a telephone interview from Kathmandu, Nepal’s capital, where the region’s public health experts are meeting this week to chart a response ahead of a possible winter surge in (H1N1) flu cases. "We expect this new vaccine to be ready in the first quarter of 2010. That is an optimistic scenario."
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Five candidates compete for regional director of WHO EURO (The Lancet, 12 September 2009)
WHO's European region will elect a new leader on Sept 15. Five people, including three internal candidates, have applied for the post. Clare Kapp and Udani Samarasekera review their credentials.
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The deadly toll of S pneumoniae and H influenzae type b (The Lancet, 12 September 2009)
... Katherine O'Brien, James Watt, and their colleagues reveal for the first time that Streptococcus pneumoniae (pneumococcus) and Haemophilus influenzae type b (Hib)—the pathogens responsible for most child deaths from bacterial pneumonia and meningitis—are directly responsible for just as many child deaths as HIV⁄AIDS, malaria, and tuberculosis combined. This finding is shocking because vaccines against both pathogens are readily available and have been consistently safe and effective in trials in developing countries.
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FDA approves sBLA for Influenza A (H1N1) 2009 Monovalent Vaccine (Pharmaceutical News, 16 September 2009)
Sanofi Pasteur, the vaccines division of the sanofi–aventis Group (EURONEXT: SAN and NYSE: SNY), announced today that the U.S. Food and Drug Administration (FDA) has approved the company's supplemental biologics license application (sBLA) for licensure of its Influenza A (H1N1) 2009 Monovalent Vaccine.
The U.S. licensed Influenza A (H1N1) 2009 Monovalent Vaccine is an inactivated influenza virus vaccine indicated for active immunization of persons 6 months of age and older against influenza disease caused by pandemic (H1N1) 2009 virus. Sanofi Pasteur provides the only influenza vaccine licensed in the U.S. for populations as young as 6 months of age and older.
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Poor infrastructure hits Nepal cholera fight (Financial Times, 14 September 2009)
... Nepal's cholera and diarrhoea epidemics, largely unnoticed by the outside world, have quietly killed more than 280 poor villagers in hamlets mostly reachable only on foot or mule since the outbreak began three months ago. Medical teams hesitate to go to remote villages as there is a lack of security, weak infrastructure and shortages of food for residents, let alone for visitors.
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Afghanistan: Taliban gives nod to polio immunization in south (IRIN, 16 September 2009)
In an unprecedented move Taliban insurgents in Afghanistan have endorsed a three–day polio immunization drive in areas under their influence in Afghanistan, according to aid agencies.
The insurgents issued a “letter of support” through the International Committee of the Red Cross (ICRC) before the immunization campaign started on 13 September, ...
... Over one million under–five children in southern, southeastern, western and eastern parts of the country are being targeted in the current immunization drive, which will involve over 15,000 vaccinators and health workers, according to UNICEF.
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10,000 fewer children dying daily (IRINs, 11 September 2009)
DAKAR, 11 September 2009 (IRIN) – The number of children worldwide dying before age five dropped 28 percent between 1990 and 2008, according to the UN Children's Fund (UNICEF), or 10,000 fewer children are dying each day. UNICEF says while the trend is encouraging improvement is coming too slowly.
... The biggest child killers globally are malaria, pneumonia and diarrhoea, according to UNICEF. Malaria has proven to be relatively easier to prevent, while pneumonia and diarrhea – prevention of which requires reforms to health care systems, improved water and sanitation infrastructure and behavioural changes – have proven harder to tackle, ...
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Vaccination Drive Planned As Measles Cases Soar in Namibia (IRIN, 11 September 2009)
WITH the number of confirmed measles cases almost tripling from last week's 13, the Ohangwena Region is planning to carry out a measles vaccination campaign next week.
The vaccination campaign, which will target children between the ages of six months and five years, ...
The region has confirmed 35 cases from villages scattered around the Engela District. The figure includes 19 Namibians and 15 Angolans. Nationally, 38 cases have been laboratory confirmed.
The increasing numbers of confirmed Namibian cases in the Engela District indicates that the measles virus is spreading among the Namibian population.
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A shot in the arm: analysing vaccine delivery system (www.livemint.com, 9 September 2009)
The public health sector has made massive investments in recent years to improve vaccination rates in the 70 poorest countries in the world. Galvanized by the Bill and Melinda Gates Foundation, developed countries now provide free vaccines to these countries for all the basic infectious diseases through the Global Alliance for Vaccines and Immunization. In addition, organizations such as the World Health Organization, United Nations Children's Fund, CARE, Save the Children and national foreign aid agencies have worked with health ministries to design, resource and implement more effective vaccine delivery programmes.
While great progress has been made in raising vaccination levels in many countries, these interventions have been unsuccessful in about a dozen countries. In countries such as India, the Democratic Republic of Congo, Nigeria, Ethiopia and Indonesia, vaccination rates often run below 50% in certain regions, compared with the 80% or more needed to achieve a low risk of the disease spreading.
To help address this problem, we designed a research project which uses marketing techniques to diagnose the systemic barriers to effective vaccine delivery in the problematic countries. Our ultimate goal is to propose alternative interventions that will significantly boost routine vaccination rates in countries that are not on track to achieve immunization goals.
... We are finding that the design of the delivery system, seemingly efficient from a supply chain viewpoint, severely impedes vaccination. It is not reasonable to expect mothers living at a subsistence level to organize their lives around a single day a month, to walk 10–20 km to get their child vaccinated.
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Polio Vaccination Resumes In Pakistan's Swat Valley (www.globalhealth.kff.org, 9 September 2009)
“Authorities in Pakistan's Swat Valley have resumed vaccinating children for polio, an act once banned by Taliban militants, now beaten back by an army offensive,” the Associated Press reports. The three–day campaign, which started on Monday, is targeting about 215,000 children, said government official Khurshid Khan.
“The Islamist militants, who began spreading their reign in the valley in 2007, had declared that vaccinating against the potentially crippling disease was un–Islamic because it was a foreign–funded campaign. Swat Taliban leader Maulana Fazullah said the vaccinations were a Western conspiracy to make Muslim children infertile,” the AP writes.
... Since the campaign resumed, six polio cases have been reported in the Swat valley, according to a health official, the Daily Times reports. He said the number of cases of the disease had risen in the district because of the lapse in vaccinations (9⁄9).
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E.V-Trax Employee Vaccination Tracking System helps eliminate manual data entry (www.news-medical.net, 10 September 2009)
General Data Company, Inc., which specializes in barcode–based error–proofing and tracking system solutions, is offering a new mobile application to help healthcare organizations administer employee vaccinations and track the immunization status of their personnel for H1N1, influenza, and other vaccinations. This new system eliminates paper forms and electronically tracks all details of immunizations that are administered to healthcare personnel. Organizations can now have accurate and updated information on their employee immunization programs to help prevent further infection among patients and staff, and streamline existing patient care within their facilities.
The introduction of the E.V–Trax Employee Vaccination Tracking System (http://www.general-data.com/healthcare/solutions/evtrax.aspx) coincides with the Department of Health and Human Services’ (HHS) efforts to improve vaccination rates amongst healthcare personnel
.... The E.V–Trax system was initially developed for a major US teaching hospital with over 17,000 HCPs. The system utilizes a handheld computer equipped with a barcode scanner, magnetic stripe reader, and special software to collect and manage employee immunization information at the time the vaccines are administered, whether it's at the facility or at off–site locations. Customized screens on the handheld computer take the caregiver through each step of the process, assuring all information is properly collected and updated ...
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First trial of 2009 H1N1 influenza vaccine testing launched (www.news-medical.net, 10 September 2009)
The first trial testing a candidate 2009 H1N1 influenza vaccine in pregnant women is launching this week, the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health, announced today.“Women are at higher risk of developing severe illness if they become infected with influenza virus while pregnant, which is why they are strongly encouraged to receive the seasonal influenza vaccine every year,” ...
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Tracking the Flu (Global Health, Summer 2009)
Public and private efforts can be synergistic when looking to this new age of information and technology to detect the spread of flu. For example, Google Flu Trends is built on the close relationship between how many people search for flu-related topics (query counts) and how many people actually have flu symptoms. Google engineers compared query counts with historical public health flu surveillance systems and found that many search queries tend to be popular exactly when flu season is happening. By using aggregated Google search data, Google Flu Trends can estimate how much flu is circulating in different states and countries around the world. In urgent response to the swine flu outbreak in Mexico, Google launched an experimental Google Flu Trends Mexico without benefit of historical flu data.
... The present and future of infectious disease surveillance requires earnest engagement of the ‘public’ in public health. It means utilizing the social constructs that often spread disease to be part of the solution for monitoring its spread, demonstrating the effectiveness of community control measures, and educating each other. It may also entail leveraging the use of electronic media to enhance the public's participation.
... Delays can have unforseen consequences. David Heymann, assistant director-general for health security and environment at the World Health Organization, illuminated the “window of opportunity” that we almost missed with smallpox eradication. HIV persons would not have been able to be vaccinated for smallpox as it would have overwhelmed their weakened immune systems. Had it not been completed just prior to the HIV pandemic, we might never have eradicated smallpox.
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Oral cholera vaccine Shanchol from Shantha for India (Dance with Shadows, 27 April 2009)
Shanchol, an oral vaccine for cholera from Shantha Biotechnics has been launched in India. Shanchol vaccine would be commercially available in the country from June.
Shanchol vaccine is recommended for children above one year and in two doses. Shanchol would be priced at Rs 300 (6 US dollars) a dose in India. The other WHO approved oral cholera vaccine available is Dukoral, a Swedish vaccine, which costs about Rs 2000 ($40).
... The oral cholera vaccine Shanchol has been approved India based on the results of in a phase II trial on 70,000 human subjects (aged 12 months and older) conducted in Kolkata by the National Institute of Cholera and Enteric Diseases (NICED).
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WHO supports fair access to influenza A (H1N1) vaccine. An interview with Marie-Paule Kieny (WHO Bulletin, 9 Sept. 2009)
Q: When will the first doses of vaccine for the pandemic influenza A (H1N1) be ready?
A: Some manufacturers announced in July that vaccine is available, but that doesn't mean it's ready for use, as it needs regulatory approval. Regulatory authorities are considering the best way to register these vaccines as quickly as possible. The consensus is that the first doses will be available to governments for use in September.
Q: Who will get vaccinated first? Who decides this?
A: Vaccine will not be available on the private market and governments will decide who gets vaccinated first. WHO recommends that health workers be the first, to protect the health system and allow them to care for influenza and other patients. The strategy a country takes will depend on its policy objectives and the availability of vaccine. ....
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Pregnant women express fears over swine flu vaccine (The Guardian, 2 Sept. 2009)
Almost half of all pregnant women say they will refuse to be vaccinated against swine flu once the jab is available, suggesting there is widespread concern about its safety, a poll has revealed.
Pregnant women are one of the target groups for vaccination identified by experts advising the government. In July, a study in the US showed they are more at risk of complications if they get the virus and more likely to end up in hospital than other people. ...
Yesterday's survey, published by the website mumsnet.com, confirms the fears of the authors of the US study, which was published online by the Lancet. It showed almost half – 48% – of pregnant women who responded said they probably or definitely would not have the jab if it is available. Only 6% said they definitely would and 22% said they probably would.
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Laboratory Surveillance for Wild and Vaccine–Derived Polioviruses —Worldwide, January 2008––June 2009 (MMWR, 4 Sept. 2009)
The Global Polio Laboratory Network (GPLN) isolates and characterizes polioviruses from fecal specimens of persons with acute flaccid paralysis. The network is coordinated by the World Health Organization (WHO) and includes 144 laboratories in 97 countries. Data from the network are used to guide the Global Polio Eradication Initiative by confirming polio cases, detecting and determining the origin of importations, identifying vaccine–derived polioviruses (VDPVs), and documenting the circulation of wild polioviruses (WPVs). This report updates previous reports (1) and summarizes GPLN activities and detection of WPVs and VDPVs during January 2008––June 2009. During this period, GPLN tested 247,794 fecal samples from 127,566 acute flaccid paralysis cases, from which 14,279 (5.8%) poliovirus isolates (vaccine-related and WPV) were detected, including 4,280 (1.7%) WPVs from 22 countries. GPLN laboratory capacity and capabilities remain an integral part of surveillance for polioviruses and efforts to eliminate polio from the remaining areas of circulation.
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Finland introduces rotavirus vaccine into the national vaccination programme in September 2009 (Eurosurveillance, 3 Sept. 2009)
Supported by an economic evaluation, rotavirus vaccine is introduced into the national immunisation schedule in Finland. The vaccination programme has been estimated to be reasonably cost-effective. Given at the age of two, three and five months, the vaccine is expected to prevent annually in Finland among children under the age of five years approximately 2,000 rotavirus diarrhoea episodes needing hospitalisation, and over 10,000 outpatient visits. The impact of the programme will be evaluated in 2011 by repeating the economic analysis and carefully monitoring adverse events.
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Inhalable measles vaccine soon in India (PTI, 30 August 2009)
A single deep breath will soon be enough to vaccinate children against measles as human trials of an inhalable vaccine for the deadly disease are expected to begin early next year in India.
Serum Institute of India will be conducting the trials of the new vaccine in the country.
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A new website for the rapid sharing of influenza research (PLOS, 20 August 2009)
PLoS Currents: Influenza ... is built on three key components: a small expert research community that PLoS is working with to run the website; Google Knol with new features that allow content to be gathered together in collections after being vetted by expert moderators; and a new, independent database at the National Center for Biotechnology Information (NCBI) called Rapid Research Notes, where research targeted for rapid communication, such as the content in PLoS Currents; Influenza will be freely and permanently accessible. ...
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Phase 3 malaria vaccine trial begins—final testing of RTS,S (www.malariavaccine.org, 27 May 2009)
The Phase 3 trial of the most clinically advanced malaria vaccine candidate began May 26 with inoculations administered at the Bagamoyo Research and Training Centre of the Ifakara Health Institute (IHI) in Tanzania. In the coming months, the trial is expected to start in other countries across sub–Saharan Africa and will enroll up to 16,000 children and infants.
... Recent Phase 2 studies showed that over an eigh–month follow–up period, RTS,S reduced the risk of clinical episodes of malaria by 53 percent and has a promising safety and tolerability profile when used alongside standard infant vaccines. The Phase 3 trial builds on more than ten years of clinical research in Africa ...
... Phase 3 testing will occur in diverse transmission settings—ranging from areas where malaria occurs year-round to areas where it is more of a seasonal threat—to allow researchers to observe how the vaccine behaves in relation to intensity of malaria transmission. The various research centers were chosen for their track record of world–class clinical research, strong community relations and commitment to meeting the highest international ethical and regulatory standards.
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Interim guidance for use of 23-valent pneumococcal polysaccharide vaccine during novel influenza A (H1N1) outbreak (CDC, 9 June 2009)
... CDC's Advisory Committee on Immunization Practices (ACIP) recommends a single dose of PPSV23 for all people 65 years and older and for persons 2 to 64 years of age with certain high–risk conditions (Table). People in these groups are at increased risk of pneumococcal disease as well as serious complications from influenza. A single revaccination at least five years after initial vaccination is recommended for people 65 years and older who were first vaccinated before age 65 years as well as for people at highest risk, such as those who have no spleen, and those who have HIV infection, AIDS or malignancy.
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FDA licenses new HIB vaccine, Hiberix (www.fda.gov, 19 August 2009)
The U.S. Food and Drug Administration today approved Hiberix, a Haemophilus influenzae Type b (Hib) vaccine, as a booster dose for children 15 months through 4 years old. Hiberix is manufactured by GlaxoSmithKline, with U.S. headquarters in Research Triangle Park, N.C. and Philadelphia.
A nationwide shortage of Hib vaccine began in December 2007 due to a voluntary recall by the manufacturer and subsequent production suspension of PedvaxHIB and COMVAX, two of four vaccines licensed in the United States for primary and booster immunization against invasive disease due to Hib.
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The Risks and Benefits of HPV Vaccination (JAMA, 19 August 2009)
When do physicians know enough about the beneficial effects of a new medical intervention to start recommending or using it? When is the available information about harmful adverse effects sufficient to conclude that the risks outweigh the potential benefits? If in doubt, should physicians err on the side of caution or on the side of hope? These questions are at the core of all medical decision making. It is a complicated process because medical knowledge is typically incomplete and ambiguous. It is especially complex to make decisions about whether to use drugs that may prevent disease in the future, particularly when these drugs are given to otherwise healthy individuals. Vaccines are examples of such drugs, and the human papillomavirus (HPV) vaccine is a case in point.
If HPV infection can be prevented, cancer will not occur. But in practice the issue is more complex. First, there are more than 100 different types of HPV and at least 15 of them are oncogenic. The current vaccines target only 2 oncogenic strains: HPV-16 and HPV-18. Second, the relationship between infection at a young age and development of cancer 20 to 40 years later is not known. HPV is the most prevalent sexually transmitted infection, with an estimated 79% infection rate over a lifetime. The virus does not appear to be very harmful because almost all HPV infections are cleared by the immune system. In a few women, infection persists and some women may develop precancerous cervical lesions and eventually cervical cancer. It is currently impossible to predict in which women this will occur and why. Likewise, it is impossible to predict exactly what effect vaccination of young girls and women will have on the incidence of cervical cancer 20 to 40 years from now. The true effect of the vaccine can be determined only through clinical trials and long-term follow-up.
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Autism group softens stance on vaccines (Post-gazette Now, 16 August 2009)
The autism wars aren't over –– but they may have entered a new phase.Autism Speaks, the nation's largest autism advocacy group, recently made its clearest public statement yet that minimizes the link between vaccines and autism.
In a prepared interview posted on the Autism Speaks Web site, the group's chief science officer, Dr. Geri Dawson, says that scientific studies have found no link between thimerosal, a mercury preservative used in certain vaccines, and autism. Nor have they found a connection between the measles–mumps–rubella vaccine and autism.
"So ... given what the scientific literature tells us today,"she says, "there is no evidence that thimerosal or the MMR vaccine cause autism" and "evidence does not support the theory that vaccines are causing an autism epidemic."
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Beyond Gender as Usual: How HIV⁄AIDS Donors Can Do More for Women and Girls
Global AIDS donors have both an opportunity and a responsibility to ensure that HIV/AIDS programs take into account gender-related issues; failure to do so will seriously undermine their efforts to slow the epidemic. But how are the three major global HIV⁄AIDS programs performing? A new study by CGD's HIV⁄AIDS Monitor reviewed gender-related activities of the U.S. President's Emergency Plan for AIDS Relief (PEPFAR), the Global Fund to Fight AIDS, Tuberculosis and Malaria (the Global Fund), and the World Bank's Africa Multi-Country AIDS Program (the MAP). Bottom line: they talk the talk but sometimes stumble when it comes to walking the walk.
This brief shows how three of the biggest donors to global HIV/AIDS programs can go beyond their stated commitments to address gender inequality and more effectively combat HIV and AIDS.
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Fighting AIDS in Conservative Mauritania (IPS News, 4 August 2009)
"With a predominantly Muslim population that seeks guidance from the Quran, any advocacy outside the main parameters of religion is more often than not frowned upon, derided and scorned,"says John Sadeed head OF NADOA, an advocacy NGO in Mauritania that promotes attitudinal changes and positive living for those people with HIV.
The latest official statistics from UNAIDS, report that adult HIV prevalence rate is 0.8 percent; roughly 14,000 people are living with HIV⁄AIDS out of a population of 3.2 million people.
.... Corea Mint Sidi has experienced difficulties in her work with women living with HIV. "When I started this community advocacy and outreach programme, men in my community were telling their wives not to have anything to do with me because I was promoting promiscuity... I was also subject of a community tongue-lashing not only from men but even from my women folk," she said.
"Some religious leaders still refer to us as infidels or non believers who are being used by the West to fight Islam. Now in Muslim country like Mauritania, that is a very serious allegation to live with."
... An interview with Sheikh Abdoullah Ould Abdoullah, a religious leader in the capital Nouakchott, was a revealing encounter as far as gauging the opinion of the clerics on HIV/AIDS is concerned.
"Muslim leaders in Mauritania will continue to be suspicious of the motives of Western-backed campaigners against HIV/AIDS especially when they are promoting safe sex and condom use," the Sheikh said. "Our religion forbids that. If they are concerned about HIV/AIDS let them tell people to stop doing things that give them the virus."
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Polio immunization drive reaches children on the move in Pakistan (www.unicef.org, 31 July 2009)
Dr. Mohammed Salem walks alongside volunteers carrying small coolers filled with oral polio vaccine around the streets of Fauji Colony in Rawalpindi, Punjab Province.
It's National Immunization Day for polio, a country-wide government vaccination campaign supported by UNICEF and the World Health Organization (WHO). Volunteers look for pen marks on the little finger of every child under the age of five to see if he or she has been vaccinated. If the mark is absent, they administer the vaccine.
“The biggest challenge we face,”Dr. Saleem explains, “is to reach children who are on the move.”
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Burkina Faso: When is malaria not malaria? (IRIN, 20 August 2009)
Two months into using malaria rapid tests, some health facilities in Burkina Faso continue treating for malaria despite negative test results, according to community health workers.
Since June 2009, the government has made available 240,000 rapid malaria tests in half of its 63 health districts, the national anti-malaria programme coordinator, Laurent Moyenga, told IRIN.
... if the child had a fever, headache, loss of appetite, or was vomiting, his centre automatically administered malaria treatment even if the test result was negative. "The test result could be a false negative. If the malaria treatment does not work, then we search for another solution."
In a recent World Health Organization (WHO) evaluation of rapid tests, two brands accurately detected malarial parasites 95 percent of the time, but researchers said quality varied depending on the test manufacturer, and storage and transport conditions.
... David Bell, a scientist at the Geneva-based non-profit Foundation for Innovative New Diagnostics, told IRIN that new approaches were needed to diagnose febrile diseases in addition to malaria.
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Gambia: Pneumococcal immunization campaign underway (IRIN, 20 August 2009)
Health officials have launched a nationwide pneumococcal vaccine campaign in the Gambia, where one in six deaths is caused by pneumonia – the most common pneumococcal illness – according to the World Health Organization (WHO).
Researchers from the US-based Johns Hopkins School of Public Health estimate at least 5,000 children fall ill to pneumococcal disease every year in the Gambia, leading to hundreds of deaths.
... The vaccine introduced in the Gambia – Prevenar, produced by Wyeth Pharmaceuticals – is expected to prevent half of the forms of pneumococcal diseases found in Gambia, Privor-Dumm told IRIN. "Given the high disease mortality in Gambia, even though we are not getting all the types of pneumococcal diseases, this is still significant."
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Zimbawbe: Return of cholera expected soon (IRIN, 19 August 2009)
The return of cholera to Zimbabwe is not a matter of if, but when, said Rian van de Braak, head of mission of the medical NGO Médecins Sans Frontières (MSF).
In an interview published on its website on 19 August, Van de Braak commented, "The threat is definitely not over. Everyone expects cholera to be back, at the latest with the next rainy season [in September or October], because the root causes of the outbreak [in 2008] have not been addressed adequately yet."
... Broken sanitation and water systems, the cause of Africa's worst outbreak of the waterborne disease in 15 years, are unlikely to be repaired in time.
"Several aid agencies are drilling new boreholes in cholera hotspots, which is an important contribution to safe drinking water. Dealing with those causes before the next rainy season is a race against the clock," Van De Braak said.
... However, the cholera outbreak has often masked an even bigger killer. "There are more than 400 people dying in Zimbabwe every day of AIDS-related causes. To put things in perspective: there were around 4,000 cholera-related deaths in total during the nine-month outbreak; with AIDS we have that number of casualties within 10 days, every 10 days, again and again," Van De Braak said.
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18 million Indian children to receive life-saving five-in-one vaccine (www.gavialliance.org, 11 August 2009)
More than 18 million children in India will be immunised with a pentavalent five-in-one vaccine thanks to funding worth US$ 165 million from the GAVI Alliance, a public-private partnership which brings together all key players in immunisation including the Indian government, the World Health Organization, UNICEF, donors, industry and the Hib Initiative. A decision by the GAVI Alliance‘s Executive Committee in Geneva announced today paves the way for the introduction of the combination vaccine in India...
The pentavalent vaccine protects against five potential killers –– diphtheria, tetanus, pertussis (whooping cough), hepatitis B, and Haemophilus influenzae type b (often known as Hib) which causes some severe forms of pneumonia and meningitis. Children need to be vaccinated three times before they can be considered fully immunised.
While children in all countries are routinely immmunised against diphtheria, tetanus, pertussis and increasingly hepatitis B, the introduction of this pentavalent vaccine in India, will mean that now more than 90% of the world‘s poorest children will be vaccinated against Hib.
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Public health and peace building in Nepal (The Lancet, 15 August 2009)
Since the cessation of the civil war in 2006, Nepal has seen a large influx of development aid, with around US$700 million committed for fiscal year 2008—09—a substantial proportion of its $3 billion budget according to the Ministry of Finance. When the Maoist party announced its budget in September, 2008, it was accompanied by the slogan "New Nepal, Healthy Nepal".
Nepal has committed to meeting the Millennium Development Goals (MDGs) by 2015. Already faced with a large disparity in health outcomes between urban and rural, high caste and low caste, Nepal's progress towards the MDGs is further challenged by its precarious political situation.
Nepal offers an intriguing case study of the challenges of meeting development and public health goals in post-conflict countries. According to Claude Bruderlein, the director of the Humanitarian Policy and Conflict Research Center at Harvard University, Cambridge, MA, USA, "Nepal is not a standard case. In order to understand public health in Nepal it is important to stay above the cynical view of Nepal as a failed state and below the development narrative of the ‘New Nepal’. The truth is somewhere in between."
The case of Nepal illustrates how political legacies and social forces mould the public health agenda. Most importantly, it shows that health is a transformative political issue and a cornerstone to successful peace building.
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USAID: an agency without leader and direction (The Lancet, 15 August 2009)
After 7 months without a leader, the USAID staff's morale has plummeted, and a vacuum has been created to be filled by others with vested interests.
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New superbug resistant to antibiotics and more difficult to tackle than MRSA (The Guardian, 12 August 2009)
Hospitals have been put on alert about a group of new superbugs brought into the UK by patients returning home after surgery abroad, including cosmetic treatments and organ transplants.
The virulent new strains of drug resistant bacteria, which are much harder for doctors to tackle than MRSA or Clostridium difficile, have killed two people and left 18 others seriously ill in 12 months.
At least 17 hospitals in England and Scotland have seen cases, prompting the Health Protection Agency to issue a warning about what it calls "a notable public health risk". The bacteria can cause wound infections, septicaemia, pneumonia and gastroenteritis and are posing real problems for the NHS because they are proving resistant to all the usual antibiotics.
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Pandemic influenza vaccine manufacturing process and timeline (WHO, 6 August 2009)
It takes approximately five to six months for the first supplies of approved vaccine to become available once a new strain of influenza virus with pandemic potential is identified and isolated. These months are needed because the process of producing a new vaccine involves many sequential steps, and each of these steps requires a certain amount of time to complete.
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Pandemic (H1N1) 2009: WHO advice on face masks (WHO)
Evidence suggests that the main route of human-to-human transmission of the Pandemic (H1N1) 2009 virus is via respiratory droplets, which are expelled by speaking, sneezing or coughing. Any person who is in close contact (approximately 1 meter) with someone who has influenza-like symptoms (fever, sneezing, coughing, running nose, chills, muscle ache etc) is at risk of being exposed to potentially infective respiratory droplets.
Mask use has been found useful ...
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Over 33 000 laboratory-confirmed cases of pandemic (H1N1) 2009 virus infection in Europe (WHO)
As of 10 August 2009, 46 of the 53 countries in the WHO European Region had reported over 33 000 laboratory-confirmed cases of pandemic (H1N1) 2009 virus infection, including 55 fatalities in 7 countries: Belgium, France, Hungary, Ireland, Israel, Spain and the United Kingdom.
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Deaths linked to Pandemic (H1N1) 2009 rise in Malaysia (12 August 2009, WHO)
The number of deaths in Malaysia associated with Pandemic (H1N1) 2009 climbed to 38, after additional fatalities were announced by the Ministry of Health in that country. The number of deaths linked with the virus in the Western Pacific Region stands at 169.
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Ministers plan swine flu vaccination in every school (The Guardian, 6 August 2009)
All 8.5 million pupils in the UK would be immunised against swine flu at immunisation posts in every school, under plans being studied by ministers, the Guardian has learned.
In the biggest mass vaccination since the 1964 operation against smallpox, school nurses, health visitors and GPs would deliver the injections to five- to 16-year-olds at all 33,700 schools. The move would be part of a concerted government effort to minimise the harm caused by the expected second wave of the pandemic this autumn.
"The general principle of schools being the ideal, logical place to do this is well established. They have captive audiences," said one senior source involved in Whitehall planning.
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South Africa tries new approach to resistant tuberculosis (The Lancet, 8 August 2009)
... MSF and Cape Town health authorities embarked on a pilot project in the sprawling suburb of Khayelitsha to provide decentralised patient-centred care, support, and treatment for people with drug-resistant tuberculosis. The township is home to more than 500 000 people, and has one of the highest burdens of HIV/AIDS and tuberculosis in South Africa. Around 30% of pregnant women are HIV positive, and the tuberculosis incidence rate is at least 1500 per 100 000 people per year—nearly four times WHO's emergency level. The co-infection rate is an estimated 70—75%. In 2008, 196 patients were diagnosed as having drug-resistant tuberculosis—an incidence rate of around 60 per 100 000, one of the highest in the world. “We have no clue how many people are dying. Many are dying before we make the diagnosis”, said Virginia Azevedo, a senior City of Cape Town health official.
Current South African practice is to refer patients with drug-resistant tuberculosis to centralised specialist units, where they spend at least 6 months. But the policy is overwhelmed by the reality of too few beds and trained staff and a fatally slow diagnosis, which allows time for tuberculosis to spread. The “lucky” few who are referred to isolation wards often find themselves far from family and surrounded by weapon-wielding guards and barbed wire to prevent escape. “After a while, if you weren't depressed you will be depressed and you will try to walk out of hospital, and that is what is happening”, says Azevedo in reference several reports of tuberculosis-ward occupants storming their way out of hospital and being hidden by family members.
Nationwide, drug-resistant tuberculosis has increased from 6000 reported cases in 2002, to 14 000 cases in 2008, according to MSF and official figures. Between 2004—08, more than 24 000 cases of multidrug-resistant tuberculosis were diagnosed, of which about 7% were infected with extensively drug-resistant tuberculosis.
The Khayelitsha pilot project aims to speed up detection of drug-resistant tuberculosis cases, increase community awareness and education, boost infection control, and improve treatment protocols.
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Evaluation of Rapid Influenza Diagnostic Tests for Detection of Novel Influenza A (H1N1) Virus (7 August 2009)
The recent appearance and worldwide spread of novel influenza A (H1N1) virus (1,2) has highlighted the need to evaluate commercially available, widely used, rapid influenza diagnostic tests (RIDTs) for their ability to detect these viral antigens in respiratory clinical specimens. As an initial assessment, CDC conducted an evaluation of multiple RIDTs. Sixty-five clinical respiratory specimens collected during April--May 2009* that had previously tested positive either for novel influenza A (H1N1) or for seasonal influenza A (H1N1) or A (H3N2) viruses by real-time reverse transcription--polymerase chain reaction (rRT-PCR) assay were used in the evaluation. The results showed that, although the RIDTs were capable of detecting novel A (H1N1) virus from respiratory specimens containing high levels of virus (as indicated by low cycle threshold [Ct] values), the overall sensitivity was low (40%--69%) among all specimens tested and declined substantially as virus levels decreased (and Ct values increased). These findings indicate that, although a positive RIDT result can be used in making treatment decisions, a negative result does not rule out infection with novel influenza A (H1N1) virus.
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Text Me! Flash Me! Helpline (The Communication Initiative Network)
Launched in September 2008, the Text Me! Flash Me! Helpline uses cell phone technology to provide most-at-risk populations (MARP) in Ghana with friendly and accessible HIV and AIDS information, referrals, and counseling services from qualified providers. ...
Specifically, Text Me! relies on a database of cell phone numbers collected by peer educators and social networks. Outgoing SMS texts are sent with educational and promotional messages, either through a "phased communication" strategy or in response to trends noticed through ongoing quality assurance and monitoring and evaluation (M&E). Automatic SMS text responses are sent to clients' SMS text inquiries that refer clients who text "HELP" to live Helpline counselors, who call back within 24 hours.
The Helpline is advertised through peer educators, social networks, and discrete Text Me! posters, which read: "To get more info about friendly services in your area, use your phone to send a short text and the name of your town to XXXX. Worried that you may have gotten an infection from sex? Text STI. Need to know where to go for friendly HIV testing? Text VCT. Want to know about medicines and therapies for HIV-positive people? ...
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Women's health in rural China (The Lancet, 1 August 2009)
China's sheer size, along with its ongoing economic and cultural metamorphosis, creates enormous challenges in health care. Cervical cancer and breast cancer are major threats to women's health, with the 100 000 new cervical cancer cases recorded in China every year accounting for 29% of the world's total. Worryingly, cervical cancer incidence is greater in women younger than 30 years in China than it is in developed countries, and the disease is over-represented in rural areas—owing to lack of education, poverty, and inability to pay for health care.
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Indonesian doctor sends her message via radio and TV (Bulletin of the World Health Organisation, August 2009)
... according to a preliminary study of prescribing patterns for common paediatric ailments carried out in 2006–2007 by paediatrician Purnamawati S Pujiarto, founder of a nongovernmental organization (NGO) Yayasan Orang Tua Peduli, in collaboration with her colleague Dr Arifianto. This limited study, based on e-mail testimony from mothers aged between 26 and 30 years, found that in every case the women’s children had been prescribed mixtures of up to 11 medications for ailments that were both mild and self limiting. The most commonly prescribed drugs were antibiotics.
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Supply and safety issues surrounding an H1N1 vaccine (The Lancet, 1 August 2009)
Last week, Australia and the USA announced that they would begin trials of an H1N1 vaccine. Vaccination against H1N1 will be an important development in controlling the impact of the pandemic. However, several thorny issues exist around vaccine manufacture and approval. All countries will require the vaccine but current global manufacturing capacity will not be able to meet this demand. Additionally, experts think that individuals might need two doses of the vaccine instead of one, reducing capacity further. Vaccine manufacturers are also struggling to produce good vaccine yields with the H1N1 seed virus.
One way to ease these supply problems is the use of adjuvants in a vaccine. On July 7, WHO's Strategic Advisory Group of Experts on Immunization recommended that vaccine formulated with oil-in-water adjuvants and live-attenuated influenza vaccines should be promoted to help increase the global supply of a vaccine and because they are better at protecting against strain variations. Yet there are signs that the USA might not follow this recommendation.
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Making sense of health statistics (Bulletin of the World Health Organisation, August 2009)
Many physicians, patients, health journalists and politicians do not understand health statistics. Yet we make little effort to educate our children in statistical thinking or our medical students in understanding health statistics. This collective statistical illiteracy has resulted in serious consequences for health.1
... statistical illiteracy is largely caused by non-transparent framing of information. Albeit not always intentional, non-transparency is often a deliberate tactic to manipulate or persuade people. ... there is a simple solution: confusing numbers can be easily understood when represented in a transparent way. ... unlike relative risks and 5-year-survival rates, which mislead many people, absolute risks and mortality rates provide transparent tools for risk communication.
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A key piece of the jigsaw for improving world health (Bulletin of the World Health Organisation, August 2009)
... If we are going to achieve what the World Conference on Science held by UNESCO and the International Council for Science in 1999 termed the true “orienting of scientific progress towards meeting the needs of humankind”, then we must improve the research effort on the health problems that afflict the greatest part of the world’s population. That cannot happen until research communication is optimized: at the turn of the new millennium more than half of research-based institutions in lower-income countries had no current subscriptions at all to international research journals.
Open access changes this. It permanently delivers free research information to any would-be user. The security of long-term free access is relevant here because other programmes that purport to deliver health research information on an equitable basis to the developing world are not guaranteed for the long-term.
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Maintaining momentum for malaria elimination (The Lancet, 25 July 2009)
... Seven countries in sub-Saharan Africa and an additional 22 countries worldwide reduced mortality from malaria by 50% between 2000 and 2007. But huge obstacles still need to be overcome to move towards elimination. Coverage of the key interventions to prevent and treat malaria—long-lasting insecticide-treated bednets, artemisinin-based combination therapies, and indoor residual spraying—is poor in Africa and Asia because of weak public health systems and infrastructure. ...
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Countries race to contain resistance to key antimalarial (The Lancet, 25 July 2009)
Pailin, a green lush province in western Cambodia, on the border with Thailand, one of the Khmer Rouge's last strongholds, was once famed for its rich gemstones and dense forests. Now it is gaining notoriety for a different reason: malaria. But it is not a high prevalence of the disease that has made Pailin noteworthy. Rates of malaria have actually been in steady decline in the province over the past decade. What has put Pailin on the malaria map is its Plasmodium falciparum parasites, which, since the 1970s, have been the first in the world to successively develop resistance to key antimalarial drugs—choloroquine and sulfadoxine-pyrimethamine. These resistant parasites have not only spread throughout Cambodia but also across Asia and sub-Saharan Africa, rendering important weapons in the fight against falciparum malaria ineffective. ... Scientists in and around Pailin are beginning to confirm that parasites in the region are also developing resistance to another class of antimalarial drugs—artemisinin derivatives—with potentially devastating consequences for the treatment of malaria globally.
... “At the beginning we talked about tolerance to artemisinin but after the Pailin study, resistance was confirmed—the 1973 definition of resistance had been met”,
... But there is a possibility that it might be too late. “Resistance used to move west to Burma but now people travel from Bangkok to Nairobi”, says Mark Fukuda, who is leading the clinical trials on resistance at the AFRIMS centre in Tasahn. He plans to work with the military to do a wider geographical study on resistance in Latin America and Africa. “We need to expand our global surveillance”, he says.
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Malaria drug-makers ignore WHO ban (Afronets, July 2009)
There is a growing risk that malaria parasites will develop resistance to artemisinin because almost half of both its manufacturers and malaria-affected countries are failing to comply with World Health Organization (WHO) demands to sell it only in combination with other drugs. Artemisinin and its derivatives are the leading treatments for the disease, being the only antimalarials that have not yet seen widespread resistance in malaria parasites.
The full scale of the problem is revealed in a soon-to-be-published WHO Briefing seen by Nature, "Stop the marketing of oral artemisinin monotherapies", which calls for governments to empower national drug-regulatory authorities to clamp down on offending companies.
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Discovery of New Transmission Patterns May Help Prevent Rotavirus Epidemics (CDC press release, 16 July 2009)
... The research, published in the July 17 issue of the journal Science, is based on mathematical modeling that takes into account regional birth rates and predicted vaccination levels and effectiveness. The model suggests that when 80 percent or more of children in a given population are vaccinated, annual epidemics may occur on a less regular basis and more unvaccinated children will be protected. Data from 2007-2008, when vaccination first reached appreciable coverage levels in the United States, validate the model′s predictions. ...
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Delivering local disease prevention and health promotion: Brazil and Chile compared (www.id21.org, 2009)
In Chile there is a vertically structured system, with a national health promotion policy dictating local and regional activities. However lack of funding means that regional authorities and local health systems must compete for resources, producing uneven results. By contrast in Brazil where there is a horizontal approach, funding for primary health care programmes is available to all who apply and show they are eligible.
However, lack of awareness and capacity produces similarly uneven results.
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Cured patients help in TB treatment in Tanzania (WHO, July 2009)
... Not everyone can travel daily to a health facility, however. The closest treatment facility may be too far away. Or the person may not be well enough. The WHO Stop TB Strategy therefore encourages alternative arrangements for supporting TB patients as they take their treatment.
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PEPFAR's biggest success is also its largest liability (The Lancet, 18 July 2009)
The President's Emergency Plan for AIDS Relief (PEPFAR) is one of the few foreign policy initiatives inherited by the Obama Administration that is not in crisis—not yet anyway. The recent buzz about the unceremonious dismissal of PEPFAR's well-respected director1, 2 and concern about the effects of the global financial crisis on upcoming appropriations has cast an uncertain pall over the USA's global AIDS programme. But these issues are unlikely to derail PEPFAR. What could subvert PEPFAR is failure to adequately emphasise maintenance and adherence in patients now receiving treatment through the programme.
... PEPFAR II should be amended to require two additional performance metrics: one for patients' retention (the ratio of patients currently on treatment to the total number ever started), and one for patients' adherence to treatment.
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Is disease eradication ethical? (The Lancet, 27 June 2009)
... If eradication is the goal behind various past and current public heath campaigns, and if it is to be the goal of future efforts, it is important to realise exactly what target is being set by the use of this term. The stakes involved in aiming for eradication are enormous; talk of eradication portends relief forever from a disease as well as the ability to relax humanity's guard against that disease.
There are many reasons to doubt the desirability of seeking to eradicate all infectious diseases. Some have to do with the certainty with which eradication can be ascertained. Some have to do with the cost and reliability of achieving eradication. Both problems are troubling because of what happens after eradication is certified as having been achieved. If eradication is claimed to have been achieved for a disease then efforts to prevent its reccurrence will most probably cease.
... In addition to ending prophylactic efforts, a claim of eradication will also probably stop or greatly reduce efforts at training health workers to recognise and treat the eradicated disease given other pressing educational needs. Efforts to undertake intense surveillance and further research involving the eradicated disease and its causal agents will also rapidly diminish.
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Sanofi-Aventis to Donate 100 Million Swine Flu Vaccinations to WHO (OHS, 21 June 2009)
Christopher A. Viehbacher, Chief Executive Officer of Sanofi-Aventis, a leading global pharmaceutical company, declared at the June 17 opening session of the Pacific Health Summit in Seattle that the company will donate 100 million doses of the novel A(H1N1) influenza strain the World Health Organization (WHO).
... In addition to ending prophylactic efforts, a claim of eradication will also probably stop or greatly reduce efforts at training health workers to recognise and treat the eradicated disease given other pressing educational needs. Efforts to undertake intense surveillance and further research involving the eradicated disease and its causal agents will also rapidly diminish.
"I want to back Director-General of WHO’s call for common action to fight the influenza pandemic," Viehbacher said. "This is our collective responsibility, as companies, as an industry, as national health authorities, as NGOs, as Foundations, to pool our collective strengths as well as our dedication and our motivation to find solutions that are affordable for every patient throughout the world."
This donation is tailored to respond to the 2009 influenza pandemic and includes a previous commitment made by the company in 2008 in the context of the A(H5N1) pandemic threat.
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Hope for health in Turkmenistan? (The Lancet, 20 June 2009)
Six years ago, The Lancet drew attention to Turkmenistan,1 where President Saparmurat Niyazov's increasingly oppressive policies had extended to widespread closure of health and education facilities.2, 3 Although the official secrecy was difficult to penetrate, we revealed a picture of an unfolding health crisis, subsequently reported by two courageous BBC journalists.4
In December, 2008, Niyazov died unexpectedly, and was succeeded by his Health Minister, Gurbanguly Berdimuhamedow, who gradually abandoned the worst excesses of his predecessor, in particular Niyazov's bizarre personality cult. International attention now concentrates on Turkmenistan's foreign policy, which is not surprising in view of the country's strategically important gas reserves. We wanted to know whether the new regime had made a difference to the health of the Turkmen people.
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Progress Toward Poliomyelitis Eradication --- India, January 2007--May 2009 (MMWR, 10 July 2009)
India is the most populous of the four remaining countries (including Afghanistan, Nigeria, and Pakistan) where transmission of wild poliovirus (WPV) has never been interrupted. The last cases of WPV type 2 worldwide were reported in October 1999 in India. However, transmission of WPV type 1 (WPV1) and WPV type 3 (WPV3) persists in India in the northern states of Uttar Pradesh and Bihar. Transmission of indigenous WPV in all of India's other states was successfully interrupted in 2002, and all WPV cases reported since then in the country have resulted from WPV circulating in Uttar Pradesh and Bihar. This report updates previous reports and summarizes India's progress toward polio eradication since January 2007, as of May 29, 2009. In 2005, the government of India introduced the use of monovalent oral polio vaccine type 1 (mOPV1), which has higher efficacy against WPV1 than does trivalent oral polio vaccine (tOPV) (1--3), in supplementary immunization activities. After a multistate WPV1 outbreak in 2006, preferential use of mOPV1 was accelerated and WPV1 cases decreased from 83† in 2007 to 18 during January--May 2009. A resurgence of WPV3 cases in Uttar Pradesh in 2007 led to an outbreak in Bihar. SIAs using monovalent type 3 OPV (mOPV3) were expanded in 2007, and the number of WPV3 cases declined from 794 in 2007 to 41 during January--May 2009. Simultaneously interrupting transmission in high-risk areas of western Uttar Pradesh and Bihar is the key to successful interruption of all WPV transmission in India.
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Moving Beyond Gender as Usual (Center for Global Development, 29 July 2009)
Gender inequalities drive the HIV epidemic, increase the burdens of the disease on women and girls, and hinder the effectiveness of the fight against HIV and AIDS. In this analysis, CGD’s HIV/AIDS Monitor argues that despite well-meaning global strategies and policies, the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), the Global Fund to Fight AIDS, Tuberculosis and Malaria, and the World Bank’s Africa Multi-Country AIDS Program have not yet been able to turn them into systematic programming that addresses the needs of women and girls.
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World Bank health work flawed (www.brettonwoodsproject.org, 10 July 2009)
A recent evaluation of the World Bank’s health work is damning in its criticism of the lender’s approach, particularly in Africa. Meanwhile, the Bank is continuing to push privatisation in public services such as health, education and water, despite fierce criticism.
A World Bank Independent Evaluation Group (IEG) report on almost $18 billion worth of health, nutrition and population work covered projects from 1997 to 2008 across the World Bank Group. It rated 220 projects according to how well they met stated objectives, regardless of how good those objectives were. Highly satisfactory outcomes were almost unheard of, and only about two-thirds of projects had moderately satisfactory outcomes or better. Projects in Africa were “particularly weak”, with only 27 per cent achieving satisfactory outcomes. ...
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Malaria vaccine researchers face cultural challenges (The Lancet, 11 July 2009)
... Not only was RTS,S the first vaccine capable of taking on a parasite, its invention was also unprecedented for focusing the intellectual and financial might of the pharmaceutical industry on cash-strapped communities across sub-Saharan Africa, where malaria kills nearly a million children each year. But the vaccine's creators could hardly have known how the pristine logarithms of the laboratory would play out on a continent of floods, scarce infrastructure, and threadbare health systems.
... Over 20 years later, with money from the Bill & Melinda Gates Foundation and a chain of research collaborations stretching across 11 trial sites in seven countries, the largest and most advanced trial ever of a malaria vaccine began in May this year. And a recent visit to the Kenyan coastal province of Kilifi suggests that the success of these trials rests with the acquiescence of mercurial weather patterns and the ability of a new generation of African health workers to win the trust of communities that have long been neglected by health systems.
“Whenever you start a malaria trial you have to have a strong heart”, Cohen said. “No matter how much planning in advance and looking at transmission data years pretrial, you really never know what's going to happen during the year you are doing the trial.” ...
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Fear of Polio Drops Overcome (www.comminit.com, Dec. 2008)
...
In response to overcoming the rumour that the polio vaccine caused impotency, a two-pronged approach was used that consisted of engaging the multi-agency Social Mobilisation Network (with the United Nations Children's fund (UNICEF), CORE, and Rotary appointing community-level mobilisers). Mobilisers from the network began systematically recording and updating a list of children under five years of age in their area, as well as building local networks among religious leaders and local influencers, and counseling mothers/mothers-in-law. In particular, mobilisers were trained to counsel on the issue of impotency using examples from countries that have eradicated polio, including Islamic countries.
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Protecting children with HIV against pneumococcal disease (The Lancet, July 2009)
Rwanda has become the first developing nation to introduce pneumococcal conjugate vaccine. The aim is to vaccinate nearly all Rwandan infants by the end of 2009. However, equally at risk older children with HIV are unfortunately not yet on the agenda.1 WHO estimates that disease due to Streptococcus pneumoniae claims the lives of up to 1 million children every year.2 These deaths are disproportionately represented in the developing world, particularly in children infected with HIV3 of whom there are about 2 million in sub-Saharan Africa alone.
... The focus of vaccination with PCV-7 has so far been directed towards infants, as outlined in the 2007 WHO pneumococcal vaccine position paper. There have been very large reductions in disease burden in countries where the vaccine has been introduced into the routine immunisation schedule for infants. Immunisation of older age groups, especially those more vulnerable to pneumococcal disease, is now an important area of investigation. In particular, unvaccinated children over 4 months of age infected with HIV (i.e., beyond the age of routine vaccination as per the WHO Expanded Program on Immunization) might benefit greatly from PCV-7 vaccination. A recent pivotal trial in South Africa, found that 83–91% of invasive pneumococcal isolates were covered by the nine-valent pneumococcal conjugate vaccine. The vaccine was effective in 65% of the children that were HIV-positive.
...We find it perverse that PCV-7 is now supplied in 26 countries, 24 of which are high-income, have low childhood mortality, and low prevalence of HIV infection. The children in developing countries who desperately need the vaccine are the very ones still denied it. The call is increasing to make the worldwide introduction of pneumococcal conjugate vaccines an urgent public health priority. We propose urgent implementation for children with HIV. Paediatric HAART can now be purchased through special mechanisms for as little as US$200 per year, the expected cost to recipient countries of Global Alliance for Vaccines and Immunization funded PCV-7 might be in the order of $1 per three dose course. Global vaccination of children against pneumococcal disease is important, but will take time; we argue that vaccinating children that are HIV-positive is more feasible and worth implementing now.
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Strengthening research capacity in Africa (The Lancet, 4 July 2009)
On July 2, an important and positive step was taken towards strengthening research capacity in Africa. As part of its African Institutions Initiative, the Wellcome Trust announced the formation of seven new international consortia, each led by an African institution. By developing research networks and building a critical mass of sustainable research capacity across Africa, local ability to tackle disease and poverty will be improved. The Wellcome Trust is putting aside £30 million to fund the seven consortia
The Consortium for Advanced Research Training in Africa (CARTA) consists of institutions in Kenya, South Africa, Tanzania, Uganda, Malawi, Nigeria, Rwanda, the USA, Australia, Switzerland, and the UK, and is directed by Alex Ezeh of the African Population and Health Research Centre in Kenya. CARTA aims “train and retain a critical mass of networked African researchers with complementary research skills, able to work in multidisciplinary environments”. Critical thinking skills, analytical techniques, writing and publication planning abilities, and grant management knowledge are all essential to generate top researchers in Africa who can compete on equal terms with those elsewhere. ...
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An ongoing measles outbreak in Bulgaria, 2009 (Eurosurveillance, 2 July 2009)
After seven years without indigenous transmission of measles in Bulgaria, an increasing number of cases have been reported since 15 April 2009. By 19 June, the total number of notifications reached 84. To date, 64 were confirmed as measles cases and 15 cases, for whom laboratory results are pending, have been classified as probable. The present measles outbreak affects mostly the Roma population living in the north-eastern part of the country. The most affected age groups are young children below 1 year of age and children 1 to 9 years of age. An immunisation campaign was started in the affected administrative regions, targeting all persons from 13 months to 30 years of age who had not received the complete two-dose MMR vaccination. After seven years without indigenous transmission of measles in Bulgaria, an increasing number of cases have been reported since 15 April 2009. By 19 June, the total number of notifications reached 84. To date, 64 were confirmed as measles cases and 15 cases, for whom laboratory results are pending, have been classified as probable. The present measles outbreak affects mostly the Roma population living in the north-eastern part of the country. The most affected age groups are young children below 1 year of age and children 1 to 9 years of age. An immunisation campaign was started in the affected administrative regions, targeting all persons from 13 months to 30 years of age who had not received the complete two-dose MMR vaccination.
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Progress Toward the 2012 Measles Elimination Goal --- Western Pacific Region, 1990—2008 (MMWR, 26 June 2009)
In 2003, the World Health Organization (WHO) Regional Committee of the Western Pacific Region (WPR) formally declared a measles elimination goal* (1), and in 2005, the committee established a target date of 2012 for regional measles elimination (2). Key strategies recommended by WHO for achievement of measles elimination include 1) very high (≥95%) vaccination coverage with 2 doses of measles-containing vaccine (MCV1 and MCV2) through routine vaccination and/or supplemental immunization activities (SIAs)†; 2) high-quality case-based§ measles surveillance; and 3) access to an accredited measles laboratory network for testing of suspected measles cases and identification of measles virus genotypes. This report describes progress toward measles elimination in the WPR through 2008. Measles likely has been eliminated or nearly eliminated in 24 of the 37 countries and areas in the WPR (referred to in this report as countries). However, large numbers of measles cases continue to be reported from several countries. During 2008, a total of 131,441 confirmed measles cases (98.4 per million population) were reported from China and 11,015 cases (86.1 per million population) from Japan, two countries that account for 82% of the region's population and >97% of its confirmed measles cases. Intensified efforts by WPR countries, particularly China and Japan, will be required to achieve the 2012 goal.
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Russia's health promotion efforts blossom (The Lancet, June 2009)
... Health and social welfare minister Tatyana Golikova announced the first sizeable state-funded project in line with that aim last month: the creation of a chain of 500 “prophylactic health advice rooms” in medical institutions as part of 830 million roubles (US$26 million) to be spent on health promotion in 2009. She also gave details of a new campaign to improve school meals.
But health-care experts say there is a mountain to climb with immense opposition from powerful cigarette and vodka companies, open hostility among doctors to some WHO-recommended disease prevention measures, and a structurally segregated system of care which hinders radical intersectoral efforts.
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Relentless spread of extensively drug-resistant tuberculosis (The Lancet, July 2009)
Around 500 000 of the 9 million new cases of tuberculosis seen worldwide each year are now due to extensively drug-resistant (XDR) strains. Canadian researchers warned recently that repeated fluoroquinolone prescriptions—routinely dispensed on an outpatient basis in Canada for community-acquired pneumonia—encourage development of resistant strains of Mycobacterium tuberculosis in patients with tuberculosis. “Drug resistance is largely man-made—it is vitally important to review antibiotic treatment strategies and to ensure the Stop TB Strategy is fully applied to prevent further selection of drug-resistant mutants”, commented Leonard Amaral ...
XDR tuberculosis isolates are resistant to isoniazid and rifampicin (two first-line tuberculosis drugs), any fluoroquinolone, and at least one of the three injectable second-line drugs: amikacin, kanamycin, and capreomycin. Multidrug-resistant (MDR) tuberculosis isolates are resistant to isoniazid and rifampin only. XDR tuberculosis is widespread in Europe and the Middle East. “Countries that have the highest percentage of XDR tuberculosis among their MDR tuberculosis cases include Azerbaijan (12·8%), Ukraine (15%), and Estonia (23·7%)”, reported Philip LoBue (Division of Tuberculosis Elimination, CDC, Atlanta, GA, USA). Amaral highlights Portugal as the worst-affected country in western Europe; “over 50% of MDR tuberculosis is XDR, and rates in Porto have continued to escalate ...
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Subsidy Plan Seeks to Cut Malaria Drug Cost (The New York Times, 17 April 2009)
A new campaign to save lives and prevent drug resistance by driving the price of the best malaria medicine down to as little as 20 cents was announced Friday by international health agencies and European governments.
The subsidy program, unveiled in Norway, will have an initial budget of $225 million and will be run by a new partnership called the Affordable Medicines Facility for Malaria.
Malaria experts hailed the program as one of the most important recent advances in fighting the disease, which kills one million people a year, 90 percent of them children. Awa Coll-Seck, executive director of the Roll Back Malaria Partnership, called it “a triumph of international cooperation.”
But the United States, the world’s biggest donor to the war on malaria, is not supporting it yet.
The goal of the program is to press the few drug companies that now make artemisinin combination drugs to lower their private-sector price to $1 per treatment from $4, and then use donor funds to pay 95 cents of that dollar so the drugs cost only a nickel wholesale. The hope is that when the drugs are sold at retail in villages in Africa and Asia, the marked-up price will still be low enough to drive out inexpensive but less effective alternatives.
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HHS Announces Advanced Development Contract for New Way to Make Flu Vaccine (www.hhs.gov, 23 June 2009)
HHS Secretary Kathleen Sebelius announced today that the department will pursue advanced development of new way to make influenza vaccine. The work will be done by Protein Sciences Corporation, Inc., of Meriden, Conn., under a new $35 million contract. The contract could be extended up to five years at a total cost of approximately $147 million.
.... With this new technology, known as recombinant influenza vaccine, a gene would be extracted from a flu virus and placed into an insect virus called baculovirus, which does not affect people and can multiply quickly to high levels in insect cells. The cells are purified to become a basic part of a human vaccine..
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Managing the Health effects of Climate Change (The Lancet.com)
A collaboration between The Lancet and University College London, UK, resulting in the first UCL Lancet Commission report, setting out how climate change over the coming decades could have a disastrous effect on health across the globe. The report examines practical measures that can be taken now and in the short and medium term to control its effects.
Executive summary
Climate change could be the biggest global health threat of the 21st century. Effects on health of climate change will be felt by most populations in the next decades and put the lives and wellbeing of billions of people at increased risk. During this century, the earth's average surface temperature rises are likely to exceed the safe threshold of 2°C above pre-industrial average temperature.
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Ethiopia extends health to its people. An interview with Dr Tedros A Ghebreyesus (WHO Bulletin, July 2009)
Q: In 2005, Ethiopia's total health expenditure per capita was about US$ 6, much lower than the average US$ 24 for sub-Saharan countries. Has this increased?
A: Government health expenditure increased to 11% from 7% of the total budget three years ago. External resources and partners' contributions have also increased. The issue of long-term sustainability is well recognized by our government and that is why we have been prudent in choosing where to target our investments. We are investing in high impact low-cost interventions aimed at addressing the most pressing health problems. Hence, the priority we have given to primary health care delivery. By the end of 2008, we had trained and deployed 30 190 health extension workers. By engaging health extension workers as full-time salaried civil servants, we have moved away from volunteerism and this has been a key success factor.
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No change in WHO position on DDT (6 June 2009, www.mediaglobal.org)
Despite controversy over the safety of dichlorodiphenyltrichloroethane (DDT) to curb the spread of malaria, the World Health Organization (WHO) has been an advocate of its use in the past. This month the United Nations and WHO have announced their research objectives to reduce DDT use by 30 percent by 2014, phasing it out completely by 2020.
... DDT has been linked to harmful environmental effects, like the thinning of bird eggs, since it was first used as an insecticide in 1935. WHO began to support its use to eradicate malaria-carrying mosquitoes in the 1950s and 1960s, which led to a reduction in malaria transmission throughout the world and, according to WHO literature, “was probably instrumental in eradicating the disease from Europe and North America.” WHO maintains their stance that, when used indoors, “DDT poses very little if any environmental threat.”
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The mosquito catchers (Down to Earth, June 2009)
OVER the last few years, people from some villages of Orissa got used to a team of researchers knocking on their doors at five in the morning. The team was on a mission to collect mosquitoes to study the insects' role in the transmission of malaria in the area.
The team would enter houses and use sucking tubes to collect mosquitoes.
... “Any malaria control strategy has to consider aspects like distribution and identification of the vectors and their host preferences besides their susceptibility to insecticides. Now all this will be easy,” said Rupenangshu Hazra, a team member. Details of the technology are to be published in the coming issue of Transactions of the Royal Society of Tropical Medicine and Hygiene.
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Combating one of Africa's most neglected tropical diseases (www.mediaglobal.org, 29 May 2009)
Signaling a change in the current treatment of human African trypanosomiasis (HAT), the Drugs for Neglected Disease Initiative (DNDi), has announced two potential treatment options to replace current “toxic” and even life-threatening therapies.
According to DNDi, the treatment option of fexinidazole is ready to enter its clinical trial on humans, while the Nifurtimox eflornithine combination therapy (NECT), has been approved by the World Health Organization (WHO) with the roll-out planned in endemic countries for later in the year. ...
... According to DNDi, the sleeping sickness threatens 60 million people in 36 countries with the brunt of the disease impacting the vulnerable region of sub-Saharan Africa.
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Who runs global health? (The Lancet, 20 June 2009)
The past two decades have seen dramatic shifts in power among those who share responsibility for leading global health. In 1990, development assistance for health—a crude, but still valid measure of influence—was dominated by the UN system (WHO, UNICEF, and UNFPA) and bilateral development agencies in donor countries. Today, while donor nations have maintained their relative importance, the UN system has been severely diluted. This marginalisation, combined with serious anxieties about the unanticipated adverse effects of new entrants into global health, should signal concern about the current and future stewardship of health policies and services for the least advantaged peoples of the world.
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AFGHANISTAN: NGOs squeezed out of funding appeals – analysis (IRIN, 25 June 2009)
The Afghanistan Humanitarian Action Plan (HAP) 2009 launched on 3 February in Geneva by John Holmes, the UN under–secretary–general and emergency relief coordinator, requested US$625 million and is just under 70 percent funded, but little HAP funding has gone to NGOs.
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Why the world needs global health initiatives (WHO, 22 June 2009)
Dr Margaret Chan’s (Director-General of the World Health Organization) address at the high-level dialogue on maximizing positive synergies between health systems and global health initiatives in Venice, Italy
Global health initiatives were established with a strong sense of purpose and great ambition. They set out to save lives, on an emergency basis, even though not everything was known at the start about everything that needed to be done, or the best way to do it.
There were risks, and there were missed opportunities, which better planning might have prevented. But there was also courage, or to use words from the report, “an invigorating sense of ambition and purpose.”
And there was a clear moral imperative to act. The AIDS epidemic demonstrated the relevance of equity and universal access in a substantial way. With the advent of antiretroviral therapy, an ability to access medicines and services became equivalent to an ability to survive for many millions of people.
This is the essence of the equity argument: people should not be denied access to life-saving interventions for unfair reasons, including an inability to pay.
These global health initiatives have gathered knowledge along the way, and in so doing, they have shed light on a cause of much ill health in this world: weak and inequitable health systems.
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Right-to-health responsibilities of pharmaceutical companies (The Lancet, 13 June 2009)
Almost 2 billion people worldwide lack access to essential medicines. The human rights responsibility to improve access lies mainly with the state. However, non-state actors, such as the pharmaceutical industry, share that responsibility too. On June 3, a UN independent human rights report on the practices and policies of GlaxoSmithKline (GSK) in relation to their right-to-health responsibilities and access to medicines was presented to the UN Human Rights Council. It is the first time that such a mission on a pharmaceutical company has ever been done. GSK should be commended for subjecting themselves to the process.
Paul Hunt‘s report can be downloaded at http://www.reports-and-materials.org
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Gates Foundation Invests in 81 Unconventional Global Health Research Projects (www.grandchallenges.org, 4 May 2009)
The Bill & Melinda Gates Foundation today announced 81 grants of US$100,000 each to explore bold and largely unproven ways to improve health in developing countries. The grants were awarded to researchers in 17 countries through the foundation’s Grand Challenges Explorations initiative, which aims to develop a pipeline of creative ideas that could change the face of global heath.
The projects focus on novel approaches to prevent and treat infectious diseases, such as HIV, malaria, tuberculosis, pneumonia, and diarrheal diseases. The first round of 104 Grand Challenges Explorations grants was announced in October 2008.
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Greater equity in health should be a progress indicator (http://www.who.int/en/, 15 June 2009)
WHO Director–General Dr Margaret Chan today, speaking at the UN Headquarters in New York identified three issues that need to be highlighted to promote health: maintain the current momentum for health development. Second, do so with a firm focus on fairness. And third, need for transformational policy changes in the international systems that govern this world.
According to her the world is in the midst of the most ambitious drive in history to reduce poverty and to reduce the great gaps in health outcomes.
"The need to stay the course is greater today than ever before. Precisely because of these global crises, the price of failure keeps getting higher.
The crises we face are global, but the consequences are not evenly felt. Developing countries have the greatest vulnerability and the least resilience. They will be hit the hardest and take the longest to recover."....
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Pandemic alert level 6: sustained community transmission of influenza A(H1N1)v virus in two different WHO regions (Eurosurveillance, 11 June 2009)
The World Health Organisation (WHO) today announced the decision to raise the level of influenza pandemic alert from phase 5 to phase 6 [1]. This makes the current influenza A(H1N1)v outbreak officially a pandemic.
In its press conference at 18:00 CETS, the WHO emphasised that the severity of the pandemic is, at least currently, moderate. Countries are advised to concentrate on mitigation measures as appropriate for their specific situation. They are not advised to close borders or restrict international traffic and trade as there is no evidence that these measures stop the spread of the disease and are unnecessarily disruptive for international traffic and trade.
At the same time, vaccine manufacturers are working on the production of influenza vaccine specific for the pandemic strain.
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WHO Recommends Global Use of Rotavirus Vaccines (allafrica.com, 5 June 2009)
The World Health Organization (WHO) has recommended that rotavirus vaccination be included in all national immunization programmes in order to provide protection against a virus that is responsible for more than 500,000 diarrheal deaths and two million hospitalizations annually among children. More than 85 percent of these deaths occur in developing countries in Africa and Asia. This new policy will help ensure access to rotavirus vaccines in the world's poorest countries.
... The clinical trial investigators from Malawi and South Africa will present and publish their data on the GSK Rotarix™ vaccine later this summer. Clinical trial sites in Bangladesh and Vietnam--along with sites in Ghana, Mali, and Kenya--evaluated the performance of Merck's rotavirus vaccine, RotaTeq®, and data are expected in Fall 2009. While efficacy data from Asian countries are forthcoming, SAGE recommended rotavirus vaccines for all populations, including Asia, since available evidence indicates that efficacy data can be extrapolated to populations with similar mortality patterns, regardless of geographic location.
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A Broken Trust: Lessons from the Vaccine–Autism Wars (PLOS Biology, 26 May 2009)
...
Despite overwhelming evidence that vaccines don't cause autism, one in four Americans still think they do. Not surprisingly, the first half of 2008 saw the largest US outbreak of measles–one of the first infectious diseases to reappear after vaccination rates drop–since 2000, when the native disease was declared eliminated. Mumps and whooping cough (pertussis) have also made a comeback. Last year in Minnesota, five children contracted Hib, the most common cause of meningitis in young children before the vaccine was developed in 1993. Three of the children, including a 7-month-old who died, hadn't received Hib vaccines because their parents either refused or delayed vaccination.
.... Until researchers get a better handle on the causes of autism, Baker thinks scientists need to find a way to make dry scientific results as compelling as anecdotal case studies. The studies that are "most elegant to a scientist," he says, are just much harder for most parents to understand than what happens to an individual child.
Rachel Casiday, a medical anthropologist at the Centre for Integrated Health Care Research at Durham University, UK, who studied British parents' attitudes toward MMR, says scientists should not underestimate the importance of narrative. People relate much more to a dramatic story–"he got his vaccination, he stopped interacting, and he hasn't been the same since"–than they do to facts, risk analyses, and statistical studies. "If you discount these stories, people think you have an ulterior motive or you're not taking them seriously," she explains. Casiday suggests providing an alternative, science-based explanation or relating emotionally compelling tales about counter-risk–such as helplessly watching a young child die of a vaccine-preventable disease–in the same narrative format.
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Moving closer to a new tuberculosis vaccine (The Lancet Infectious Diseases, March 2009)
This month sees the start of a phase IIb proof-of-concept efficacy trial of the MVA85A candidate tuberculosis vaccine in around 2800 infants at the South African Tuberculosis Vaccine Initiative field site in Worcester, Western Cape, South Africa. Clinical trials of other candidates are also underway, and it seems possible that the first new tuberculosis vaccine for nearly 90 years could be available in less than a decade.
"We can anticipate a definitive phase III trial for licensure perhaps as early as 2012, with actual licensure possibly by 2016", commented Jerry Sadoff, President of the Aeras Global TB Vaccine Foundation (Rockville, MA, USA)
In the planned proof-of-concept trial co-funded by the Wellcome Trust and Aeras, 4-month-old BCG-vaccinated infants will be randomised to receive either MVA85A or placebo. "We will determine the incidence of tuberculosis disease in each group over 2 years, and expect results in 2011–12", reports Helen McShane (University of Oxford, UK), who is coordinating the trial. McShane told TLID that, if successful, this would lead to a larger phase III licensure trial at several sites. This type of trial is powered to discover if the new vaccine is 60% more effective than BCG alone. "With this degree of efficacy, a new vaccine could enable us to reduce tuberculosis incidence to less than one per million people by 2050", predicted Sadoff.
... Close behind MVA85A, in terms of clinical development, is the AERAS-402/Crucell Ad35 recombinant adenovirus vaccine. This non-replicating adenovirus expresses three mycobacterial antigens: Ag85A, Ag85B, and Tb10.4. Designed as a boost to BCG or recombinant BCG, it has already been tested in American and African adults and infants, and phase IIB trials in South Africa are planned. One of the most promising aspects of this vaccine is the observation that introducing 2–4 ?m sized viral particles containing AERAS-402 directly and deeply into the lung induces high levels of cellular immunity. "Inducing an immune response that recognises infected cells and kills organisms when they first enter the lung could prevent infection at its very onset", commented Sadoff. ...
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Climate change and infectious diseases in Europe (The Lancet Infectious Diseases, June 2009)
Concerted action is needed to address public health issues raised by climate change. This Review discusses infections acquired through various routes (arthropod vector, rodent, water, food, and air) in view of a changing climate in Europe. Based on an extensive review of published work and expert workshops, the authors present an assessment of the infectious disease challenges: incidence, prevalence, and distribution are projected to shift in a changing environment. Due to the high level of uncertainty on the rate of climate change and its impact on infectious diseases, they propose to mount a proactive public health response by building an integrated network for environmental and epidemiological data. This network would have the capacity to connect epidemic intelligence and infectious disease surveillance with meteorological, entomological, water quality, remote sensing, and other data, for multivariate analyses and predictions. Insights from these analyses could then guide adaptation strategies and protect population health from impending threats related to climate change.
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Nigerian authorities warn of malaria parasites' growing resistance to drugs (ASNS News, 7 June 2009)
Nigeria's National Agency for Food and Drug Administration and Control (NAFDAC) has said there was emerging evidence that resistant strains of malaria against effective drugs was spreading, warning that Artemisin-based Combination Therapies (ACTs) is not excluded.
Dr. Paul Orhi, Director General of NAFDAC, is quoted in the local press that the main reason for this was because people were not taking proper doses and that hey still use monotherapy instead of combining two drugs appropriately.
"It is a big problem round the world now when people take suboptimal dosage of anti-malarial drug, it develops resistance. Once it develops resistance for malaria, there is no other treatment for malaria and many people will have to die", Obi said.
... He said international scientists say they have found the first evidence of resistance to the world's most effective drug for treating malaria.
They say the trend in western Cambodia has to be urgently contained because full-blown resistance would be a global health catastrophe.
Drugs are taking longer to clear blood of malaria parasites than before. This is an early warning sign of emerging resistance to a disease, which kills a million people every year.
The World Health Organisation (WHO) warned in 2006 there was a possibility the malaria parasite could develop a resistance to artemesinin drugs and that there was particular concern about a decreased sensitivity to the drug being seen in Southeast Asia.
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Immediate funding required to protect health of 3 million people displaced in Pakistan (WHO, 3 June 2009)
Immediate funding is needed for national and international health providers in Pakistan so they can provide life-saving health care to the more than 3 million internally displaced people now residing in temporary camps and in host communities in the country's northwest.
The World Health Organization, UNICEF, UNFPA and 19 non-government organizations, who form the Health Cluster, are requesting US$ 37 million in the revised Pakistan Humanitarian Response Plan (PHRP) to provide and manage medicines, comprehensive Primary Health Care services, monitoring of the disease situation, health and hygiene promotion, testing of drinking water supplies and strengthening the secondary and tertiary level healthcare services to avert a humanitarian disaster.
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West African meningitis outbreak strains vaccine supplies (The Lancet, 30 May 2009)
With the meningitis outbreak this year having killed more than 2500 people in Africa's so-called meningitis belt, shortage of vaccines has been blamed for the high case fatality rate (CFR) seen in some countries.
The International Coordination Group (ICG)—the WHO-led interagency group that coordinates meningitis vaccines—said by the end of April it had approved 9.1 million doses of vaccine from "the limited global stockpile" for the outbreak. This was much higher than the 2 million doses approved for the entire 2007–08 season. ...
... According to UNICEF, the countries most affected by the epidemic were Nigeria, Niger, Burkina Faso, and Chad. Early in May, the Nigerian Health Ministry reported that the meningitis outbreak in the country had been more serious than initially thought. The ministry said 2148 people had died since December, 2008, and the number of reported cases stood at 47 902.
Marie Yherese Guigui Zoundi, health specialist at UNICEF for West and Central Africa, said in Burkina Faso the CFR has been higher than usual because the bacterium causing meningitis is the pneumococcus, which seems to be more virulent than the meningococcus bacterium involved in other countries.
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New issue of EpiNorth Journal is online (Eurosurveillance, 28 May 2009)
EpiNorth Journal is published in English and Russian, on-line and in print (3,500 copies) four times a year. It is one of the products of the EpiNorth project (www.epinorth.org), a network co-funded by the European Centre for Disease Prevention and Control (ECDC) and the Norwegian Institute of Public Health.
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Preparation for a pandemic: influenza A H1N1 (The Lancet, June 2009)
Influenza A H1N1 (swine flu) has spread around the world with what has, at times, felt like horrifying speed, but there is a feeling that many of us have dodged a bullet. Of the 2384 laboratory-confirmed cases reported in 24 countries, as TLID went to press, there had been 44 deaths, 42 of which were in Mexico. These numbers are far lower than the annual toll from seasonal influenza, which kills hundreds of people every day in the peak season.
... The threats of severe acute respiratory syndrome (SARS) and H5N1 a few years ago prompted the world to set up plans to deal with the possibility that these viruses would, by developing sustained human-to-human transmission, trigger a pandemic. The chaos caused by the outbreaks revealed just how badly countries around the world-increasingly linked by frequent international travel and growing globalisation-were prepared to deal with a worldwide infectious disease pandemic. Pandemic preparedness has come a long way since those two viruses caused worldwide alarm, says Sandra Mounier-Jack (London School of Hygiene and Tropical Medicine, London, UK) but there are holes in many countries' plans.
... In 2004, Richard Webby and Robert Webster (St Jude Children's Research Hospital, TN, USA) raised a note of concern that in 1998 swine H1N1 had recombined with human and bird viruses. They warned that "the growing complexity of influenza at this animal-human interface and the presence of viruses with a seemingly high affinity for reassortment makes the US swine population an increasingly important reservoir of viruses with human pandemic potential".
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Child health leaders call for day to unite against pneumonia, world's top child iller (http://www.gavialliance.org/: Baltimore, MD, 7 April 2009)
Pneumonia kills more children than AIDS, malaria and measles combined. UNICEF and WHO estimate that pneumonia accounts for nearly 1 out of 5 deaths in children under five years old. For each child who dies from pneumonia in an industrialized country, more than 2000 children die from pneumonia in developing countries.
"In wealthier countries, we don't often see life-threatening child pneumonia. It's easy to forget that around the world, pneumonia is still killing more than 5500 kids every day," said Dr. Orin Levine, a pneumonia expert and associate professor at Johns Hopkins Bloomberg School of Public Health.
"Pneumonia is both common and extremely serious, but with existing tools like vaccines and antibiotics, we can save more than a million children every year."
Read more
A Broken Trust: Lessons from the Vaccine–Autism Wars (PLOS Biology, 26 May 2009)
...
Despite overwhelming evidence that vaccines don't cause autism, one in four Americans still think they do. Not surprisingly, the first half of 2008 saw the largest US outbreak of measles—one of the first infectious diseases to reappear after vaccination rates drop—since 2000, when the native disease was declared eliminated. Mumps and whooping cough (pertussis) have also made a comeback. Last year in Minnesota, five children contracted Hib, the most common cause of meningitis in young children before the vaccine was developed in 1993. Three of the children, including a 7-month-old who died, hadn't received Hib vaccines because their parents either refused or delayed vaccination.
.... Until researchers get a better handle on the causes of autism, Baker thinks scientists need to find a way to make dry scientific results as compelling as anecdotal case studies. The studies that are "most elegant to a scientist," he says, are just much harder for most parents to understand than what happens to an individual child.
Rachel Casiday, a medical anthropologist at the Centre for Integrated Health Care Research at Durham University, UK, who studied British parents' attitudes toward MMR, says scientists should not underestimate the importance of narrative. People relate much more to a dramatic story–"he got his vaccination, he stopped interacting, and he hasn't been the same since”–than they do to facts, risk analyses, and statistical studies. "If you discount these stories, people think you have an ulterior motive or you're not taking them seriously," she explains. Casiday suggests providing an alternative, science-based explanation or relating emotionally compelling tales about counter-risk–such as helplessly watching a young child die of a vaccine-preventable disease–in the same narrative format.
West African meningitis outbreak strains vaccine supplies (The Lancet, 30 May 2009)
With the meningitis outbreak this year having killed more than 2500 people in Africa's so-called meningitis belt, shortage of vaccines has been blamed for the high case fatality rate (CFR) seen in some countries.
The International Coordination Group (ICG)–the WHO-led interagency group that coordinates meningitis vaccines–said by the end of April it had approved 9.1 million doses of vaccine from "the limited global stockpile" for the outbreak. This was much higher than the 2 million doses approved for the entire 2007–08 season. ...
... According to UNICEF, the countries most affected by the epidemic were Nigeria, Niger, Burkina Faso, and Chad. Early in May, the Nigerian Health Ministry reported that the meningitis outbreak in the country had been more serious than initially thought. The ministry said 2148 people had died since December, 2008, and the number of reported cases stood at 47 902. Marie Yherese Guigui Zoundi, health specialist at UNICEF for West and Central Africa, said in Burkina Faso the CFR has been higher than usual because the bacterium causing meningitis is the pneumococcus, which seems to be more virulent than the meningococcus bacterium involved in other countries.
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UN Calls for AIDS Law Reform (Voice of America, 21 April 2009)
The United Nations is calling for governments in Asia, many with tough anti-drug laws, to review their legislation to allow for alternative drug treatments and policies in an effort to reduce the spread of the AIDS virus across the region.
... Across Asia there are about five million people living with the AIDS virus, with the highest rates of infection in South East Asia.
A director for the UNAIDS in Asia and the Pacific, Prasada Rao, says law reform is necessary to reduce the spread of the AIDS pandemic, especially through injecting drug users.
The United Nations is advocating methods of "harm reduction", such as injecting needle exchange and drug substitution programs through the use methadone, to reduce the spread of the virus. Such programs reduce the transmission of the virus that otherwise would occur by way of infected needles.
Such programs have been successful in Australia and have been adopted in Taiwan, Bangladesh and Vietnam. In Taiwan, new infection rates dropped by 70 percent during the past two years. ...
"It is high time that harm reduction has been brought to the forefront as an important tool, as an important strategy in the prevention of HIV," ...
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Are you number 12? (http://www.worldhepatitisday.org/)
One in 12 people around the world are infected with Hepatitis B (HBV) or C (HCV). On May 19 Hepatitis day was observed worldwide to create awareness about the disease. The activities around this day are being coordinated by the World Hepatitis Alliance, an NGO representing almost 200 hepatitis B and hepatitis C patient groups from around the world. The global campaign's theme is "Am I Number 12?"
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UN, WHO heads meet vaccine manufacturers (WHO, 19 May 2009)
WHO Director-General Dr Margaret Chan and United Nations Secretary-General Ban Ki-moon met with over 30 vaccine manufacturers from developing and developed countries at WHO headquarters today.
Both the Director-General and the Secretary-General stressed the importance of assuring that any eventual vaccine for Influenza A(H1N1) was made available in a spirit of equity and fairness, and invited the manufacturers to continue to work with them to develop a strategy for this. Industry representatives affirmed their wish to cooperate in making supplies available to developing countries, and said they stood ready to produce the vaccine when requested.
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'Malaria deaths occur where political power ends' (InfoChange News & Features, May 2009)
Community health activists have come out strongly against recent changes in the Indian government's drug policy for treatment of the deadly falciparum malaria, which is responsible for almost all deaths due to malaria in India. ...
Some of the changes in the national vector-borne disease control programme's new National Drug Policy on Malaria (2008) are particularly worrisome. Artemesinin, an expensive drug of last resort, will be given as first-line treatment for all proven falciparum malaria cases in certain states - even when chloroquine might be the best choice. All studies on the malaria parasite's sensitivity to various drugs such as chloroquine and sulphadoxine-pyrimethamine will be stopped. Expensive rapid diagnostic tests are promoted in place of microscopy. Pregnant women will no longer receive preventive drugs, taking away whatever little protection they used to receive from this important cause of maternal mortality. Finally, the changed treatment protocols, as well as new guidelines for treating complications in severe malaria, are to be implemented by a health system that doesn't have the necessary infrastructure, personnel or other facilities.
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Digital Disease Detection - Harnessing the Web for Public Health Surveillance (The New England Journal of Medicine, 21 May 2009)
Over the past 15 years, Internet technology has become integral to public health surveillance. Systems using informal electronic information have been credited with reducing the time to recognition of an outbreak, preventing governments from suppressing outbreak information, and facilitating public health responses to outbreaks and emerging diseases. Because Web-based sources frequently contain data not captured through traditional government communication channels, they are useful to public health agencies, including the Global Outbreak Alert and Response Network of the World Health Organization (WHO), which relies on such sources for daily surveillance activities.
Early efforts in this area were made by the International Society for Infectious Diseases' Program for Monitoring Emerging Diseases, or ProMED-mail, which was founded in 1994 and has grown into a large, publicly available reporting system, with more than 45,000 subscribers in 188 countries.2 ProMED uses the Internet to disseminate information on outbreaks by e-mailing and posting case reports, including many gleaned from readers, along with expert commentary. In 1997, the Public Health Agency of Canada, in collaboration with the WHO, created the Global Public Health Intelligence Network (GPHIN), ...
More recently, the advent of openly available news aggregators and visualization tools has spawned a new generation of disease-surveillance "mashups" (Web application hybrids) that can mine, categorize, filter, and visualize online intelligence about epidemics in real time. For instance, HealthMap (see image) is an openly available public health intelligence system that uses data from disparate sources to produce a global view of ongoing infectious disease threats. It has between 1000 and 150,000 users per day, including public health officials, clinicians, and international travelers. Other similar systems include MediSys, Argus, EpiSPIDER, BioCaster, and the Wildlife Disease Information Node. Automated analysis of online video materials and radio broadcasts will soon provide additional sources for early detection.
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Avian influenza A(H5N1) - current situation (Eurosurveillance, 7 MAY 2009)
The A(H5N1) influenza virus has re-emerged in 2003 in Asia, Africa, the Pacific Region as well as Europe and since then has become endemic in some countries. The virus is usually highly pathogenic and is associated with high morbidity and overall mortality rates that reach 61%. The cumulative number of confirmed human cases from 2003 to 2009 is 423 cases, with 258 deaths [1]. During the current year, sporadic human infections have occurred only in Egypt, China and Vietnam. In Egypt, no deaths have been reported from a total of 17 confirmed human cases in 2009, which could be an indication of altered pathogenicity of the circulating strains.
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MMWR DISPATCH REPORTS ON H1N1 INFLUENZA IN THREE PREGNANT WOMEN (MMWR, 12 May 2009)
As part of surveillance for infection with the novel influenza A (H1N1) virus, CDC initiated surveillance for pregnant women who were infected with the novel virus. As of May 10, a total of 20 cases of novel influenza A (H1N1) virus infection had been reported among pregnant women in the United States, including 15 confirmed cases and five probable cases.* Among the 13 women from seven states for whom data are available, the median age was 26 years (range: 15--39 years); three women were hospitalized, one of whom died. This report provides preliminary details of three cases of novel influenza A (H1N1) virus infection in pregnant women. Pregnant women with confirmed, probable, or suspected novel influenza A (H1N1) virus infection should receive antiviral treatment for 5 days. ...
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A preliminary estimation of the reproduction ratio for new influenza A(H1N1) from the outbreak in Mexico, March-April 2009 (Eurosurveillance, 14 May 2009)
Influenza A(H1N1)
WHO is coordinating the global response to human cases of influenza A(H1N1) and monitoring the corresponding threat of an influenza pandemic.
This section contains information on the evolving situation, technical guidance and information for the general public.
http://www.cdc.gov/h1n1flu/For comprehensive information regarding novel influenza A (H1N1) virus.
U.S. Human Cases of H1N1 Flu Infection
U.S. Human Cases of H1N1 Flu Infection
(As of May 13, 2009, 11:00 AM ET) States*
Laboratory confirmed cases Deaths
45 states* 3352 cases 3 deaths
This table is updated daily Monday-Friday at around 11 AM ET.
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Britain 'not covered' for swine flu epidemic (The Independent, 15 May 2009)
Britain will not be able to vaccinate the whole population against a potential winter epidemic of swine flu, Alan Johnson, the Health Secretary, admitted yesterday.
Mr Johnson told the Commons it might take up to six months before a vaccine could be available for use but it would be well into 2010 before sufficient quantities could be delivered for the whole country.
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World Malaria Day celebrates progress made towards wiping out the disease (UNICEF, 24 April 2009)
On the eve of World Malaria Day, 25 April, a new report co-sponsored by UNICEF shows that the world is on the verge of banishing malaria to the sidelines of serious global health issues....
The report - 'Malaria and Children: Progress in Intervention Coverage' - was issued by UNICEF, the Roll Back Malaria Partnership and the Global Fund to Fight AIDS, Tuberculosis and Malaria....
But despite this progress, malaria still kills an estimated 1 million people every year - most of them children in Africa - and affects the health of more than 50 million pregnant women annually.
"The report shows financing is now available to purchase enough nets to put Africa well on the way to achieving universal coverage by 2010," ....
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World Malaria Day 2009 Media Coverage
Child health leaders call for day to unite against pneumonia, world's top child iller (http://www.gavialliance.org/: Baltimore, MD, 7 April 2009)
Pneumonia kills more children than AIDS, malaria and measles combined. UNICEF and WHO estimate that pneumonia accounts for nearly 1 out of 5 deaths in children under five years old. For each child who dies from pneumonia in an industrialized country, more than 2000 children die from pneumonia in developing countries.
"In wealthier countries, we don't often see life-threatening child pneumonia. It's easy to forget that around the world, pneumonia is still killing more than 5500 kids every day," said Dr. Orin Levine, a pneumonia expert and associate professor at Johns Hopkins Bloomberg School of Public Health.
"Pneumonia is both common and extremely serious, but with existing tools like vaccines and antibiotics, we can save more than a million children every year."
Read more