Global cooperation crucial to achieving MDGs, nations tell UN

Meeting the Millennium Development Goals (MDGs), eight ambitious anti-poverty targets agreed on by world leaders, by their 2015 deadline will require concert global cooperation, nations have told the General Assembly’s high-level annual debate.

Norway pointed out that the financial crisis has pushed millions into poverty. “Loss of income is placing public policies at perilous risk, potentially undermining services on which the poorest and weakest depend the most, such as health and education,” said Foreign Minister Jonas Gahr Støre.

The international community, said Denmark’s ambassador to the United Nations, must assist the world’s poorest in mitigating the effects of the global recession as well as to achieve development aims.

The lack of progress in improving maternal health is “the most disgraceful underachievement” to date, said Mr. Støre.  “Strengthening health services is key for reducing mother and child mortality, and is also a vital element in realizing the rights of women and children.”

Malaria parasite’s resistance to top drug grows

The World Health Organisation last week warned that the parasite which causes malaria is increasingly resistant to artemisinin, the best drug around, and failure to contain this trend would bring serious consequences.

“This (Asia Pacific) region has traditionally been the focus of resistance to antimalarial drugs and now we have artemisinin resistance primarily on the Thai-Cambodian border,” said John Ehrenberg, WHO regional adviser on malaria and other vectorborne and parasitic diseases.

From WHO's World Malaria Report, 2008

Artemisinin, derived from the sweet wormwood shrub, is the best drug available but misuse and over-prescription have led to the parasite becoming resistant to it.

The best way to prolong the use of the drug would be to use it in combination with other antimalarial drugs. Nearly all the Asia Pacific region countries that suffer most from the disease pledged on Wednesday to do that.

The 10 countries are Cambodia, China, Laos, Malaysia, Papua New Guinea, the Philippines, South Korea, Solomon Islands, Vanuatu and Vietnam. In 2008, these 10 states reported 248,141 confirmed cases of malaria and 1,005 deaths.

Under the agreement, the use of artemisinin alone for treating malaria must be banned by 2015.  All 10 states will also help fight counterfeit antimalarial drugs, again a major cause of deaths.

In recent years, parts of Asia have been awash with fake antimalarial drugs. They contain little or no active ingredient that would fight the disease and many people have died because of that. Some of the fakes have been traced back to illegal factories in China, according to experts.

Although malaria is preventable and treatable, there were still between 189 million to 327 million cases in 2006, resulting in between 610,000 to 1.2 million deaths.

“If it is not contained, it can have global implications and the most serious one would be in Africa which has a high disease burden and the highest mortality rates,”  said Ehrenbergh on the sidelines of a regional meeting of the WHO in Hong Kong.

Half the world’s population is at risk, particularly the poor and those living in remote areas with limited healthcare access. A child dies from malaria every 30 seconds.

HIV vaccine trial cuts infection by 31.2%

A Phase III clinical trial involving more than 16,000 adult volunteers in Thailand has demonstrated that an investigational HIV vaccine regimen was safe and modestly effective in preventing HIV infection. According to final results released by the trial sponsor (the U.S. Army Surgeon General), the prime boost combination of Sanofi Pasteur’s ALVAC vaccine and AIDSVAX, developed by VaxGen and now owned by the Global Solutions for Infectious Diseases, lowered the rate of HIV infection by 31.2% compared with placebo.

More than 16,000 HIV-negative men and women between the ages of 18 to 30 participated in the study; half of these participants received the prime-boost vaccine regimen and half received placebo. Volunteers received vaccinations over the course of six-months and were followed for an additional three-years.

“This is the first HIV vaccine candidate to successfully reduce the risk of HIV infection in humans. We are very excited and pleased with the outcome of this trial and congratulate all those who participated in it,” said Lieutenant General Eric Schoomaker, Surgeon General, U.S. Army. “In addition, this study is an outstanding example of international and interagency collaboration involving many partners from the Thai and U.S. governments, private companies, non-profit organizations and volunteers.”

“The study results, representing a significant scientific advance, are the first demonstration that a vaccine can prevent HIV infection in a general adult population and are of great importance,” the World Health Organization (WHO) and the Joint UN Programme on HIV/AIDS (UNAIDS) said in a statement, calling the results of the trial encouraging.

Michel DeWilde, R&D senior vice president for Sanofi Pasteur, noted that “albeit modest, the reduction of risk of HIV infection is statistically significant” and “this is the first concrete evidence, since the discovery of the virus in 1983, that a vaccine against HIV is eventually feasible”.

In the final analysis, 74 placebo recipients became infected with HIV compared to 51 in the vaccine regimen arm.

UN report on patents and innovation

“History has shown… that companies and countries which continue to invest in new products and innovation during times of economic recession will be those that will be best positioned to take advantage of the recovery, when it arrives,” said WIPO Director General Francis Gurry.

Demand for international trademarks and patents dropped last year in the wake of the global economic crisis.  A report by the World Intellectual Property Organization (WIPO) points to weaker growth in patent filings in 2008, after a 3.7 per cent increase in 2007.

“What happens in an economic crisis is that there’s an interference in the value chain of intellectual property,” said Gurry.

Thus reduced profits from innovation lead to reduced investment in research and development and reduced applications for patent filings and trademarks.

But the trend is not uniform across countries and the WIPO report points to the growing use by East Asian countries, such as China, as its enterprises and universities become familiar with the international patent system.  China’s State Intellectual Property Office (SIPO) office has replaced the EPO as the fourth largest issuer of grants behind offices in Japan, the US, and the Republic of Korea.

Innovative vaccine venture offers hope to less-developed countries

Britain’s largest charity, the Wellcome Trust, and pharmaceutical company Merck & Co. 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.”  According to Nature News, “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.”

Wellcome Trust Director Mark Walport said, “Linking the ingenuity of academic research with the know-how of industry is vital if we are to produce a new generation of vaccines to reduce the burden of infectious diseases in low-income countries.”

The joint venture has yet to decide which diseases it will tackle, but will base the decisions on criteria such as scientific and technical feasibility, affordability and whether vaccine formulations will meet the field and other needs of the large procurement agencies such as the WHO, the United Nations Children’s Fund (UNICEF) and the GAVI Alliance.

“Affordability will be key in the technical and other choices all along the product design and development path,” said Mark Feinberg, Merck’s vice president of medical affairs and policy. “We really want to lower a lot of the barriers that exist for developing promising products.”  The center is expected to open by the end of the year.

U.S. and other countries make H1N1 vaccine available internationally through the WHO

The United States joins Australia, Brazil, France, Italy, New Zealand, Norway, Switzerland and Britain in efforts to make the H1N1 vaccine available to less-developed countries.  The White House announced yesterday that they are prepared to make 10 percent of America’s H1N1 vaccine supply available to other countries through the World Health Organization.

The recent news that a single dose of H1N1 vaccine can protect adults against the virus has sparked conversations between the WHO and developed countries about sharing their vaccine stockpiles with developing countries.

The White House said it would make the vaccine available to the WHO on a rolling basis as vaccine supplies become available, to assist countries that might not have direct access to the vaccine.  The vaccine is expected to be available in the coming weeks, earlier than originally anticipated.

Millions of people around the world have been infected with the H1N1 vaccine, thousands have died and the virus continues to spread across international borders.

Mapping out the fight against malaria

One of the biggest challenges in the fight against malaria is knowing where to hand out the nets since not all mosquitoes transmit the disease. Researchers at the University of Ottawa are using satellite mapping to better direct the distribution of aid resources.

To generate their maps of malaria-risk areas, the scientists use a process called ecological niche modelling.  This begins with inputting locations where the researchers and others have already found the insects.  To this they add climate data and the information from their infrared analysis of vegetation.  These “data layers” are analyzed together in a computer program that ultimately spits out a map of where mosquitoes live.

A satellite picture taken from 700 kilometres above the Earth shows agricultural and irrigated land in Tanzania. Researchers Jeremy Kerr and Manisha Kulkarni used the map to track the local mosquito population, and accurately predicted where it would be most dense. Their research allowed them to target the village of Kiruani, seen as an oblong orange strip in this image, just below the large orange ring surrounding Mount Kilimanjaro.

ABOUT MALARIA

TRANSMISSION: From bites of mosquitoes infected with the plasmodium parasite.

SYMPTOMS: Fever, headache, chills and vomiting usually appear 10 to 15 days after a person is infected.

TREATMENT: Early treatment with a combination of drugs known as artemisinin-based combination therapies averts most deaths. However, parasite resistance to the drugs is growing.

COST: In heavily afflicted countries, malaria accounts for up to 40 per cent of public health expenditures, including 30 per cent to 50 per cent of in-patient hospital admissions.

HOW IT KILLS: The microscopic parasites infect red blood cells and cause knobs of proteins to appear on the surface of the cells. These knobs encourage the red cells to stick together in formations called rosettes. The rosettes in turn stick to the blood vessels’ walls in a condition known as cytoadherence.

Clumps of red blood cells lodge in the vital organs and the brain, interfering with circulation and organ function. When the brain is involved, the disease is called cerebral malaria, and often leads to death.

Those who do not die may suffer blindness, speech problems or deafness.

TRAVELLERS: Visitors from malaria-free areas to disease “hot spots” are especially vulnerable because they have little or no immunity. Preventative drug regimens are recommended.

Counterfeit malaria drugs kill thousands in Africa

MediaGlobal (a global news agency, based in the United Nations Secretariat) recently reported on the WHO’s increasing efforts to combat counterfeit medications in Africa — and the deadly impact of these fakes.

The World Health Organization (WHO) has stepped up their efforts to combat the creation and distribution of counterfeit malaria pills in Africa.  WHO estimates that upwards of 2,000 children a day are being killed as a result of taking these phony medications.  Dr. Lembit Rago, Coordinator of WHO Essential Medicines and Pharmaceutical Policies, told MediaGlobal, “Usually products in high demand, price or sizeable market are counterfeited; malaria drugs fulfill all these criteria…[Counterfeit malaria pills] may contain no active ingredients, may contain wrong active ingredients or even correct active ingredients.”

There is usually a low amount of active ingredient, like the pain reliever paracetamol, in fake malaria medications, according to Rago, in order to “cheat qualitative screening tests that just react to the presence of certain actives, and thus may mimic false positive results.”  The ingredient may soothe malaria symptoms temporarily, but the disease remains unaffected.  It is also possible that counterfeit drugs contain harmful or strange chemicals, like sildenafil, normally contained in the anti-impotency drug known as Viagra.  Rago continued to say that, since malaria kills, counterfeit pills that provide no treatment “kill as well”.

Low quantities of actives can also contribute to raising resistance and losing valuable drugs in the long term.”  As far as steps being taken to combat this practice, Rago reported, “There is no one magic bullet. It is a complexity of measures and cooperation of all concerned parties that works the best.  The key is effective market control and functioning regulatory systems, including good cooperation between different enforcement agencies.”

UN report: Public health experts credit immunizations and other health interventions for decrease in deaths of children under 5

Newly released data compiled by demographers and health experts from UNICEF, the World Health Organization (WHO), the World Bank and the UN Population Division shows a 28 per cent decline in the under-five mortality rate, from 90 deaths per 1,000 live births in 1990, to 65 deaths per 1,000 live births in 2008.

Public health experts attribute the continuing drop to greater use of health interventions such as immunizations, the use of insecticide-treated bednets to prevent malaria and vitamin A supplementation.

Progress has been seen in every part of the world, and even in some of the least-developed countries.  In addition, Niger, Mozambique and Ethiopia have all reduced under-five mortality by more than 100 per 1,000 live births since 1990.

While progress has been made in many countries, the global rate of improvement is still insufficient to reach the Millennium Development Goals (MDGs) – eight anti-poverty targets of which one is reducing under-five mortality by two-thirds (from 1990 to 2015).

“A handful of countries with large populations bear a disproportionate burden of under-five deaths, with 40 per cent of the world’s under-five deaths occurring in just three countries: India, Nigeria, and the Democratic Republic of Congo,” said UNICEF Executive Director Ann M. Veneman.

“Unless mortality in these countries can be significantly reduced, the MDG targets will not be met,” she cautioned, adding that this will require a strong sense of urgency with targeted resources for greater progress.

The absolute number of child deaths in 2008 declined to an estimated 8.8 million from 12.5 million in 1990, but Africa and Asia combined still account for 93 per cent of all under-five deaths that occur each year in the developing world.

Innovative mobile application helps fight fake drugs

mPedigree is a mobile application that allows users to text-message at no cost, a quality-authentication code found on the packaging of anti-Malarial and other medications to a provisioned mobile shortcode in order to guard against counterfeit drugs believed to be responsible for an alarming number of deaths, especially in the developing world.

With the mounting cost of healthcare in Africa coupled with the dangers associated with using fake drugs, the mPedigree innovation is an enormous boost to healthcare on the continent.

Earlier this year,  mPedigree won the 1st place position in the Emerging Markets category of the Nokia Innovators contest and has won a number of other honours since then.