UN Report: Efforts to boost maternal and child health falling short

From the UN Daily News:

An annual assessment report released today by the United Nations shows that while significant declines have been recorded by many countries in reducing maternal and child mortality, greater progress must be made to meet the global targets contained in the Millennium Development Goals (MDGs).

According to the MDG Report 2010, launched by Secretary-General Ban Ki-moon in New York, the number of deaths among children under the age of five has dropped from 12.6 million in 1990 to an estimated 8.8 million in 2008.

The greatest advances were made in Northern Africa, Eastern Asia, Western Asia, Latin America and the Caribbean, and the countries of the Confederation of Independent States (CIS).  But most striking is the progress that has been made in some of the world’s poorest countries. Bangladesh, Bolivia, Eritrea, Laos, Malawi, Mongolia and Nepal have all reduced their under-five mortality rates by 4.5 per cent annually or more.

“Despite these achievements, and the fact that most child deaths are preventable or treatable, many countries still have unacceptably high levels of child mortality and have made little or no progress in recent years,” stated the report.  The highest rates of child mortality continue to be found in sub-Saharan Africa, which accounted for half of the 8.8 million deaths in children under five worldwide in 2008.

The publication pointed out that child deaths are not falling quickly enough to reach Goal 4, namely a two-thirds reduction in childhood mortality rates between 1990 and 2015, and millions of children continue to die each year at a tragically young age.

First agreed at the UN Millennium Summit in September 2000, the eight MDGs set worldwide objectives for reducing extreme poverty and hunger, improving health and education, empowering women and ensuring environmental sustainability by 2015.

US releases IP enforcement strategy

Today, Vice President Joe Biden and Victoria Espinel, Intellectual Property Enforcement Coordinator, released the U.S. government’s official IP enforcement strategy.  The plan — developed following extensive public consultation — identifies 33 key action items to combat intellectual property infringement, both domestically and internationally.

Download the PDF to read the complete 2010 Joint Strategic Plan on Intellectual Property Enforcement.

The following are highlights from Vice President Joe Biden’s remarks, delivered today at the Eisenhower Executive Office Building:

Whether we’re talking about fake drugs that hurt instead of help the patient or knockoff car tires that fall apart at 65 miles an hour causing injury and death, counterfeits kill — counterfeits kill.  There’s a reason why they counterfeit, they don’t know how to do it in the first place.

But to state it very bluntly and obviously, piracy hurts.  It hurts our economy to the tune of billions — some argue tens of billions of dollars — in lost private sector profit and government revenue.  It hurts our health and safety, the health and safety — that’s why the FDA commissioner is here, in part.

Piracy is theft, clean and simple.  It’s nothing but theft.

Innovation & HIV: an evaluation of UNITAID as a tool to foster R&D

There’s no denying that continued innovation in the field of HIV/AIDS is essential for global health, however there is much debate on the best approach to fostering this development.

The International Policy Network (IPN) – a health policy think-tank — recently released a paper evaluating Unitaid’s new patent pool for AIDS treatments, considering the weaknesses in the case for such a pool, the lessons from historical examples and the likely consequences for research and development.

Unitaid is a multilateral fund to provide sustainable funding for AIDS medicines, financed in part by small levies on airline tickets. Recently, Unitaid has taken steps to expand its remit to research and development (R&D) and has established a patent pool for the intellectual property rights protecting anti-retroviral medicines (ARVs). The rationale behind this move is the perception that patents on ARVs held by different companies hinder development of new “fixed dose combination” drugs (FDCs), because of the legal complications associated with combining patents held by different rights holders. These FDCs form the backbone of AIDS treatment programmes in Africa and new combinations are needed for specific subpopulations such as children.

The Unitaid patent pool will ask companies to voluntarily contribute patents on ARVs, which will allow third party organisations to research and experiment with different combinations. Any new medicines that emerge from the pool will be sold on a non-profit basis and the original patent owners will be given a royalty determined by the patent pool administrators and underwritten by Unitaid funding. In June 2010 a separate legal entity, the Medicines Patent Pool Foundation, was established to administer the pool. At the time of writing, no pharmaceutical company has committed a patent.

Download the entire report.

Global polio eradication initiative launches 2010-2012 strategy

In Geneva this Friday, a broad range of stakeholders will formally launch the new Strategic Plan 2010-2012 for eradicating wild poliovirus (WHO newsroom).

Last month, the World Health Assembly welcomed the new plan while expressing deep concern about the US$ 1.3 billion funding shortfall (out of a budget of US$ 2.6 billion) over the next three years. This financing shortfall is a serious risk to the eradication of polio – activities are already being cut back or postponed due to a lack of funds.

Polio eradication sits at a critical juncture
Across Africa, 10 of the 15 previously polio-free countries re-infected in 2009 have successfully stopped their outbreaks¹. Key endemic countries are witnessing historic gains against the disease. Nowhere is progress more evident than Nigeria, where case numbers have plummeted by more than 99% – from 312 cases at this time last year, to three in 2010. In India, for the first time ever, the remaining endemic states of Bihar and Uttar Pradesh have not reported any wild poliovirus type 1 cases concurrently for more than six months.

The new plan introduces district- and area-specific strategies to target the ever-shrinking remaining reservoirs of poliovirus, exploits the game-changing bivalent oral polio vaccine to increase the impact of immunizations, and tackles health system weaknesses.

The risk of not stopping polio in endemic countries was made clear when a large type-1 outbreak originally from India spread to Tajikistan early in 2010 where, to date, it has paralysed 239 children. Tajikistan had been polio-free since 1997.

Global Polio Eradication Initiative
The Global Polio Eradication Initiative (GPEI) is spearheaded by national governments, WHO, Rotary International, the US Centers for Disease Control and Prevention (CDC) and UNICEF. Since 1988 (the year the GPEI was launched), the incidence of polio has been reduced by more than 99%. In 1988, more than 350 000 children were paralyzed each year in more than 125 endemic countries. In 2009, 1 595 children were paralyzed in 24 countries. Only four countries remain endemic: Afghanistan, India, Nigeria, and Pakistan.

New research unit boosts hope for patients with rare diseases

On Monday, Pfizer announced the creation of a new research unit which will specifically focus on the treatment of orphan diseases — those that affect fewer than 200,000 patients worldwide.

Of the more than 6000 diseases classified as orphan diseases, fewer than ten percent have therapies that directly address the underlying disease.  Pfizer stated that they intend to work closely with patient advocacy groups as it develops and advances the unit’s research strategy.

The new unit got the thumbs-up from National Organization for Rare Disorders in the USA. Its chief executive, Peter Saltonstall, noted that “30 million Americans, 30 million Europeans and millions more around the world have rare diseases” and applauded the development of new treatments “for this medically-underserved population.”

Why innovation is sometimes just as important as invention for pharmaceutical patents

An interesting article on incremental innovation, invention, access to medicines and IP — from Global Health Progress.

The Asian Age recently discussed the dilemma around the language of the Indian Patents Act, which requires “significant” improvements or efficacy in existing medicines for them to become eligible for pharmaceutical patents.  Reporter Deepak Joshi discusses the role of “incremental innovation” in many breakthrough inventions, including medical improvements like the new generation of HIV/AIDS treatments.  Joshi adds that these improvements, while not groundbreaking, nevertheless play an important role in medical progress.  Below is an excerpt from this article.

“In India, however, the debate about incremental innovations has become an unsettling one, particularly in the pharmaceutical sector. Section 3(d) of the Indian Patents Act has a controversial clause calling for “significant” improvement or efficacy in an existing compound to become eligible for a patent. Who defines “significant” and how? The issue is left delightfully vague.

Why does India more or less bar incremental innovations? There is a popular misperception that incremental innovations are unnecessary and will only result in more expensive medicines. The first point is plain wrong and the second one only half true. Of the 325 drugs on the World Health Organisation’s essential medicines list, 95 per cent are off-patent. This means they will be freely available to any drug manufacturer even if incremental innovation results in a better version also being in the market.

It is another matter that some two billion people worldwide don’t have access to these 325 drugs. That is an issue of access and health infrastructure. Patents and the presence or absence of incremental innovations have nothing to do with it. Look at it another way, if a large number of people across the planet don’t have black and white televisions, should the government stop attempts to develop and produce high-end plasma televisions? It may sound ridiculous, but that analogy holds true for the pharmaceutical industry.”

Read the full The Asian Age article here.

Customs groups commit to fight counterfeit drug industry

Counterfeit drugs have become a $200-billion-a-year industry and the 176-nation World Customs Organisation (WCO) will sign a declaration later this month to fight the scourge, an official said on Thursday (Source:  Reuters).

Fake or substandard versions of medicines are often hidden in cargoes sent on circuitous routes to mask their country of origin. “We have more fakes than real drugs in the market,” said Christophe Zimmermann, the WCO’s anti-counterfeiting and piracy coordinator. “In 2007-2008 alone, it rose 596 percent.”

The World Trade Organisation says fake anti-malaria drugs kill 100,000 Africans a year and the black market deprives governments of 2.5-5 percent of their revenue.

The Brussels-based WCO represents customs operations globally and has joined with former French president’s Jacques Chirac’s foundation to raise awareness at upper echelons to curtail the illicit industry.

Fake medicines often contain the wrong or toxic ingredients and pose a growing health threat worldwide, especially in poor countries where drugs are sold to treat conditions such as malaria, tuberculosis and HIV.

“If these subjects are not dealt with and strong action not taken, they will be a source of conflict,” said Catherine Joubert, director general of the Fondation Chirac, adding that so far 30 groups had signed the declaration.

In a sign Europe is taking the issue seriously too, justice ministers on the Council of Europe are set to ratify a convention on counterfeit medicines in Istanbul this November.

1.2 million Afghan children protected from polio

The United Nations World Health Organization (WHO) has vaccinated more than 1.2 million children in Afghanistan against polio after an outbreak of the sometimes deadly disease in neighbouring Tajikistan, where it was thought to have been eradicated nearly one decade ago.  (UN Daily News)

Polio, sometimes called poliomyelitis, is a highly infectious and sometimes fatal disease, and is often marked by acute flaccid paralysis among sufferers. It has been eradicated from much of the world, but experience shows that the virus can travel far relatively rapidly.

Most of the 200 cases reported as of 5 June were near Tajikistan’s border with Afghanistan, the target of WHO’s vaccination drive earlier this month.  More than 1 million children were vaccinated in Tajikistan against polio last month.

Afghanistan’s Badakhshan region has been polio-free for some 10 years, making it all the more important to contain possible spill-over effects from outbreaks in neighbouring areas.

Malaria outbreak in Venezuela

Statistics published this week by Venezuela’s Health Ministry show that malaria cases have doubled so far this year, particularly in Bolivar, where officials say there is an epidemic.  21,601 cases of malaria have been reported nationwide so far this year, up from 10,758 during the same period last year.

Public health officials attribute the rise in malaria in part to a government-led operation this year in which soldiers have evicted thousands of miners from illegal strip-mines.  That has led to a movement of displaced miners to other towns, and they have carried the disease with them and helped it spread into areas that didn’t used to have much malaria.

For more details, read the report published by the Miami Herald.

Italy cuts generic drug prices – to save 600 million euros

Italy is taking new steps to rein in healthcare spending by imposing a cut in generic drug prices – estimated to save the country 600 million euros ($733.8 million).

Under a package of measures, the price of off-patent generic drugs will be cut by 12.5 percent from June 2010 until the end of this year.  From 2011, reimbursement of generics will be limited to the cheapest version of a medicine within four therapeutic categories, with the lowest price established by a tender system. Purchases of goods and services by the state health service above reference prices will have to be justified.

The introduction of a tender system for purchases of generics follows similar action by Germany.

(Source:  Reuters)