Key health issues of 2010: control of NTDs is possible

From the WHO’s photo story,  2010 in review:  key health issues.

Control of neglected tropical diseases is feasible

Neglected tropical diseases thrive in impoverished settings, where housing is substandard, environments are contaminated with filth, and disease-spreading insects and animals abound.

The misery and disability caused by these diseases can now be substantially reduced according to the WHO report Working to overcome the global impact of neglected tropical diseases.

Key health issues of 2010: drug-resistant TB

From the WHO’s photo story,  2010 in review:  key health issues.

Drug-resistant tuberculosis at record high levels

In some areas of the world, one in four people with tuberculosis becomes ill with a form of the disease that can no longer be treated with standard drugs regimens, according to WHO’s Multidrug and extensively drug-resistant TB (M/XDR-TB): 2010 global report on surveillance and response.

However, there are encouraging signs that governments and partners can achieve a decline in this drug-resistant tuberculosis by implementing WHO recommendations.

US Bill proposes to strengthen drug safety laws

Leaders of four committees in the US House of Representatives have introduced a bill — Drug Safety Enhancement Act (Bill HR 6543) — which would upgrade America’s prescription drug safety laws.  This Bill proposes to equip the FDA with the authorities and resources it needs to adequately regulate the growing global marketplace for drugs.

HR 6543 would:

• create an up-to-date registry of all drug facilities, both foreign and domestic, serving US consumers;
• generate funding for increased Good Manufacturing Practices (GMP) inspections for brand and generic drugs;
• require parity between foreign and domestic inspections;
• prohibit entry of drugs coming from domestic and foreign facilities that limit, delay or deny FDA inspections;
• prohibit the entry of drugs into the US lacking documentation of safety;
• require manufacturers to know their supply chain, identify and mitigate risk throughout the chain, and to document measures taken to secure their supply chain;
• prohibit false or misleading reports to FDA;
• provide strong new enforcement tools, including mandatory recall authority, increased civil and criminal penalties and new FDA authority to subpoena records related to possible violations;
• provide protection for whistleblowers who bring attention to important safety information; and
• require unique identification numbers for drug establishments and importers to improve the FDA’s ability to identify parties involved in a crisis situation more quickly.

In 2009, there were a record 1,742 drug recalls in the US – a fourfold increase from the prior year – and the vast majority were related to manufacturing quality and testing.  Up to 80% of the active ingredients in US drugs are now made overseas, many in countries where regulatory oversight does not meet U.S. standards.

Source:  PharmaTimes.

 

Google and Microsoft help fight illegal internet pharmacies

Bloomberg reports that Google Inc. and Microsoft Corp. are helping to establish a nonprofit organization targeting illegal Internet pharmacies in support of Obama administration efforts.  The group is comprised of companies that serve as Internet choke points and was in response to a call from the administration for private efforts to police illegal pharmacies, said Victoria Espinel, the White House intellectual property enforcement coordinator.

Counterfeit drug sales account for about $75 billion in global sales, according to the National Association of Boards of Pharmacy. An estimated 1 percent to 2 percent of drugs in North America are counterfeit, according to the group’s website.

Companies participating in the effort include Yahoo! Inc., MasterCard Inc., Visa Inc., American Express Co., GoDaddy.com Inc., Neustar Inc., eNom Inc. and EBay Inc.’s Paypal Inc.

Stem cell transplant has cured HIV infection in ‘Berlin patient’

National AIDS Manual (NAM) reports that doctors who carried out a stem cell transplant on an HIV-infected man with leukaemia in 2007 say they now believe the man to have been cured of HIV infection as a result of the treatment, which introduced stem cells which happened to be resistant to HIV infection.

The man received bone marrow from a donor who had natural resistance to HIV infection; this was due to a genetic profile which led to the CCR5 co-receptor being absent from his cells. The most common variety of HIV uses CCR5 as its ‘docking station’, attaching to it in order to enter and infect CD4 cells, and people with this mutation are almost completely protected against infection.

The case was first reported at the 2008 Conference on Retroviruses and Opportunistic Infections in Boston, and Berlin doctors subsequently published a detailed case history in the New England Journal of Medicine in February 2009.

They have now published a follow-up report in the journal Blood, arguing that based on the results of extensive tests, “It is reasonable to conclude that cure of HIV infection has been achieved in this patient.”

Read more.

Children breathe easier with smoke-free laws

(Reuters Health) – Children with asthma who live in areas with “smoke-free” laws may suffer fewer bouts of coughing and wheezing as a result, a new study suggests.

The findings, reported in the journal Pediatrics, add to evidence that smoking bans in workplaces, restaurants and bars have produced health benefits. But until now, most research has focused on adults.

In the current study, researchers found that children and teenagers who lived in U.S. counties with smoke-free laws were no less likely to have asthma than kids in counties without such laws.

Kids with asthma were, however, less likely to report persistent problems with wheezing and nighttime coughing bouts when they lived in smoke-free counties.

Lower education level tied to heart failure risk

A recent report from Reuters Health highlights results from a new study which found that the less education people have, the greater their risk of eventually developing chronic heart failure.

Researchers say lower education levels are basically a stand-in for people’s overall economic condition, and that their findings add to evidence connecting poverty to heart disease.

The results, they add, also suggest that heart failure prevention for lower income people needs to begin early in life.

Heart failure is a chronic condition in which the heart can no longer pump efficiently enough to meet the body’s demands, causing symptoms like fatigue, breathlessness and fluid buildup in the limbs.

Coronary heart disease (blockages in the heart arteries) is the underlying cause of about half of heart failure cases. Other major causes include damage to the heart from uncontrolled high blood pressure or diabetes.

A number of studies have found that people with lower incomes and less education have higher rates of coronary heart disease. But little has been known about their risk for heart failure.

The new study, which followed more than 18,600 Danish adults for two decades, found that those with the most education — more than 10 years of schooling — were 39 percent less likely to be admitted to a hospital for chronic heart failure than those with the least education, defined as fewer than eight years.

Men and women whose education levels were in between also fell in between when it came to heart failure risk. They were 25 percent less likely than less-educated counterparts to be hospitalized for the condition.

The findings, published in the European Heart Journal, do not prove that lower education, itself, is the reason for the elevated risks.

However, the researchers did account for a number of lifestyle-related factors — like participants’ weight, smoking habits, cholesterol levels and exercise levels — and found that there was still a link between education and heart failure hospitalizations.

 

Cancer risk cut with small daily dose of aspirin

A small daily dose of aspirin – 75mg – substantially reduces death rates from a range of common cancers, a study suggests.  Research at Oxford University and other centres found that it cut overall cancer deaths by at least a fifth. (source: BBC News)

Experts say the findings show aspirin’s benefits often outweighed its associated risk of causing bleeding.  Aspirin is already known to cut the risk of heart attack and stroke among those at increased risk. However, this latest research shows that when weighing up the risks and benefits of taking aspirin, experts should also consider its protective effect against cancer.

Those patients who were given aspirin had a 25% lower risk of death from cancer during the trial period and a 10% reduction in death from any cause compared to patients who were not given the drug.

The treatment with aspirin lasted for between four and eight years, but long term-follow-up of around 12,500 patients showed the protective effect continued for 20 years in both men and women.

The risk of cancer death was reduced by 20% over 20 years. For individual cancers the reduction was about 40% for bowel cancer, 30% for lung cancer, 10% for prostate cancer and 60% for oesophageal cancer.

The reductions in pancreas, stomach and brain cancers were difficult to quantify because of smaller numbers of deaths.  There was also not enough data to show an effect on breast or ovarian cancer and the authors suggest this is because there were not enough women in the trials. Large-scale studies investigating the effects on these cancers are under way.

Economic benefits of polio eradication estimated at US$40-50 billion

A new study, published in the journal Vaccine, estimates that the Global Polio Eradication Initiative (GPEI) could provide net benefits of at least US$40-50 billion if transmission of wild polioviruses is interrupted within the next five years.

The study considers investments made since the GPEI was formed in 1988 and those anticipated through 2035. Over this time period, the GPEI’s efforts will prevent more than 8 million cases of paralytic polio in children. This translates into billions of dollars saved from reduced treatment costs and gains in productivity.

The study also reported that “add-on” GPEI efforts improve health benefits and lead to even greater economic gains. Notably, it estimates an additional $17-90 billion in benefits from life saving effects of delivering vitamin A supplements, which the GPEI has supplied alongside polio vaccines.

The global incidence of polio has been reduced by 99 percent since 1988 and type 2 wild polioviruses were eradicated in 1999. Intense efforts are underway to stop transmission of types 1 and 3 completely within the next several years, with indigenous transmission remaining only in relatively small areas in Afghanistan, India, Nigeria, and Pakistan and re-established transmission in a few countries, including Angola and the DRC.

GPEI is a public-private partnership led by national governments, spearheaded by the World Health Organization, Rotary International, the CDC, and the United Nations Children’s Fund (UNICEF) and supported by organizations including the Bill & Melinda Gates Foundation.

Alternative health treatments hinder asthma management: study

As reported by the National Post, a new Canadian study suggests that a sizable minority of child asthma patients rely on alternative treatments like acupuncture and homeopathy, and are more likely to have poor outcomes as a result.

The research by doctors associated with the University of Montreal looked at 2,000 children who came to the Montreal Children’s Hospital asthma centre between 1999 and 2007. About 13% were regular users of alternative therapies, the most common being vitamins, homeopathy and acupuncture. The most concerning finding was that those being treated with such methods were twice as likely to have poor control over their asthma. And the the children most likely to be under alternative care were less than six years old, the scientists’ paper in the Canadian Respiratory Journal says.