Tag: Global Fund

The Greatest Thing You’ll Ever Learn: Drug-Resistant Tuberculosis on the Rise

by Jessica, posted in Infectious Disease

On most days, tuberculosis only crosses the average American’s awareness radar when he or she is watching Moulin Rouge! for the fifth time. Even then, the sight of the courtesan Satine (played by Nicole Kidman) coughing up blood after singing about diamonds gives the impression that TB is the problem of sex workers living in elephants in 19th-century France. All of this changed in 2007, when Georgia lawyer Andrew Speaker snuck back into the U.S. through Canada after honeymooning in Europe – and being diagnosed with extensively-drug-resistant tuberculosis (XDR-TB).

As if regular TB were not bad enough, global health professionals are now grappling with the rising incidence of multi-drug-resistant (MDR-TB) and extensively-drug-resistant (XDR-TB) tuberculosis. MDR-TB is resistant at least to isoniazid and rifampicin, the two most powerful first-line antibiotics used to treat TB. It typically develops when patients being treated for fully sensitive TB stop their treatment course or do not follow it regularly (either because they feel better or forget to take their drugs, or because treatment supplies run out). When the treatment is interrupted before all of the bacteria are killed, the microbes develop resistance to the drugs. XDR-TB has all of this and more: it is also resistant to any fluoroquinolone and at least one of three injectable second-line drugs (capreomycin, kanamycin, and amikacin). If these drugs sound scary, it is because they are: most second-line drugs are less effective than isoniazid and rifampicin and can be moderately to highly toxic.

While the incidence of drug-resistant strains of TB is low for the moment, it is on the rise: a recent report by the WHO found that over two million people will contract some form of drug-resistant TB by 2015. The frequency of these infections is increasing fastest in India, China, and the former USSR. The WHO is asking countries to put their money where their mouths are and step up to fight the disease. “Commitments by some countries are too slow off the mark or simply stalled,” said Rifat Atun, director of strategy, performance and evaluation at the Global Fund. In the meantime, the greatest thing you’ll ever learn…is to finish your antibiotic course.

Global Health News Last Week

by ihsection, posted in News

POLICY

  • Assistant Senate Majority Leader Richard Durbin (D-IL) and Senator Bob Corker (R-TN) introduced the Water for the World Act of 2011, a bill in the Senate which will make providing safe and clean drinking water around the world a priority for US foreign aid.
  • More than 60 world nutrition experts met at WHO headquarters last week to revise guidelines and to identify solutions to tackle the growing problems of both malnutrition and obesity around the world.
  • Ministers of health and other high-level health officials from throughout the Americas called for a series of actions to reduce the toll of chronic noncommunicable diseases, in a declaration issued last week in Mexico City.
  • The Global Fund announced that former President of Botswana Festus Mogae and former U.S. Health and Human Services Secretary Michael O. Leavitt have agreed to lead a high-level panel of experts that will conduct an independent and thorough review of the Global Fund’s financial safeguards.
  • UN agencies are concerned that reduced donor funding due to the recession, combined with free trade agreements, will reduce the availability of low-cost HIV medications in developing countries.
  • The United Nations General Assembly will convene a high-level meeting in September this year to discuss the financial burden caused by non-communicable diseases (NCD) on countries.

RESEARCH

  • A study done is Malawi by the World Bank attracted attention (and criticism) from Businessweek. Young women were given to stay in school and deter them from accepting money and gifts from “sugar daddies” in exchange for sex. The study found that HIV infection rates were 60% among schoolgirls who received cash compared to those who received nothing.
  • A recent review of malaria treatment clinical trial results, published in the Chochrane Library, shows that artesunate was more effective that quinine at treating severe malaria.
  • A personalized text messaging reminder service significantly boosted antiretroviral (ARV) adherence over a six-week period compared with a standard beeper reminder system, according to a study published in the March issue of AIDS Patient Care and STDs.
  • About 600 people gathered at the Global Health Metrics and Evaluation conference in Seattle to discuss issues surrounding the evaluation of effectiveness of health programs.

PROGRAMS

  • Global health blogger Alanna Shaikh discusses how micro-credit and the Green Revolution, two of international development’s biggest successes, are being re-evaluated.
  • The Nepalese government is planning launch a large vaccination campaign against elephantiasis in 40 high-risk districts.
  • Dubai’s Ministry of Health introduced Pneumococcal Conjugate Vaccine PCV13, a vaccine that protects young children from the worst effects of illnesses including pneumonia, blood infections and meningitis.
  • The National Influenza Center of the Chinese Center for Disease Control and Prevention has been designated as a World Health Organization Collaborating Centre for Reference and Research on Influenza, making China the first developing country to house such an institution.

DISEASES AND DISASTERS

  • Europe is concerned by the growing incidence of drug-resistant TB, particularly in children.
  • The world continues to follow the aftermath of the earthquake and tsunami in Japan, including the unfolding situation at the Fukushima Dai-ichi nuclear power plant. The WHO has assured that there is no danger to individuals being exposed to radiation in nearby nations (e.g. China).
  • As if Haiti needed any more bad news, a study published in the Lancet says that the UN estimate of 400,000 cholera cases in Haiti this year is nearly half of what the real projection should be for the recovering nation. Meanwhile, health officials in Lagos have called on residents to observe high standards of personal and environmental hygiene and have designated emergency numbers to call in case of suspected cases; the Ghana Health Service has set up cholera centers in Accra to deal with the outbreak there; and the interim federal government of Somalia on Tuesday denied reports of an outbreak of cholera in the country, responding to an Associated Press story over the weekend that Somali doctors had reported that more than 20 people had died from the disease.
  • In the February 2011 issue of PLoS Neglected Tropical Disease Journal, contributing editor Serap Aksoy discussed the triumphs behind the control of human African trypanosomiasis, or African Sleeping Sickness.
  • Although women get diagnosed for tuberculosis (TB) later than men, treatment outcomes among women are better than men with higher TB treatment success rate and lower default (drop-out) rate in the female patients. The finding was announced at a meeting on TB and women in New Delhi, India.
  • While the total number of newly reported HIV positive people and AIDS patients are still low in Japan compared with other countries, the number of newly HIV-infected people in Japan has doubled in the past decade due to public complacency and lower awareness.

Global Health News Last Week (plus interest in a new working group!)

by ihsection, posted in News

Attention IH Section Members: Dr. Kaja Abbas, MPH student at the University of Rochester, is gauging interest in forming a working group focused on using system science to improve global health, similar to the intitiaves being promoted by NIH. Her interests are in conducting system science research on global health policy by modeling population and disease dynamics and economic evaluation of public health interventions and systems, with a focus on HIV and TB. Dr. Malcolm Bryant, our section chair, has encouraged the expansion of our section’s activities in areas of technical expertise, and Dr. Abbas is enthusiastic about a working group within the section that promotes system science methodologies for global health solutions. She welcomes your thoughts and suggestions at kaja [dot] abbas [at] gmail [dot] com.

Global Health Delivery online’s HIV prevention community is hosting a “virtual expert panel” March 7-11 to continue the dialogue around PrEP as a novel approach to prevention. Panelists from Uganda, South Africa and the United States will lead the online discussion, highlighting various barriers and opportunities to implementing PrEP in clinical settings; how to encourage long-term adherence; and what additional research questions need to be answered. Panelists include (1) Douglas Krakower, MD, a fellow in Infectious Diseases at Beth Israel Deaconess Medical Center/Harvard Medical School, (2)Andrew Mujugira, MBChB, MSc, the East Africa regional medical director for the Partners PrEP study, and (3) Vivek Naranbhai, PhD, who was involved in CAPRISA microbicide gel study. All GHDonline members can participate in this online discussion. You can sign up here if you are not currently a member.

POLICY

  • Paramount Chief Mpezeni of the Ngoni people in the Eastern Province of Zambia has urged his subjects to get circumcised in order to reduce the chances of spreading HIV/AIDS and other communicable diseases in his land.
  • Britain is threatening to pull out of the Food and Agriculture Organization due to “patchy” performance.
  • Due to uncertainty in past estimates, the Indian government has formed a 16-member expert group to determine the annual death rate caused by malaria in the country each year.
  • The breakdown of the air conditioning in the plenary hall of the Philippines’ House of Representatives stalled the heated debate of a controversial reproductive health bill. The bill is vehemently opposed by the Catholic Church and pro-life groups and has caused a stir in the largely Catholic country.
  • A massive demonstration rally was held in New Delhi to protest a free trade agreement between India and Europe, which many fear may threaten the production of low-cost generic drugs, particularly HIV medicines.

RESEARCH

PROGRAMS

DISEASES

Global Health News Last Week

by ihsection, posted in News

The PSI Healthy Lives Blog has begun running a daily global health news summary called “The Healthy Dose,” written by Mark Leon Goldberg and Tom Murphy (who also blogs about development at A View from the Cave).

STUDENTS AND YOUNG PROFESSIONALS: The Global Health Corps is currently accepting applications for its Global Health Fellows Program, which comes highly recommended by just about everyone I have heard mention it.

February 6 was International No Tolerance Day to Female Genital Mutilation.

The Vatican will host an international conference in May on preventing AIDS and caring for those afflicted with it amid continued confusion over its position concerning condoms as a way to prevent HIV transmission.

The Global Fund announced the launch of new anti-corruption measures after intense scrutiny from donors following stories on fraud investigations by The Associated Press. Meanwhile, debate and public controversy over the AP’s presentation of the story rages on.

The discovery of a new type of mosquito, a subgroup of Anopheles gambiae (the species which transmits malaria), is causing concern among scientists because it appears to be very susceptible to the malaria parasite.

Bill Gates is becoming frantic in his pursuit to eradicate polio. In addition to making it the cornerstone of his 2011 annual letter, he held a webcast event last week, campaigned for funds at Davos, and is needling governments to donate funds for a “final push.” He is also beginning to irk some, who say he is distorting other priorities.