Review: “EXPOSED” Film Series by Aeras

EXPOSED: The Race Against Tuberculosis (video review)

This post was written together with Niniola Soleye.

EXPOSED: The Race Against Tuberculosis is a series of four short films (about ten minutes each) about the global epidemic of multidrug-resistant tuberculosis (MDR-TB) and extensively drug-resistant tuberculosis (XDR-TB). The series was produced by Aeras, a biotech company working toward a tuberculosis vaccine. It features personal stories from patients, as well as commentary from physicians, researchers, policymakers, and experts around the world.

The global health community has seen TB morph from a death sentence to a treatable disease with antibiotics to an increasingly drug-resistant (and persistent) monster – thus completing the cycle and essentially bringing it back to a death sentence in the case of XDR-TB. Even more terrifying is the emergence of totally drug-resistant TB (that’s TDR-TB) in Iran, India, and Western Europe.

From testing and treatment costs to lost wages and productivity costs, TB, especially DR-TB, is also a very expensive disease. The first video, which features a woman from Tennessee, really drives the point home. She went on a short mission trip with her church to South Africa, where she contracted a strain of TB that was resistant to seven drugs, and wound up in isolation for two years. The total treatment course cost the health department over $1 million – a case in point of how the uninformed desire to “do something” can do more harm than good.

The purpose of the video series, in addition to raising awareness about drug-resistant tuberculosis, is to build support for Aeras’s mission to develop a TB vaccine. Currently, there is no effective vaccine against the most infectious form of tuberculosis, pulmonary TB. The BCG vaccine which was developed 90 years ago does not prevent the majority of TB cases. While the movies play to the emotional side to a certain extent, and I wasn’t crazy about the fact that they opened the series with a profile of a Westerner who “just wanted to help,” I felt that the series did an overall good job of giving voice to individuals in the developing world who are most immediately affected by the disease – both a survivor of treatment and a woman who is volunteering in a clinical trial for a vaccine candidate.

You can watch the films here.

Global Health News Last Week

SECTION NEWS
The Advocacy/Policy Committee would like to invite you to participate in our first Advocacy Day, led in partnership with the Global Health Council. The day, scheduled for Thursday, November 3rd, 2011, immediately following the annual meeting in Washington, D.C., will be an opportunity for us to voice support for a continued focus on international health to our elected officials. With the intense Congressional pressure to cut the budget, our voices can make a real difference. As a participant during this exciting day, you will be provided with training materials on effective advocacy techniques to ensure your message is clearly heard. Even if you do not have advocacy experience, you need not hesitate to sign up because you will be teamed with others. Please consider joining your fellow International Health Section members on Thursday, November 3rd, 2011 on Capitol Hill to advocate for a healthy globe.  Interested parties should register here.  Please note that registration will close on October 14th.  Any questions should be directed to Peter Freeman, Advocacy/Policy Committee Chair, at pffreeman@gmail.com or 773.318.4842.


POLITICS AND POLICY

  • GOP Presidential hopeful Michelle Bachmann has been slammed by scientists, doctors and others for claiming that the HPV (human papilloma virus) vaccine can cause mental retardation. An ethicist has now put up money behind his challenge to her claim.
  • A commitment by G20 nations to strengthen agricultural research in developing countries will help reduce food insecurity as long as it focuses on small farmers and their needs, officials and experts said at a G20-backed conference this week.

PROGRAMS

  • The Gates Foundation has presented the Harvard School of Public Health with a $12 million grant to support its maternal health task force.
  • USAID is teaming up with former President George Bush to reduce cervical cancer deaths by 25% in five years for target developing countries.
  • The magic number may be $6 billion to make a real dent in ending the spread of AIDS.
  • A collaboration between UK and US funding agencies has announced more than £3.5M new funding for research aimed at controlling the transmission of diseases amongst humans, animals and the environment.

RESEARCH AND INNOVATION

  • The number of African countries with national policies on traditional medicine increased almost fivefold between 2001 and 2010, according to a report on a decade of traditional medicine on the continent.
  • The recently published results from two malaria vaccine trials appear to show that scientists are getting closer to developing a vaccine against the mosquito-borne illness.
  • Effective nursing is the backbone of a high quality health care delivery system. GHDonline’s nursing community will discuss how ongoing mentoring and training programs can enhance nursing in an expert panel discussion September 19-23.
  • The number of young women with breast cancer has more than doubled worldwide since 1980, say researchers at Seattle’s Institute for Health Metrics and Evaluation.
  • After 2 years of analyzing the results of the largest AIDS vaccine clinical trial ever held, the so-called Thai prime-boost trial, and the only one so far to show some protection against HIV, researchers say they have discovered insights that could lead to an effective vaccine.
  • IUDs can prevent cervical cancer, finds a study published in the Lancet.
  • Reducing the incidence of malaria could also drastically reduce the number of deaths from bacterial infections among children in Africa, a study has found.

DISEASES AND DISASTERS

  • Authorities worry that tropical mosquitoes found in San Gabriel Valley could spread disease if they gained a foothold in Southern California.
  • A human rights investigator for the United Nations says up to a quarter of the world’s trash from hospitals, clinics, labs, blood banks and mortuaries is hazardous and much more needs to be done to regulate it.
  • A report from UNICEF and the WHO shows the decrease in the rate of deaths for children under the age of five.
  • The WHO warns that thousands may die if multi-drug resistant and forms of tuberculosis continue to spread throughoutEurope.
  • One of the scientific advisers to the new blockbuster movie “Contagion” says the “risks are very real — and are increasing drastically… Our vulnerability to such diseases has been heightened by the growth in international travel and the globalization of food production.”

FOCUS – NON-COMMUNICABLE DISEASES

  • Cancer, cardiovascular disease, respiratory illness and diabetes account for 63 percent of all global deaths, yet up to half could be prevented, according to a new report, Noncommunicable Diseases Country Profiles 2011, released Wednesday by the  World Health Organization.
  • The WHO released a 207 page “global score card” on the prevention of chronic illness, one week ahead of the NCD summit at the UN.
  • Eli Lilly and Company has committed $30 million to the Global Health Initiative. The Lilly NCD Partnership will work to identify comprehensive, sustainable approaches to patient care. Initially it will concentrate on diabetes.

Thanks to Tom Murphy and Mark Leon Goldberg, Tom Paulson, Isobel Hoskins, and Public Health Newswire.

Global Health News Last Week

SECTION NEWS

The IH Section hosted its third topic-focused conference call, on Current Developments in MCNH, took place on Monday, June 27, 2011 from 1:00 to 2:00 EST. We had several members of the IH section offer their commentary and expertise on current issues concerning maternal and child health.  Speakers included Laura Altobelli, Elvira Beracochea, Carol Dabbs, Miriam Labbock, and Mary Anne Mercer.  Read the summary here.

IH Section Communications Chair Jessica Keralis attended APHA’s Mid-Year Meeting on healthcare reform.  There were several interesting sessions on technology implications of reform, the public health workforce, advocacy, and others.  Read all about it on the IH Blog.


POLITICS AND POLICY

  • In the first part of a two-part series called “The great billion dollar drug scam,” investigative journalist Khadija Sharife questions the accuracy of figures given by the pharmaceutical industry to justify the high cost of drugs.
  •  The American Chronicle reports how Brazil has been implementing numerous programs to reduce the rate of HIV infection within the country.

PROGRAMS

RESEARCH

  • At the 7th annual meeting of the World Conference of Science Journalists, several speakers said clinical research trials done in the developing world lack adequate patient protections as well as an ethical and legal framework.
  •  Arizona State University Scientists have developed recombinant attenuated salmonella vaccines which they believe will make vaccines more effective.
  •  A test for dengue through saliva has been developed by researchers from Singapore.
  • Researchers believe that they have discovered the precise mechanism by which drugs attack and beat malaria. In doing so, they believe that they can gain a more precise understanding of how resistances are forming and develop better malaria medicines.
  • A recently published report on research and development by the Malaria Research Initiative examines the current state of malaria research and offers six recommendations in going forward to improve R&D.
  • A dramatic increase in support for malaria R&D since the mid-1990s puts the world well on the way to achieving global malaria control, treatment and elimination goals in the next five to six years.
  • A study has found that AIDS patients who take nucleoside analog reverse-transcriptase inhibitors experience premature aging.

DISEASES AND DISASTERS

  • The WHO has put together a series of graphs based on 2008 global health data to illustrate the 10 leading causes of death by broad income group. Heart disease, stroke and other cerebrovascular disease represent the top two killers in middle and high-income nations while they sit as number three and five respectively for low-income countries.
  •  A report published in Emerging Infectious Diseases, a journal of the CDC, has determined that UN peacekeepers from Nepal brought cholera to Haiti, which led to an outbreak last fall.
  • More than 350,000 women die in childbirth every year and 8 million children will die of preventable diseases before their fifth birthday. A new report concludes that more trained midwives could help save prevent millions of such deaths.
  • In a recently released report, UNICEF says as many as 70% of the world’s children are exposed to violence amounting to 1.5 billion children each year.
  • The drug misoprostol is saving women’s lives around the world by preventing excessive bleeding after childbirth, the leading cause of maternal death in the developing world; it is also causing controversy, as the drug can also be used to induce abortion.
  • Multi-drug resistant tuberculosis is on the rise and hard to cure. Médecins Sans Frontières wants people with the disease to blog about it, to find out what they really need.
  • A new study in The Lancet shows that over the past thirty years the number of adults diagnosed with diabetes has doubled to 350 million.
  • Ghana’s Food and Drugs Board (FDB) issued a statement to warn the public against the sale of counterfeit Artesunate tablets on the market, which it claims are from China; laboratory analysis had confirmed that contained no active anti-malaria ingredient.

Many thanks, as usual, to the Toms – Tom Murphy and Tom Paulson.

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

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 prostitutes 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.