Posts Tagged ‘WHO’

New ways to tackle neglected tropical diseases

May 18th, 2010

A debate published today in PLoS Medicine examines new approaches to tackling neglected tropical diseases (NTDs), with three viewpoints from experts in the field—including Sabin President Dr. Peter Hotez—arguing which approach shows the most promise.

Dr. Hotez and colleagues say that the best return on investment will continue to be mass drug administration for NTDs.

“In terms of both health impact and cost-effectiveness, few other interventions can rival mass drug administration for NTDs, and increasingly this approach is being recognized for its beneficial effects on strengthening health systems, improving economic development, and achieving the Millennium Development Goals,” says Dr. Hotez.

In contrast, Jerry Spiegel and colleagues from the University of British Columbia argue that there has been too much focus on biomedical mechanisms and drug development for NTDs, which has come at the expense of the social determinants of health such as clean water, sanitation, good housing, and community education.

Burton Singer of the Emerging Pathogens Institute at the University of Florida argues that the recent designation of a set of tropical diseases as “neglected” has led to strategies for control that are inappropriately “overmedicalized.” He cites the emphasis on drug administration alone to alleviate schistosomiasis as an example.

Read the full debate here.

Reading List 5/17/2010

May 17th, 2010

A great list of new reads! Today we’re reading about the distribution of trachoma treatment amongst indigenous communities in Australia, a protein (arrestin) found in worms that could potentially help the fight against cancer, along with a series of articles on vaccines – particularly the challenges that public health professionals face in providing access to vaccines in low-income countries, The All India Drug Action Network’s push for the WHO to introduce the pneumococcal (Hib) vaccine to Asian countries, and how worms are having an adverse impact on vaccine efficacy in swine.

Eye care boost for Indigenous communities, Australian Healthcare and Hospital Association
New protein found that controls longevity — in roundworms, MTB Europe
Report Examines Vaccine Costs, Access In Low-Income Countries, Medical News Today
AIDAN push for the WHO to introduce Hib vaccine, Gireesh Babu, PharmaBiz
Worm infections and M.hyo vaccine efficacy in pigs, VetsOnline

Strengthening Global Health Systems: The Quintessential “Win-Win”

May 12th, 2010

** We’re excited to announce that Alanna Shaikh will be a regularly contributing blogger to “End the Neglect.” Look out for her weekly posts!

By: Alanna Shaikh

Because I am the kind of person who does these things, I was reading the WHO World Health Statistics 2010 report today. Out of 168 pages, there was a paragraph and a half that talked about NTDs. About nine sentences. I guess that’s why we call them neglected? I would have liked to see a little more information – if they collect the data, why not share it? A whole page or two, say, does not seem like too much to ask. That being said, it was an interesting paragraph and a half and I guess a report that attempts to cover health on the whole planet is going to have to be brief.

 The WHO reports that more than a thousand million (a billion to we Americans) people are affected by neglected tropical diseases. They don’t break the number down – I’d love to see the details – but they do go on to report some good news. 2008 levels of dracunculiasis are very low – 4,619 – and leprosy is also at a low with 213,036 cases reported. It’s a nice reminder that we really can make progress on NTDs when we put in the effort and resources.

 Unfortunately, there is also plenty of bad news “In 2008, 2600 million people were not using “improved” sanitation facilities, and of these 1100 million were defecating in the open, resulting in high levels of environmental contamination and exposure to the risks of worm infestations…” That is a whole lot of people with no good place to defecate.

 In addition to depressing us and being pretty gross, the sanitation numbers make an important point. Sometimes fighting NTDs isn’t just about NTDs. Improving access to improved toilet facilities and clean drinking water would have an impact far beyond neglected tropical diseases. It would also decrease diarrheal diseases; reduce the spread of fecal-borne illnesses like cholera and hepatitis.

 When you are advocating awareness of specific diseases – especially unsexy ones that only merit a paragraph and a half in major global health reports – it’s easy to think that you stand alone. But the fact is, basic global health interventions help everyone. Strengthening health systems means vaccinations, disease surveillance, and access to health care, which has an impact across the board, not just on NTDs. The same is true of water and sanitation efforts. They make a difference to everything. Global health is not a zero-sum game, and it never has been. If we get our interventions right, we can advance global health for everyone.

 If you want more information on NTDs that the WHO was able to provide in the 2010 statistical report, there are some great resources out there. Here at the Global Network, we’ve got handy fact sheets on each NTD as well as an extremely snazzy interactive map. And the WHO does have plenty of resources, including an interesting news feed with updated disease reporting data. For more technical resources, the Public Library of Science has a journal on neglected tropical diseases that is free to all.

Alanna Shaikh is an expert in health consulting, writing about global health for UN Dispatch and about international relief and development at Blood & Milk. She also serves as a frequently contributing blogger to ‘End the Neglect.”

Reading List 4/7/2010

April 7th, 2010

Happy World Health Day everybody! Hope you enjoyed our guest post today and be sure to check out guest posts for the rest of the week. In addition to news about World Health Day, we’re reading about a new development in fighting leishmaniasis and an explosion of Guinea worm coverage from CNN.

Secretary Clinton’s Statement on World Health Day, US Department of State
World Health Day focuses on urbanization, Thair Shaikh, CNN.com
Sand fly barcoding in Panama reveals Leishmania strain and its potential control, Physorg.com
In Sudan, a war is waged to eradicate the ‘fiery serpent’, Madison Park, CNN.com
Sudan can rid world of a horrible disease, Jimmy Carter, CNN.com
Guinea worm a greater challenge than smallpox, Madison Park, CNN.com

Global Pulse 2010: Day 2

March 30th, 2010

(Note: to read any of the Global Pulse discussions, you need to register here first.)

 Today marks the second day of Global Pulse, the ongoing online collaborative event focused on global issues. In the last day, we’ve seen the global health discussion include some very interesting conversations, such as if the expansion of information technology and basic health capability are competitive or cooperative goals, what the role of communities is in health systems, and about the reasons for the uneven distribution of public health education opportunities. Perhaps the two most interesting threads are the welcome thread created by Amie Batson, USAID Director of the Global Health Initiative, which has turned into a sort of open discussion on global health, and a thread with many proposed answers taken from the Human Resources and Health document recently published by USAID.

 We’re also seeing a discussion of NTDs and NTD issues begin to emerge. In global health, the importance of NTD control was brought up, while in the separate “Fostering Science, Technology, and Innovation” discussion, the topic of promoting innovation in the face of a limited market was discussed.

Here were some great NTD related questions posed on one thread that we’d like to post here as well and are open for discussion:

  1. What have been your experiences with the delivery of a package(s) of services or commodities through community-level platforms? What lessons have you learned about effective integrated programming? How much can we build onto a single platform and continue to see efficiency gains?
  2. How can we best utilize and motivate community-level health workers and volunteers as we extend the health system to reach rural populations?
  3. What changes to the targeting / approaches to water and sanitation would strengthen the impact on NTD control, in both the short and long term? What else can the NTD control community do to strengthen the sustainability of its control efforts?  

With 28 hours left in the event, we’ll see if these conversations continue to develop. Check back in tomorrow for further discussion of Global Pulse.

US Government kicks off Global Pulse 2010 Day: 1

March 29th, 2010

As a communications associate for a nonprofit organization, I believe that one of the most important things an international aid agency can do is open the lines for effective two-way communication so that individuals like me can educate myself and ask questions about the world’s most pressing issues as well as get some clarity on what exactly the US government is doing to alleviate them. So, I’m happy to see that USAID, in partnership with the Departments of State, Education, Commerce, and Health and Human Services, has kicked off Global Pulse 2010.

 Global Pulse is a three day online collaborative event that allows individuals for around the world to make comments, share opinions, and add ideas about important issues in the global community.

 According to the website:

 Global Pulse 2010 will provide an opportunity to voice opinions, share ideas, and create innovative solutions to social issues facing the global community within the fields of science and technology, entrepreneurship, and human development. This is a unique opportunity to influence a global conversation that will build partnerships across borders, strengthen understanding among cultures, and unite the human race in an effort to create innovative solutions to the most pressing social issues of our time.

 Even though the event is less than a day old, we’re already seeing some very active and interesting global health discussions on topics such as prioritizing health needs, bioinformatics, and how mobile phones can be used for health services. Participants from over 130 countries have been logging in all day and most of the posts in the global health arena have settled into one of three developing themes: increasing access to health care, utilizing technology to improve health, and figuring out how to distribute health care effectively.

 There have been posts by global health luminaries as John Monahan, Counselor to the Secretary of the United States Department of Health and Human Services, Amie Batson, leader of USAIDs work with the Obama administration’s Global Health Initiative, and Ami Tsui, a Director with the Bill & Melinda Gates Foundation and professor at Johns Hopkins School of Public Health. Click here to read about other featured guests.

 By time the event ends on the 31st, this should be a valuable source of information and ideas moving forward in global health. If you want to find out more, go to the Global Pulse 2010 portal page or check back here for more info on how the conversation is developing.

More Attention Needed to Combat Drug Resistant Tuberculosis

March 24th, 2010

By Richard Skolnik

In 2006, 53 people in South Africa became ill with a form of TB that cannot be cured with the standard TB drugs.  

Fifty-two of them died. 

Some years before, there was an outbreak of TB in New York City that did not respond to standard TB treatment. These outbreaks should have made us take much greater notice of TB. Unfortunately, however, much work on effectively treating TB remains to be done, as we are reminded by World TB Day and by a new World Health Organization (WHO) Report on drug-resistant forms of TB.

There are about 9.4 million new cases of TB a year and about 1.8 million people a year who die of TB, making it one of the leading causes of adult death in low-income countries. 

TB is spread in an “airborne” manner, when people with TB breathe out the TB bacteria and someone else breathes it in.  Each person with TB is thought to infect 10 to 15 people per year. “Regular” TB can be cured with a 6-month course of treatment that is not expensive. 

However, some forms of TB, like those that occurred in South Africa and New York City that are referred to above, cannot be cured with the regular TB drugs.   One such form is resistant to two of the standard drugs and is called “multi-drug resistant” TB” (MDR-TB).  Another form of TB is resistant to even more TB drugs and is called “extensively drug-resistant TB” (XDR-TB).   People can get drug-resistant forms of TB by not fully taking their drugs when they have TB.   People can also get MDR-TB or XDR-TB by breathing in bacteria from people who already have these types of TB.    

It is harder to treat MDR-TB because it costs 10 times more to treat than drug-susceptible forms of TB, and the treatment success rates are much lower.   It is even harder and even more expensive to treat XDR-TB.

The best way of avoiding the development of more drug-resistant TB in the world is to diagnose people at an early stage of the disease and then to successfully cure them.   It is also important to successfully treat the cases of MDR-TB that already exist, so this form of TB cannot be spread further.

The new WHO report on MDR- and XDR-TB provides all the excuses we could want for getting involved with the battle against all forms of TB.  The good news is that progress is being made against MDR-TB in some places, such as in the Russian Federation.  The bad news, however, is that the data on resistant forms of TB is so limited that WHO cannot tell us the true number of cases worldwide or if that number is going down.  Even worse news is that 150,000 people died of MDR-TB in 2008, and there are 440,000 new cases a year globally with only about 1% of them being treated properly.  Moreover, there are some regions in Russia in which about 25% of all TB is MDR-TB and 58 countries have now reported XDR-TB.

We need to act urgently to get TB on the top of the global health agenda.  We also need to urgently support better detection of TB cases and their successful treatment, everywhere in the world.  We must push as hard as we can to get the world to strengthen laboratories for diagnosing MDR-TB.  This has to be coupled with measures to encourage the development of new ways of diagnosing all forms of TB, new drugs that can work better and faster on all forms of TB, and the development of a safe and effective TB vaccine.  Astoundingly for a disease of such importance, the TB vaccine is not very effective and is more than 100 years old.

We are all at risk for TB and MDR-TB poses special risks because it is harder to diagnose and harder and more expensive to treat successfully

We need to act now because waking up in a world with an increasing number of cases of drug-resistant forms of TB should be a thought too horrible to contemplate.

Richard Skolnik is a half-time Lecturer in Global Health at the George Washington University.  He previously served 25 years at the World Bank, two years as Executive Director of the Harvard PEPFAR Program, and two years as Vice-President for International Programs at PRB.  He was involved in the establishment of STOP TB and is the author of Essentials of Global Health.

Clean Water for a Healthy World

March 22nd, 2010

by Liz Borkowski, cross-posted from The Pump Handle

Today is World Water Day, when the United Nations draws attention to the importance of freshwater and advocates for sustainable water-resource management. This year, the focus is on water quality, which is declining worldwide.

According to the World Health Organization, each year 3.4 million people – most of them children – die from water-related diseases. That includes 1.4 million children dying from diarrhea annually, and 860,000 children perishing directly or indirectly from malnutrition arising from repeated diarrhea or intestinal nematodes. Many malnourished children do survive, but can suffer lifelong impairment.

Some of the most common neglected tropical diseases, which cause widespread impairment in developing countries, are water-related. Trachoma, which causes eye inflammation and is transmitted as a result of inadequate hygiene, affects more than 80 million people worldwide and has left eight million of them blind. Schistosomiasis, which spreads through water bodies contaminated with infected persons’ feces, causes progressive damage to either the bladder and kidneys or the liver, spleen, and intestines. WHO estimates that 200 million people have this preventable infection.

Because water-related diseases cause such a great reduction in quality of life and productivity, they’re a focus on the UN Millennium Development Goals. Under Goal Seven, “Ensure Environmental Sustainability,” one of the targets is “Halve, by 2015, the proportion of the population without sustainable access to safe drinking water and basic sanitation.” The world has achieved substantial progress toward this goal, but it’s been uneven.

The most recent UN report on MDG progress finds that in 2006 we were ahead of schedule in meeting the 2015 drinking water target, but less than halfway toward the sanitation target. Worldwide, 884 million people still lack access to improved water sources (which include household connections, public standpipes, and protected wells), and 84% of these people are in rural areas.

Sanitation improvements must go hand-in-hand with water improvements, because human waste can contaminate water if not handled properly. The UN Food and Agriculture Organization gives this definition of improved sanitation:

Access to improved sanitation facilities refers to the percentage of the population with at least adequate excreta disposal facilities (private or shared, but not public) that can effectively prevent human, animal, and insect contact with excreta. Improved facilities range from simple but protected pit latrines to flush toilets with a sewerage connection. To be effective, facilities must be correctly constructed and properly maintained.

 Improved

  • connection to a public sewer
  •  connection to a septic system
  •  pour-flush latrine
  • simple pit latrine
  • ventilated improved pit latrine

 Not improved

  • service or bucket latrines (where excreta are manually removed)
  • shared and public latrines
  • latrines with an open pit

 Between 1990 and 2006 in the developing world, 1.1 billion people gained access to improved sanitation – but 1.4 billion more still need to gain access by 2015 in order to meet the target. The problem is particularly acute in Southern Asia and Sub-Saharan Africa, where progress has been notable but not equal to the substantial challenge.

 While we in the developing world can and should support the achievement of the Millennium Development Goals, we also need to think about how our activities are affecting water quality. The World Water Day website has this summary of some of the top concerns:

Water quality can be affected by organic loading (e.g. sewage),  pathogens including viruses in waste streams from humans and domesticated animals, agricultural runoff and human wastes loaded with nutrients (e.g. nitrates and phosphates) that give rise to eutrophication and oxygen stress in waterways, salinization from irrigation and water diversions, heavy metals, oil pollution, synthetic and persistent engineered chemicals (e.g. plastics and pesticides), medical drug residues and hormone mimetics and their by-products, radioactive pollution, and even thermal pollution from industrial cooling and reservoir operations.

If you’re interested in learning more about water pollution problems in the US, I recommend the Frontline documentary Poisoned Waters. The World Water Day website also has plenty of suggested reading.

On World Water Day, think about the ways you use water – and how much a clean, adequate supply means to the health of the world.

Reading List 3/16/2010

March 16th, 2010

Today we’re reading about a promising new treatment for African sleeping sickness, the response to a new outbreak of schistosomiasis in Zimbabwe, and the UK upping its giving to the GAVI Alliance.

WHO approves trial drug for sleeping sickness, Frank Mugabi, The New Vision

Following Outbreak of Bilharzia in Zimbabwe, Officials Step Up Public Education, Brenda Moyo, Voice of America

UK doubles funding to GAVI Alliance, GAVI

Reading List 3/8/2010

March 8th, 2010

Today, as we join in celebrating International Women’s Day, we’re reading the WHO’s comments on this day as well as reviewing a paper Dr. Peter Hotez wrote about womens health and NTDs. We’re also reading a profile of river blindness and about Buruli ulcer, one of the less discussed NTDs.

Equal rights, equal opportunities: progress for all, World Health Organization

WHO laments “shameful” lack of respect for women’s right to good health, World Health Organization

Empowering Women and Improving Female Reproductive Health through Control of Neglected Tropical Diseases, Peter Hotez, PLoS Neglected Tropical Diseases

Blind to the river and its hazards, Stanley M. Aronson, The Providence Journal

Buruli ulcer: an overlooked tropical disease, Robert Herriman, Examiner.com