Tuberculosis Makes A Dangerous Return to Paris

RFI reports on a study released by the French public health authorities, which shows an overall increase in the number of cases of tuberculosis since 2016, particularly in the north Parisian region of Seine-Saint-Denis. Does this mean the disease, often associated with the first half of the 20th century and earlier, is making a comeback?

“I wouldn’t say we should be worried,” smiles Giulia Manina, who heads a research group studying microbial individuality and infection with a focus on tuberculosis at the Pasteur Institute in Paris. But she adds that awareness is key and while Paris has a higher incidence due to “globalisation, migration fluxes . . . it is not the only reason for the re-emergence of tuberculosis”. Although considered a disease of the past, tuberculosis has never left us. The mainly pulmonary (or lung) disease can spread to other organs such as the brain or the bones. And because it is typically in the lungs, “it can spread easily” explains Manina. If a person has an active infection, as opposed to one that is still dormant, he or she can infect a lot of other people. “For instance, it is estimated that one person can infect up to ten others with a cough” adds the scientist, explaining the infectiousness of the disease, especially in high-density areas.

May 15, 2019


Species extinction

There has been an abundance of news coverage this week, following the release of the Intergovernmental Science-Policy Platform on Biodiversity and Ecosystem Services (IPBES), a UN committee, whose report was written by 145 experts from 50 countries. One million of the planet's eight million species are threatened with extinction by humans, scientists have warned, in what commentators to CNN and other media describe as the most comprehensive assessment of global nature loss ever.

The report emphasizes the disastrous impact of population growth and rising demand. It notes that the world's population has more than doubled (from 3.7 to 7.6 billion) in the last 50 years, and gross domestic product per person is four times higher. Robert Watson, a British chemist who served as the panel’s chairman, said the decline in biodiversity is eroding “the foundations of our economies, livelihoods, food security, health and quality of life worldwide.” Humans, the very species responsible for the damage and pollution, will suffer health effects as a result.

Despite the ominous picture "it is not too late to make a difference”, says Watson, “but only if we start now at every level from local to global". He added that this would require an overhaul of economic systems and a shift in political and social mindsets. The IPBES report comes ahead of two high-level summits in 2020 where world leaders will scale up their climate and environment protection goals and when signatories of the 2015 Paris Agreement to keep global warming to less than 2 degrees will revise their commitments.

May 8, 2019


How to shape research to advance global health

An Opinion piece in Nature, Soumya Swaminathan, who heads the World Health Organization’s new science division explains how a research agenda can promote universal health coverage in all countries. The science division brings together existing research groups focused on reproductive health, infectious diseases and health-care systems. It is also charged with strengthening the WHO’s capacity to promote and establish guidelines on public health, preventive care, clinical medicine and ethical research, and ensuring that emerging technologies improve safety and well-being. This division plans to transform the ways in which the WHO collects, archives, manages, analyses and shares data.

The WHO hopes to convene global experts to help research leaders and policymakers fill knowledge gaps on issues in their nations that will have broad practical impact. For example, cost-effective interventions for non-communicable diseases would promote healthy practices and address leading causes of death. What policies increase the consumption of fruits and vegetables by people in poverty? Where physicians are scarce, can nurses help people with diabetes to manage their condition, using decision-support systems on mobile phones? The goal is for scientists from the global south to truly take the driver’s seat, so that questions and insights will address countries’ needs and deliver tangible results.

Dr. Swaminathan anticipates that this research will generalize to help strengthen health systems. For example, how best can digital-health tools assist front-line workers in providing quality services? Can real-time data visualization in a capital city recognize a hepatitis outbreak in one province, or a shortage of malaria bed nets in another? How can countries learn to use their data to improve health systems? She cautions that the WHO has a surprisingly small budget for its outsized role, and must work hard to secure consensus and cooperation from funders and member countries. However, all agree on the urgency of these tasks, and the need to come together and realize them. Greater coordination of science activities within the WHO will help to make that happen.

April 29, 2019


Malaria vaccine pilot launched in Malawi

The WHO has welcomed the Government of Malawi’s launch of the world’s first malaria vaccine in a landmark pilot programme. The country is the first of three in Africa in which the vaccine, known as RTS,S, will be made available to children up to 2 years of age; Ghana and Kenya will introduce the vaccine in the coming weeks.

Malaria remains one of the world’s leading killers, claiming the life of one child every two minutes. Most of these deaths are in Africa, where more than 250,000 children die from the disease every year. Children under 5 are at greatest risk of its life-threatening complications. Worldwide, malaria kills 435,000 people a year, most of them children.

“We have seen tremendous gains from bed nets and other measures to control malaria in the last 15 years, but progress has stalled and even reversed in some areas. We need new solutions to get the malaria response back on track, and this vaccine gives us a promising tool to get there,” said WHO Director-General Dr. Tedros Adhanom Ghebreyesus. “The malaria vaccine has the potential to save tens of thousands of children’s lives.”

Thirty years in the making, RTS,S is the first, and to date the only, vaccine that has demonstrated it can significantly reduce malaria in children. In clinical trials, the vaccine was found to prevent approximately 4 in 10 malaria cases, including 3 in 10 cases of life-threateningly severe malaria.

April 24, 2019


WHO stops short of declaring Ebola crisis a global health emergency

 The Ebola outbreak in the DRC still does not warrant the declaration of a global health emergency, the World Health Organization said Friday. This is a decision that is sure to trigger substantial debate as the virus continues to spread unabated, writes STAT, a publication that provides analysis of biotechnology and life sciences.

In the past two weeks, the case count has surged by double digits most days over the past two weeks — a far faster rate than earlier in the epidemic.

“The decision was made by WHO Director-General Tedros Adhanom Ghebreyesus on the basis of a recommendation by a committee of outside experts that has now concluded twice that the outbreak does not warrant an emergency declaration. Tedros said he accepted their advice. The panel’s chairman, Robert Steffen, said there was an explanation for the rising numbers, noting that the new cases are concentrated in or originating from Katwa and Butembo, where the outbreak response teams have had difficulty gaining the cooperation of the communities. “There was turmoil in these areas, which were just not accessible for a certain period of time.”

Tom Inglesby, director of the Center for Health Security at the Johns Hopkins Bloomberg School of Public Health, disagreed with the call. “I do think it’s a mistake. I do think conditions have been met for declaring it. It’s at least as serious as public health emergencies of international concern that have been declared so in the past,” Inglesby told STAT. “And I think it’s a mistake because I think it could have drawn in more international attention, political will and support.”

april 15, 2019


Lancet: Global Health has forgotten the Arab world

In a 2014 Lancet Series on Health in the Arab World, Abbas El-Zein and colleagues wrote about “a choice between, on the one hand, regional cooperation and ecological integration for the sake of survival and, on the other hand, war, sectarian divisions, mistrust, and little hope in the future”. 5 years on, that choice has been made, writes Richard Horton, the current editor-in-chief of the Lancet in April 2019, referencing many Arab nations that have undergone upheaval: Iraq, Syria, Yemen, Libya, Egypt, and the occupied Palestinian territory.  The editorial notes that the health community, including international health institutions, has utterly failed to prioritise a region facing endemic conflict and conflagration.

The only health organisation with an exclusive mandate to address health in the Arab World is WHO's Regional Office for the Eastern Mediterranean (EMRO). Ten “key initiatives” for 2019 include creating an “Alliance for Health for All”, revitalising community-based programmes, and promoting patient safety.

“But these priorities and initiatives are pedestrian”, writes Horton. They do not match the urgency of multiple predicaments facing Arab countries. What can be done? Instead of waiting for governments to act, the health and medical research communities could do more to encourage collaborations with Arab nations. The Arab World is home to world-class universities—the American University of Beirut, Birzeit University, the University of Jordan, to name but a few. By forging bilateral educational, clinical, and research partnerships, possibilities for a transformational shift in opportunities for a new Arab generation are palpable. (We have seen these possibilities realised during 10 years of The Lancet Palestinian Health Alliance.) Arab countries are an illuminatingly rich arena for health action. The Qur'an underlines the importance of knowledge (20.114), reflection (45.13), and education (96.5). Scaling up programmes of scientific and professional exchange would justly honour these Qur'anic commitments”.

April 8, 2019


SUPERBUGS FLOURISH AT HEALTH FACILITIES

The Telegraph reports that one in four healthcare facilities around the world lack even basic access to water services. This exacerbates the spread of drug resistant superbugs.

In the first comprehensive review of access to water, sanitation and hygiene services (WASH) in healthcare centers, UNICEF and the World Health Organization (WHO) found that roughly two billion people use health facilities lacking basic water services globally – while almost 900 million people use centers with no water services at all. The report was published on 3 April 2019. “Water, sanitation and hygiene services in health facilities are the most basic requirements of infection prevention and control, and of quality care,” said António Guterres, United Nations Secretary-General. Poor sanitary conditions have been directly linked to rising rates of so-called superbugs, which develop when bacteria and other pathogens become resistant to antibiotics.

The WHO has listed antimicrobial resistance as one of its top threats to global health, and current estimates suggest that nearly 10 million people a year will die from untreatable superbugs by 2050 – a dramatic increase from the 700,000 deaths linked to antibiotic resistance in 2014. In clinics without adequate WASH facilities this is common, as antibiotics prevent and treat infectious diseases which could have been avoided with better hygiene practices. 

april 1 2019


Disease inevitable following cyclone in Southern Africa

Officials have warned that disease is threatening to aggravate the already dire conditions facing millions of survivors following the powerful tropical cyclone which ravaged southern Africa 10 days ago, reports Agence France Press.

Cyclone Idai smashed into Mozambique's coast unleashing hurricane-force wind and rain that flooded swathes of the poor country before battering eastern Zimbabwe. More than 700 people were killed across the two nations. Speaking at a briefing in Beira, 1,000 kilometres (620 miles) northeast of the Mozambique capital Maputo, Lands Minister Celso Correia said it iss now "inevitable that cases of cholera and malaria will arise".

The World Food Programme said Friday that the humanitarian disaster unfolding in Mozambique was on par with the situation in Yemen and Syria which are both in the grip of civil wars. "The government is already setting up a cholera treatment centre to mitigate cholera. We should not be frightened when cholera issues arise," added Correia, describing efforts to control the emerging humanitarian crisis.

March 25, 2019


Nigeria: “the end of HIV/Aids in sight”

President Muhammadu Buhari of Nigeria has said the trends reflected in the latest Nigeria HIV/AIDS Indicator and Impact Survey (NAIIS) report signal that the end of the disease is in sight in the country, reports African Daily Voice.

Buhari said the availability of accurate and reliable HIV data for the country is crucial for planning effective health interventions to arrest the HIV epidemic and ultimately rid the country off this health threat. “The Nigeria AIDS Indicator and Impact Survey were designed to provide the data we need to plan adequately and consolidate on the progress towards the elimination of HIV in Nigeria.

The official HIV prevalence for persons aged 15-49 years in Nigeria is now 1.4 percent. An estimated 1.9 million Nigerians are now living with HIV with about one million persons on treatment.

March 19, 2019


Science inching forward with HIV “Cure” Research

World headlines from the Conference on Retroviruses and Opportunistic Infections (CROI) held in Seattle last week are that for the second time, a bone marrow transplant eliminates HIV from the blood of a patient. Given its complexity and cost, this method is not likely to be used on a large scale.

Researchers from University College London (UCL) reported the case of an HIV-positive man who, after receiving a bone marrow transplant, no longer showed any sign of the AIDS virus, 18 months after he had stopped taking antiretroviral therapy. Dubbed “the London patient”, the man’s “recovery” follows a similar route of that of “the Berlin patient”, Timothy Brown, whose case was reported 11 years ago. Both men had the same type of cancer and both had stem cell transplants, from donors with a rare genetic mutation that resists HIV infection.

Scientists have warned that this breakthrough should not be described as a cure or as healing, as it would give false hope. Michel Sidibé, executive director of UNAIDS did emphasize that HIV science was given a boost with this news. “It gives us great hope for the future that we could potentially end AIDS with science, through a vaccine or a cure. However, it also shows how far away we are from that point and of the absolute importance of continuing to focus HIV prevention and treatment efforts”, said Sidibé.

mar 11, 2018