The Daily Impact: Better MDR-TB Drugs Will Arrive Soon

April 24, 2014

Good news for TB control as a phase III trial for a novel combination of drugs to treat MDR-TB will launch this year. From the Guardian:

The announcement that the phase III trial called STAND (Shortening Treatments by Advancing Novel Drugs) is to go ahead in 10 countries will be enthusiastically welcomed by campaigners and clinicians. TB kills 1.4 million people a year. The old drugs – half a century old, in fact – are no longer adequate. The standard treatment is a course of antibiotics lasting for six months. With the best will in the world, it is not surprising if some people fail to complete it. Drug resistance is an ever-growing and ever more scary issue. To add to multi-drug resistant TB (MDR-TB), we now have extensively drug-resistant TB (XDR-TB). Some of the antibiotics needed to treat resistant strains are very expensive and unavailable in the developing world. Even in countries that have them, the treatment can take the best part of two years.

So if the global and growing TB epidemic is to be contained, let alone turned around, novel drugs are vital. The new trial was announced by the TB Alliance and will be carried out by partners around the world. It has a completely new approach. We know TB has to be treated with a cocktail of drugs, to prevent resistance developing. But instead of trialling one drug at a time against TB, STAND will test three in combination.

PaMZ, the new combined treatment, consists of two new drug candidates, PA-824 and moxifloxacin, and pyrazinamide, which is currently used against the disease. If it works – and it has been successful in smaller trials - it will cut the length of a course of pills for TB from six months to four and for MDR-TB from 18-24 months down to six months. There will be no more need for daily injections for MDR-TB and the Alliance says the patients will be taking maybe 360 pills or less instead of over 14,000 over the course of their treatment, as now, and the drugs will be less toxic.

The Bill and Melinda Gates Foundation, a key funder of the TB Alliance along with the UK’s Department for International Development, the United States Agency for International Development and other bodies, is putting extra cash in to make the trial happen, but more is needed. Dr Mel Spigelman, president and CEO of TB Alliance said:

We thank all our supporters to date, as without their investment, the highly promising PaMZ regimen would not have reached this critical stage. We need new and expanded commitments for the STAND trial, however, if we are to realise the significant potential of this treatment to save millions of lives.

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Richard Frank, 1936-2014

The late Richard Frank, former President and CEO, PSI.

As the long-time President and CEO of Population Services International (PSI), Richard Frank was responsible for growing the organization from a small, unconventional, independent group with a passion for social marketing into an organization that gives millions of poor people around the world the opportunity to improve their lives. He passed away on April 20, 2014.

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The Daily Impact: Acute Malnutrition Risk for 250k Children in South Sudan

April 23, 2014

UNICEF warns that the current crisis in South Sudan is placing 250,000 children at risk of dying from malnutrition, warns UNICEF. From VOA:

UNICEF spokesman Christophe Boulieroc told VOA more than 3.7 million people in South Sudan are at high risk of not getting enough to eat.  Among them, he said are 740,000 children under age five.  “This means that if nothing is done to increase, to scale up the action against malnutrition – that means that 50,000 children under five could die unless they benefit from treatment …  But, the violence is really worsening the situation in this regard,” he said.

UNICEF staff report many people are resorting to eating wild foods, such as bulbs and grasses. They warn the continuing conflict between the government and rebels is forcing more people to flee their homes.

If the violence persists, it notes farmers might miss the planting season, which would increase child malnutrition to heights never seen before.

Boulieroc said UNICEF’s immediate goal is to treat more than 150,000 severely malnourished children — a treatment that could save many lives.  “We provide them treatment.  We have several rapid response teams to reach the children.   You know there is a question of access.  We bring them therapeutic food, micro-nutrient supplements, medicines, water purification sachet and other things…The fight against malnutrition remains the priority in South Sudan,” he said.

Boulieroc said children are vulnerable even in the best of times.  But, during this intense period of violence, he says children are exposed to many dangers other than that of malnutrition.  He said many children become separated from their families while fleeing their homes.  This exacerbates their already traumatic situation.

In addition, he said children are being recruited as soldiers by both sides to the conflict.  He said UNICEF does not yet have accurate information as to the numbers.  But he said aid workers are gathering information and trying to do what they can to protect children from being recruited.

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Global leaders show unprecedented support for maternal and child health


In September 2013, World Bank, UNICEF, USAID, Norway committed an unprecedented $1.15 billion over the next three years to advance progress toward Millennium Development Goals 4 and 5, and to get essential services and medicines to women and children who need them most. This commitment could position countries to be able to help save 3 million lives.  Ray Chambers, UN Secretary General’s Special Envoy for Financing the Health Millennium Development Goals and For Malaria, shares his thoughts on this extraordinary event.


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The Daily Impact: Two UNICEF staff gone missing in Pakistan

April 21, 2014

Investigations are underway after two staff with UNICEF went missing in Karachi, Pakistan. From CNN:

The staffers went missing on Thursday evening, United Nations spokesman Vittorio Cammarota said.

Police are in close contact with the UNICEF employees’ families, he said.

The port city of Karachi is Pakistan’s financial capital.

On Saturday, gunmen wounded a prominent Pakistani TV news anchor there. His brother linked the attack to the nation’s government, drawing a denial from military officials.

Hamid Mir was shot three times by gunmen in a car and on two motorcycles near Karachi’s airport, his network Geo News — a CNN affiliate — reported.

Amir Mir — the targeted news anchor’s brother and a journalist himself — said his brother believed ISI, Pakistan’s powerful intelligence agency, had plans to assassinate him.

The Pakistani military public relations agency ISPR said that “raising allegations against ISI or the head of ISI without any basis is highly regrettable and misleading.”

In the same statement, a spokesman for that agency condemned the attack and “prayed for (Mir’s) well-being and quick recovery.”

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The Daily Impact: Gunmen attack UN mission in South Sudan

April 18, 2014

Gunmen wounded dozens of people when they stormed a UN base in South Sudan. From AFP:

The top UN aid official in South Sudan, Toby Lanzer, said he was “outraged” by the assault in the war-ravaged town of Bor, in which two peacekeepers were also wounded.

Almost 5,000 civilians are sheltering inside the fortified base of the United Nations Mission in South Sudan (UNMISS), one of the most bitterly contested regions in the four-month-long conflict splitting the country.

UNMISS condemned “heinous murders” in the attack, although it has not officially confirmed any deaths.

“The armed mob forced entry into the site and opened fire on the internally displaced persons sheltering inside the base,” the UNMISS said in a statement, saying its forces returned fire — first firing warning shots and then taking part in a ferocious gun battle — before the fighters retreated.

The gunmen had initially approached the camp “under the guise of peaceful demonstrators” intending to present a petition to the UN, before opening fire and breaching the compound, the statement added.

The civilians fled into the base weeks ago amid brutal ethnic massacres in the world’s newest nation.

Information Minister Michael Makuei said that a “huge number” of gunmen had come seeking revenge for the rebel capture of the oil town of Bentiu two days ago hoping to kill the trapped civilians, many of them children.

The conflict in South Sudan has left thousands dead and forced around a million people to flee their homes since fighting broke out on December 15 in the capital Juba before spreading to other states in the oil-rich nation.

Bor, the capital of Jonglei state, has swapped hands several times during the conflict.

The latest clashes in Bor echo an attack by gunmen in December on a UN base in Akobo, also in Jonglei, killing at least 11 civilians and two Indian UN peacekeepers.

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