Healthy Dose, 8 February

WHO Passes Resolution to Curb Counterfeit Drugs

Securing Pharma reports on a new resolution passed at the WHO to fight the nefarious sale of spurious medicines.

The World Health Organization’s executive board adopted a new resolution on counterfeit and otherwise illegal medicines at its meeting in January, with the aim of establishing a member state ‘mechanism’ to tackle the trade outside of any intellectual property considerations.

The executive board took into account an earlier report by the International Working Group of Member States on Substandard/Spurious/Falsely-Labelled/Falsified/Counterfeit Medical Products (SSFFCs) which concluded that public and health issues – and not IP or trade considerations – should underpin WHO’s activities in this area.

The characteristics of the mechanism remain vague and will no doubt be discussed further when the resolution comes up for debate at the next World Health Assembly in May.

The general principles are that it will make use of existing WHO structures, include expertise in national health and medical products regulatory matters and make recommendations on specific issues, possibly helped by the creation of subsidiary working groups.

Beyond the Malaria Numbers: What *Really* Matters

Ed Note. PSI Deputy Director for Malaria Control Angus Spiers offers his take on the ongoing dispute in the malaria community over new mortality estimates that contravene previous estimate by the World Health Organization. 

As the New York Times reports (and as we noted in the Healthy Dose today)  the new malaria study by the Institute for Health Metrics and Evaluation (IHME) has created a lot of debate in the malaria community, not least because of the much higher estimates of mortality, especially in those of 5 years of age, than World Health Organization estimates. No matter which set of statistics you use, the unacceptable underlying fact remains that hundreds of thousands of people (mostly children) will die from an entirely preventable and treatable disease.

Many of the gains in malaria control that have led to the downturn in deaths reported by WHO and the IHME study are the result of the scale up of long lasting insecticide treated bed nets in Africa. That progress is under threat unless the global community, at least, maintains funding levels for malaria control. Those nets are wearing out, and need replacing. Access to effective diagnosis and treatment for malaria is still unacceptably low, so there is still much to do if the progress reported by both the WHO and the IHME is to be maintained. Currently, global malaria funding is falling, not least because of the postponement of Global Fund Round 11 and these gains will be rapidly lost if the nets are not replaced and accurate case management of fevers is not scaled up.

A Mega-Generation of Hope

The youth population today is larger than it has ever been. Today’s mega generation of hope has the power to create a more just and equitable world.

But our fast-paced world seems to have designed the toughest ever challenges for this largest ever generation. Strategies found in old playbooks seem antiquated for young people growing up in a world in which population growth outstrips our ability to harvest and preserve natural resources, global economic stability is fragile, and the rights of women and girls still come in second far too often.

For those of us working to improve global health, this mega-generation is an opportunity to instill an understanding and appreciation for adopting healthier behaviors that can be passed on to the next generation.

But first we must be able to reach them

Healthy Dose February 7

Malaria Community Reacts to Bombshell Study

The World Health Organization has been operating under the assumption that Malaria killed 655,00 people in 2011. A Lancet study published last week put the number at nearly twice that and now experts on both sides are defending their estimates. From the New York Times:

The challenge was issued by the Institute for Health Metrics and Evaluation at the University of Washington, founded by the Bill and Melinda Gates Foundation to analyze global trends.

Almost immediately, the new head of the malaria program at the W.H.O. circulated a memo saying he stood by his agency’s estimate and noting what he considered flaws in the new study: It played down long-held beliefs that children and adults who have survived several bouts of malaria rarely then die of it, and it relied partly on “verbal autopsies,” usually guesses by family members as to what someone died of.

Some experts were dismayed. The dispute “is a little like Gingrich and Romney going at each other — it’s only going to hurt the whole field,” said Jay A. Winsten, an adviser to Raymond G. Chambers, the United Nations special envoy for malaria.

Mr. Chambers’s reaction was that it didn’t matter much which estimate was right. Both sides agree that mosquito nets and new malaria drugs are driving deaths down, he noted. The world still must get whole families, not just babies and pregnant women, sleeping under nets and then provide new nets every three years.


Impact: Broadcasting the Message

It is Wednesday, and the Amour & Vie weekly radio program – Love & Life in English – is starting in 15 minutes. Patricia Montcho and her co-host, Yann Kounde, look over their scripts and run through some lines. African pop music streams proudly through the crowded radio station. Amidst the chaos, Patricia seems relaxed, prepared and professional. She walks into the sound booth.

The intro jingle starts to play, and Patricia kicks off the show. “Hey out there, glad you could join us for this week’s show. Today we’re talking about abstinence and why or why not have you, as a young person, abstained from sex.”

Two years ago, Patricia joined Amour & Vie, a youth program organized by ABMS, PSI’s affiliate in Benin. She works voluntarily as a freelancer for the program and host for the weekly radio show. She also studies Linguistics and Public Health at the University of Abomey- Calavi in Cotonou.

Mandy Moore Writes to the New York Times in Support of Global Health

Ed note. PSI Ambassador Mandy Moored penned a letter to the editor in which she praised the Bill and Melinda Gates Foundation for its continued support for the Global Fund.  Check it out!

To the Editor:

Re “Bill Gates Donates $750 Million to Shore Up Disease-Fighting Fund” (news article, Jan. 27):

The Bill and Melinda Gates Foundation just threw the global economy a lifeline. By injecting needed financial and political capital into the Global Fund to Fight AIDS, Tuberculosis and Malaria, the Gates Foundation has reminded the world of an important truth: economic growth is directly related to global health.

In 2012, two billion to three billion people live in poverty worldwide. This huge bottom of the pyramid has an estimated $5 trillion in purchasing power. With simple investments in health, we can really turn individuals and families into healthy, active consumers and producers. New markets will develop and economies will grow. Most important, mothers will be healthy, children will reach their full potential and families will thrive. We all win.

The Global Fund, recently rocked by reduced financial commitments from donor governments, is a powerful engine to improve health. I commend Bill and Melinda Gates for their bold leadership to reignite the fund’s capacity to deliver results. The future prosperity of all seven billion of us depends on it.

Los Angeles, Jan. 27, 2012

The writer, the singer and actress, is an ambassador for PSI, a global health organization.

Healthy Dose February 6, 2012

Africa Needs to Fill $4 Billion Global Fund Shortfall

More fallout from the global financial crisis. From the East African:

Africa requires at least $12 billion for its HIV/Aids response in the next three years to stem the scourge, although this financial injection is threatened as donors hold back due to mismanagement of funds.

The continent faces an uphill task to bridge the current gap of $4 billion, according to the United Nations Programme on HIV/Aids (UNAids), a shortfall that could cause more deaths.

The UNaids is proposing in a new report that African countries need to come up with new ways of mobilising for funds.

“Revenue could be obtained by taxing alcohol and tobacco consumption or the use of mobile telephones and public-private partnerships,” says the report adding countries could also tap into loans by the African Development Bank.

Why Youth? Why Now?

The ad, which ran in Trinidad and Tobago, was one of 30 television spots produced by PSI/Caribbean across 11 countries in the English-speaking Caribbean. The target audience for this ad was very specific: middle-class, “uptown” young women. The message was clear: insist your man wear a condom. Other ads produced by PSI/Caribbean as part of its Got It? Get it! campaign target the kind of young man who wears his machismo on his sleeve, poorer women, sex workers and other niche demographics. The goal of promoting condom use is the same across each group.

“The Caribbean is a very sexualized culture,” observes Kerry Singh, marketing and technical director for PSI/Caribbean. “Between reggae, dance hall and soca music, the average young person is put in a sexual light at a very young age.” The data bear out. According to a 2011 UNICEF report, Latin America and the Caribbean is the region with the highest proportion of adolescent females claiming to have had their sexual debut before age 15. There is no equivalent data for men, but, according to Singh, social pressures encourage young men to have children at a young age. “Among black Caribbean male youth, there is a tendency to think that once you are 17 and you don’t have a child on the way, there must be something wrong with you,” says Singh.

Healthy Dose February 3, 2012

New Study: Global Malaria Deaths Much Higher than Previously Thought


A new study from the Institute for Health Metrics and published in the Lancet shows that Malaria has killed more than 1.2 million people a year. That is nearly 50% above previous estimates. The Daily Star reports:

But there is also good news: deaths from the mosquito-borne disease have in fact been falling sharply thanks to access to better drugs and insecticide-treated nets.

Published in The Lancet on Friday, the study by the Institute of Health Metrics and Evaluation (IHME) at the University of Washington, Seattle, says malaria killed at least 1.2 million people worldwide in 2010.

The estimate will be a likely shock for health policymakers. Only last September the UN-backed Roll Back Malaria (RBM) calculated mortality in 2009 at 781,000.

The higher figure, say the US researchers, derives from wider and more reliable data, including use of a technique called “verbal autopsy”.

Under this, investigators interview relatives of someone who has recently died in order to help pinpoint the cause of death. In many poor countries which lack medical infrastructure, mortality is often poorly probed or misidentified.

The new study skewers the belief that the overwhelming majority of malaria deaths occur among the under-fives.

In 2010, more than 78,000 children aged five to 14, and more than 445,000 aged 15 or older, died of malaria, together accounting for 42 percent of the total.