In TB Fight, a Call for More Teamwork

Joanna Breitstein is the Director of Communications at the TB Alliance. This post orignally appears on the USAID Impact blog.

Robert Clay speaking at the Kaiser Family Foundation. Photo: TB Alliance

At an event heralding the launch of a new clinical trial that tests tuberculosis drugs in combination, Robert Clay, Deputy Assistant Administrator in USAID’s Global Health Bureau, said that he wants researchers and those who oversee programs in countries to work more closely together.

Clay told a packed audience at the Kaiser Family Foundation in Washington, D.C. that “past polarization of research and implementation is really something that we have to overcome.”

“The researchers have to understand the barriers that implementers are facing to work through these programs, and the implementers have to understand the kinds of studies that are being carried out, and looking at these results to translate that in real time to policymakers,” he said. Clay said these kinds of working relationships were especially important in a time of tight financial resources. Speaking about efforts to fight TB, he said, “No one group can address this alone. … We’re going to have to be working together to grow the pie.”

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Growing Cambodia’s Condom Market by Partnering with USAID and DfID

PSI/Cambodia uses social marketing in Phnom Penh to bring OK condoms into the homes of the nation’s residents. The aim is to make a product that people want to use and thereby encourage safe and healthy family planning methods. Brad Arsenault, education officer for USAID’s mission in Cambodia, tells how a unique partnership developed between USAID and DfID to support the efforts of PSI and increase condom use in the country.

An excerpt from Frontlines:

Building on years of collaboration, the Social Marketing and Behavior Change Intervention program was launched in 2007 as a new, collaborative five-year program for Cambodia. The program fundamentally changed the scope, operation, and, most importantly, the impact of USAID- and DFID-funded programs in Cambodia compared with earlier years. Both agencies realized that partnering would naturally strengthen their ability to achieve their goals.

At the same time, DFID began a global restructuring and a reduction of its footprint in certain regions and countries. While DFID wanted to continue to support Cambodia’s health-sector goals, it had to reduce its overhead costs and in-country staff.

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Healthy Dose: Groundbreaking TB Trial Near Completion

March 21, 2012

Scientists say the first ever TB vaccine trial, taking place in South Africa, will end early next year. The AP reports:

South African researcher Dr. Hassan Mohomed said the trials will make medical history, even if the vaccine doesn’t work. He said the results will still help scientists understand the world epidemic and gather data that could hasten the eventual eradication of TB.

The government’s health department said Tuesday that South Africa has the second highest rate of TB infection in the world after the tiny southern African nation of Swaziland. TB is the biggest killer of HIV-positive South Africans, whose resistance to disease is lowered.

Mike Brennan, an adviser to the U.S.-based Aeras nonprofit TB research group, said the new worldwide blueprint for a plan of action followed “tremendous progress” already made in the past decade.

“Ten years ago no vaccine was in clinical trials,” he said Tuesday at the launch of a new global drive to find a vaccine.

The South African trials and work in other countries now mark “a rallying point for one of the world’s deadliest diseases” that includes strains resistant to conventional drugs, he said.

“It’s like building a house. We have the plans, we need builders to bring the finance and workers to bring the tools,” he said.

If trials over the next three years fail, scientists will learn where major gaps in their research lie.

“We are at a key time now when we have the hope of a new vaccine being developed over the next ten years,” he said.

That would relieve immense burdens on poor nations where TB and HIV/AIDS are prevalent.

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PSI and Gates Collaborate to Test Male Circumcision Innovation in Zimbabwe

This week, the New York Times reported on the development of two male circumcision devices: PrePex and Shang Ring. Both are exciting innovations that make it quicker, easier and safer to perform circumcisions on men.

Now that three studies have shown that circumcising adult heterosexual men is one of the most effective “vaccines” against AIDS — reducing the chances of infection by 60 percent or more — public health experts are struggling to find ways to make the process faster, cheaper and safer.

The goal is to circumcise 20 million African men by 2015, but only about 600,000 have had the operation thus far. Even a skilled surgeon takes about 15 minutes, most African countries are desperately short of surgeons, and there is no Mohels Without Borders.

So donors are pinning their hopes on several devices now being tested to speed things up.

Dr. Stefano Bertozzi, director of H.I.V. for the Bill and Melinda Gates Foundation, said it had its eyes on two, named PrePex and the Shang Ring, and was supporting efforts by the World Health Organization to evaluate them.

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Cholesterol-Lowering Statins Linked to Reducing Pneumonia

Results from a study on patients using cholesterol-lowering statins point to a lower likelihood of contracting pneumonia as compared to the placebo group. The news is quite exciting, but there is a major caveat. Given the design of the trial, the causality of the statin reducing pneumonia in adults is not strong. Further research will be necessary to uncover the direct link. However, there is good reason to be optimistic given that there is something that is helping to reduce the likelihood of patients contracting pneumonia.

Pneumonia is a serious problem for the elderly and small children. Determining ways to reduce risk can save thousands of lives each year. Reuters reports further on the study:

CrestorIsraeli researchers found that of nearly 18,000 adults in a clinical trial of rosuvastatin (Crestor), those given the drug were 17 percent less likely to develop pneumonia over several years, versus people given a placebo.

That’s a small effect, and no one is suggesting people start on statins in the hope of warding off pneumonia.

Instead, the researchers say their findings give indirect support to clinical trials looking at whether statins help prevent certain complications in patients with serious infections.

“We would not recommend using statins for the prevention of the infectious disease,” said lead researcher Dr. Victor Novack, of Soroka University Medical Center in Israel.

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Healthy Dose: Food Crisis Hits Chad

March 20, 2012

The international community has been warning for several months about an impending food crisis in the Sahel region.It’s here. And the Kanem region of Chad is where it is first hitting.

“Child malnutrition rates have soared in the region of Kanem, which is now in the grip of a full blown emergency, Action Contre La Faim (ACF) said. Kanem is one of the first areas to be affected by a looming crisis in the Sahel region where some 15 million people in half a dozen countries risk hunger in the coming months.

More than 2,000 children in Kanem were admitted to nutrition treatment centres in February alone, triple the number treated in December, according to ACF.

“For the people in Kanem the emergency is already here,” ACF spokeswoman Lucile Grosjean said. “I was at a therapeutic centre and two children died because they arrived very late. They were in such a bad shape that it wasn’t possible for us (ACF) to save their lives,” she told AlertNet by phone from Kanem’s main town of Mao.

Aid agencies have warned for months of an impending food crisis in the semi-arid belt south of the Sahara desert following drought and poor harvests. The United Nations estimates at least 15 million people in the Sahel could be affected, including 3.6 million in Chad, 5.4 million in Niger, 3 million in Mali, 1.7 million in Burkina Faso and hundreds of thousands in Senegal, the Gambia, and Mauritania respectively.

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Video: Investigating the Causes of Water Shortages in Ghana and Nigeria

Both Ghana and Nigeria are suffering from major water shortages and the causes are not entirely known. An investigation by Steve Sapienza for PBS looks at how Nigeria’s Ameto Akpe and Ghana’s Samuel Agyemang are holding their respective governments through investigative reporting.

Here is a small snip-it from the report:

STEVE SAPIENZA: In the neighboring country of Ghana, residents of the capital, Accra, are frustrated with the government’s failure to provide a reliable supply of piped fresh water, this despite Ghana’s ample water resources and a steady flow of foreign aid for water projects.

About four years ago, when Accra was experiencing severe water shortages, the public named these containers Kufuor gallons after the sitting president. Now reporter Samuel Agyemang is asking why these containers are still found in area neighborhoods.

Samuel Agyemang is an award-winning reporter who anchors the national evening news for Metro TV.

SAMUEL AGYEMANG, Metro TV: Hello. Good evening. And welcome to the weekend news.

STEVE SAPIENZA: His investigation into illegal nighttime water tapping led him to pursue the much bigger problem of gaps in water access citywide. The story starts right in his own backyard, the seaside enclave known as Teshie.

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WHO Director General Warns of Growing Antibiotics Resistance

Margaret Chan

“Worldwide, the fact that greater quantities of antibiotics are used in healthy animals than in unhealthy humans is a cause for great concern,” said WHO director general Margaret Chan in her remarks to a meeting of infectious disease experts in Copenhagen last week.  She warned of growing resistance and urged for restrictions in the use of antibiotics in food production and a concerted crackdown on counterfeit medicines.

The Independent reports:

“A post-antibiotic era means, in effect, an end to modern medicine as we know it. Things as common as strep throat or a child’s scratched knee could once again kill.”

She continued: “Antimicrobial resistance is on the rise in Europe, and elsewhere in the world. We are losing our first-line antimicrobials.

“Replacement treatments are more costly, more toxic, need much longer durations of treatment, and may require treatment in intensive care units.

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Healthy Dose: HIV/AIDS up in Uganda; Burden Falling on Women

March 19, 2012

More than half a million people contracted HIV in the past five years, most of whom are women, according to the Uganda AIDS Indicator Survey.

This puts the number of people now living with HIV/Aids at about 2.3 million people up from approximately 1.8 million in 2005. The results released by the Ministry of Health on Friday also indicated a slight increase in the prevalence rate of the disease from 6.4 per cent in the 2004/2005 to now 6.7 per cent among 15-49-year-olds.

Women alone had a prevalence rate of 7.7 per cent and men at 5.6 per cent with higher figures registered in the urban population and wealthier class for women and both rural and urban men had the same prevalence rate.

Those in their 30s and 40s were found most affected by the virus. The unmarried, widowed or divorced were also more likely to be infected.

What was also worrying is that comprehensive knowledge about prevention and transmission of the disease was very low at 34 per cent for women and 41 per cent for men. This meant that most of the messages were either not reaching the people or were misinterpreted.

The sampled districts in the eastern region registered the lowest prevalence rate. Incidentally, the regions where the highest numbers of men practicing circumcision were also recorded. West Nile on the other hand registered the highest prevalence increase from 2.67 per cent in 2006 to 4.4 per cent now.

Some interventions like Prevention of Mother-to-Child Transmission (PMTCT) were doing well. The survey based on household and individual interviews with 11,340 households.

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India: More Homes Have Phones Than Latrines

Data from the India census finds that, out of 246.6 million households, only 46.9%  have lavatories. The majority, 49.8%, defecate in the open and 3.2% reported using use public toilets. That means nearly half of the households in the entire country do not use a latrine of any sort.

“Open defecation continues to be a big concern for the country as almost half of the population do it,” Registrar General and Census Commissioner C Chandramouli said while releasing the latest data. “Cultural and traditional reasons and a lack of education are the prime reasons for this unhygienic practice. We have to do a lot in these fronts,” he said.¹

Standing in stark contrast is the fact that 63.2% of homes have a telephone. This means mobile technology has found a way to reach the majority of Indians by creating competitive markets that enable prices so the majority of Indians can access it. Meanwhile, a pressing public health need lags behind. To be fair, a comparison between phones and latrines is not entirely fair, but it does illustrate the possibility to reach housholds in a rapidly growing manner.

The BBC reports further on the data from the census:

About 77% of homes in the eastern state of Jharkhand have no toilet facilities, while the figure is 76.6% for Orissa and 75.8% in Bihar. All three are among India’s poorest states with huge populations which live on less than a dollar a day.

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