TropIKA Blog Portal http://blog.tropika.net Tropical Diseases Research to Foster Innovation & Knowledge Application Mon, 10 Mar 2008 21:19:45 +0000 http://backend.userland.com/rss092 en <![CDATA[WHO and Zimbabwe's cholera epidemic]]> regular updates on the worsening cholera situation in Zimbabwe, where a total of 26 497 cases, including 1 518 deaths, have been reported by the Ministry of Health. Of great concern is the fact that case fatality rates (which are averaging over 5%) are much higher than the internationally accepted norm of 1%. WHO also has a photo gallery of its work against cholera in Zimbabwe. ]]> http://blog.tropika.net/tropika/2009/01/05/who-and-zimbabwes-cholera-epidemic/ <![CDATA[Yemen to continue action against schistosomiasis]]> Saba News. For further details on schistosomiasis control in Yemen (population 2.5 million), see this report on the WHO website. ]]> http://blog.tropika.net/tropika/2009/01/05/yemen-to-continue-action-against-schistosomiasis/ <![CDATA[Save the guinea worm?]]> this a piece of satire intended to raise awareness of dracunculiasis (guinea worm disease) or do they really mean it? If efforts to eradicate guinea worm disease succeed (and there is indeed encouraging progress to report), then it will also mean the eradication of the guinea worm itself. The 'Save the Guinea Worm Foundation' seems to be alarmed at this prospect. The authors of this website say that they are not too upset that a virus had to be wiped out in order to eradicate smallpox but that to deliberately render extinct a higher life form (the guinea worm) is a step too far. They claim that malnutrition and toxins are in any case the real culprits responsible for dracunculiasis. (Another blogger says this exposes the Foundation as a piece of satire, as similar absurd claims are routinely made by AIDS denialists.) But read the Foundation's website for yourself. Perhaps you would like to join their band of volunteers willing to host guinea worms in order to save the species? Alternatively, you may prefer to read a recent press release from UNICEF, which outlines the valuable work being done in Niger to combat dranculiasis.]]> http://blog.tropika.net/tropika/2009/01/05/save-the-guineaworm/ <![CDATA[More support still needed ...but also more realism]]> TropIKA.net knowledge platform, may I wish all of our regular readers a very happy New Year. I hope that your own endeavours in the battle against the infectious diseases of poverty will bear fruit this year. It is heartening to learn that new initiatives continue to be launched to provide funding both for research and for control efforts. However, it is clear that much more financial support is still needed. A US consumer group has reported on government expenditure on neglected infections and says it is not enough. Also in the US, the Institute of Medicine has called upon the incoming President to make health a pillar of foreign policy and to double US funding for global health initiatives within the next four years. Of the diseases which we feature on TropIKA.net, malaria and tuberculosis attract the most funding and in consequence there is always more for us to report regarding new research findings. However, recent weeks have seen the publication of a number of studies on schistosomiasis. One that we have featured concerns the role of hygienic bathing in the transmission of the disease. (Do visit our Research Articles section to see the other studies that we have recently highlighted.) We also report that schistosomiasis control in China will benefit from the use of satellite technology and that new funding from the Gates Foundation will be used for operational research on the control of the disease. The development of effective new interventions against the infectious diseases of poverty is only part of the process. Their effective delivery is also crucial. This is well illustrated by vaccination programmes. Many programmes are still failing to reach targets and a worrying study published in the Lancet now suggests that some programmes over-report their success rates. As we go forward into the New Year it is important to maintain a positive position on what it being achieved but also that we should be realistic; our efforts should be informed by accurate data and not by over-estimates. ]]> http://blog.tropika.net/editorschoice/2009/01/02/more-support-still-needed-but-also-more-realism/ <![CDATA[Human health and human rights]]> selection of recent items on TropIKA.net. It is therefore of interest that the Lancet published a special report on the right to health on International Human Rights Day (10 December ) to mark the 60th anniversary of the Universal Declaration of Human Rights. The report comprises a number of commentary articles and a major 40-page study. The commentaries look at several aspects of human rights, including gender inequality, and there is an interesting discussion of rights-based approaches to improve health in Peru. The authors of the study - Health systems and the right to health: an assessment of 194 countries - point out that countries have a legal obligation under human-rights law "...to progressively realise the right to the highest attainable standard of health and therefore to improve their health systems progressively". Their article provides very extensive recommendations for governments, international bodies, civil-society organisations, and other institutions as a suggested basis for the monitoring of health systems and the progressive realisation of the right to health. None of the articles focuses specifically on infectious diseases but it is good to see a leading medical journal continuing to highlight the connection with human rights. However, a key issue seems to have escaped attention in this series of articles. The estimable Neil Pakenham-Walsh of the Global Health Information Network points out in the HIFA2015 mailing list that the right of access to health information is not discussed. To quote from the website of HIFA2015 (a global campaign for healthcare information for all by 2015): "Tens of thousands of people die every day, often for the simple reason that the parent, carer or health worker lacks the information and knowledge they need to save them". Anyone who is not already aware of this campaign should find out more about this neglected issue.]]> http://blog.tropika.net/tropika/2008/12/23/human-health-and-human-rights/ <![CDATA[Malarial parasites in tree-dwelling rats have close evolutionary relationship with P. falciparum]]> P. falciparum. The claim is based on so far unpublished data but has been reported in an online news service Huliq News. Susan Perkins, Assistant Curator of Invertebrate Zoology at the Museum is quoted as saying: "This is the first time that a relationship has been found between human and rodent malaria. In all past studies, P. falciparum seemed to not be closely related to anything else but the chimpanzee parasite. But this study places it in a sister group of parasites from rodents ... The link between human malaria and rodent malaria is exciting because, if they really are that closely related, our laboratory models might be more powerful for helping to study how to fight the disease." ]]> http://blog.tropika.net/tropika/2008/12/23/malarial-parasites-in-tree-dwelling-rats-have-close-evolutionary-relationship-with-p-falciparum/ <![CDATA[Knowledge without borders]]> Chemists Without Borders, I first noticed that this small and relatively new group is involved in initiatives relevant to the infectious diseases of poverty and to other health concerns. And then I reflected, not for the first time, that we are seeing something of an explosion of organisations and websites featuring the 'Without Borders' tag in their title. It all seems, I think, to have started with the decision by Medicins sans Frontieres, for many years now a highly esteemed organisation, that - while it would retain its original name in most countries - it would be necessary for it to be known in the US as Doctors Without Borders. The example of MSF seems to have inspired other professions to offer their services in the cause of humanity. There are now, to give a few examples, Scientists, Mental Health Workers, Teachers, Librarians and MBAs... all of them Without Borders and all seeking to provide their professional assistance to developing countries. The alternative medicine sector has also been inspired by the growing, though still unofficial, Without Borders movement and there are now groups for Acupuncturists and Osteopaths. And in Afghanistan there is a development project called Beauty Without Borders. The cynic in me wonders which profession will be next to embrace the Without Borders tag. I have been unable to find any Chartered Accountants or Hedge-fund Managers who have adopted the title but perhaps it is only a matter of time. There is indeed considerable potential for humour here but perhaps that would undermine what is a very positive phenomenon. Poverty and disease know no borders, and neither should those who want to participate in the fight against them. TropIKA.net, of course, aims to be a knowledge platform without borders! We welcome readers, and particularly comments, from disease-endemic and other countries worldwide. And if you can add to the above list of Without Borders organizations with a particular interest in infectious disease do please let us know.]]> http://blog.tropika.net/tropika/2008/12/23/knowledge-without-borders/ <![CDATA[Public engagement – now open for business in developing countries]]> http://scienceincommunity.wordpress.com) which I attended two weeks ago at the Africa Centre for Health and Population Studies, South Africa (www.africacentre.ac.za). The conference reinforced the importance of public engagement, particularly in developing countries who have a lot to gain from biomedical and public health research. The theme suggests public engagement is more than just a unilateral flow of information but a dynamic, interactive, participatory process that serves to inform, educate, and stimulate people. A quick and dirty study with ten of my academic colleagues shows that public engagement in Malawi is either unknown or misunderstood. According to Wikipedia - Public engagement is a term that has recently been used, particularly in the UK, to describe "the involvement of specialists listening to, developing their understanding of, and interacting with, non-specialists" (as defined by England's university funding agency, HEFCE, in 2006). This definition is somehow lacking and fails to portray public engagement as a process with specific goals and outcomes. Further web searches suggest public engagement is rooted in several domains: in politics (participatory democracy), and in marketing (public relations). The WT Public engagement website (www.wellcome.ac.uk/Funding/Public-engagement ) states ‘WT wants to encourage people of all ages and from all walks of life to consider, question and debate the key issues of now and the future’. This objective is clear with an outcome that can be measured. Evaluating public engagement and providing evidence of its value is major challenge for implementers. This was discussed during a session on the value of engagement with John Young, Overseas Development Institute, UK. Participants suggested community trust, positive health/behaviour outcomes, legislative reform, new links and networks are convincing evidence of the value of public engagement. In corporate environments, public relations melds strategy and communications, constituting an essential bridge between corporations and their stakeholders. In science, this would be analogous to a bridge between research institutions and stakeholders. Stakeholders could be media, policy makers, communities, or specific target groups like pregnant mothers or school children. Thulani Cele, public relations officer, Africa Centre, captured this during his presentation on media engagement. Public relations and likewise public engagement must be part of business strategy and policy formulation, in addition to being responsible for communicating decisions. What qualifies as engagement? Several creative approaches were not only discussed but experienced: from a science cafe on the day in the life of a field worker; to a visit to the University of Zululand science centre; to a debate on research and activism; to a play on peer pressure by DramAidE. Approaches may differ in style, format, and audience with similar approaches even having different adaptations e.g. adult vs junior science cafes. Despite these variations, they all strive to achieve the same outcome, of a making science more welcoming and accessible, and deepening its social impact and relevance. For engagement to be effective it needs to involve influential actors. To be influential today does not require academic or professional credentials alone. It needs person that have a personal experience, passion, and a desire to contribute to general knowledge. Through public engagement, we build trusted relationships with a broad set of influencers be it policy makers, community leaders, or media. Participants in the four thematic areas of the conference -  media engagement, policy engagement, creative approaches, and community engagement discussed several challenges. These ranged from ‘dejargoning’ the science, getting the interest of stakeholders, poor funding, lack of recognition of the role of public engagement, to evaluating public engagement programs. Where solutions were not available in the form of presentations and dialogue, contacts and networks were established for further exploration. The conference stimulated the minds of the participants, presented exciting ideas,  set up networks and partnerships, and offered new opportunities. Engagement is here to stay. Science communicators must rise to the challenge, by creating new forms of expression that will work in local contexts. Just like any new process, it will take some time to take-hold and become fully standardized, but it is undeniably a multifaceted and powerful process that can provide value to science and research --especially before research even starts.]]> http://blog.tropika.net/tropika/2008/12/20/public-engagement-%e2%80%93-now-open-for-business-in-developing-countries/ <![CDATA[Gates funded schistosomiasis project will focus on operational research]]> University of Georgia website and information on the Center's other activities may be found here.]]> http://blog.tropika.net/tropika/2008/12/19/gates-funded-schistosomiasis-project-will-focus-on-operational-research/ <![CDATA[Satellites will monitor schistosomiasis in China]]> report from the NewsWise service. The researchers have collected field data from the Poyang Lake region over the last two years. This has been fed into a geographic information system documenting water levels, vegetation characteristics and air temperatures that, when combined, identify areas favourable for the host snails to thrive. For future measurements, all Poyang Lake water level data will come from the European Space Agency’s ENVISAT satellite, which measures the water level of the lake every 35 days. The radar readings have been calibrated to compare to baseline levels recorded in the field data. Schistosomiasis affects 200 million people worldwide. People are infected through contact with water contaminated with the Schistosoma parasite which burrows into human skin and when mature settles in various parts of the body. The infection can lead to a variety of health complications, including bladder cancer, kidney and liver damage. The adult parasites lay eggs which are released into water sources through human waste, perpetuating the cycle of contamination. Tiny worms hatch from the eggs in the water, and use snails as an intermediate host until they are large enough to float freely in the water. No vaccine is available to prevent the illness, and medications to treat it generally are not effective at breaking the disease cycle, especially in poor, developing areas of the world. Dr Ibaraki said, "Really, the only prevention is to not touch the water ... There are huge signs there that tell people not to go into the lake. People know about the dangers of infection, but they have to touch the water to some extent. It’s part of their lifestyle.” Local fishermen are the most at risk. ]]> http://blog.tropika.net/tropika/2008/12/19/satellites-will-monitor-schistosomiasis-in-china/ <![CDATA[Leprosy in the USA: 'not common but not gone']]> reported that more cases of advanced leprosy (Hansen's disease) are being seen in the USA. American doctors, being unfamiliar with the condition, often fail to diagnose it early on. Dr James Krahenbuhl, Director of the US Department of Health and Human Service’s National Hansen’s Disease Pogram said, “We are seeing more and more cases that are advanced.” Speaking at the annual meeting of the American Society of Tropical Medicine and Hygiene, Dr Krahenbuhl said that about 150 new cases of leprosy were diagnosed in the US every year. In total, about 6,500 people currently have leprosy, with about half needing active medical management. He called for greater awareness of leprosy among American doctors. Another leprosy specialist Dr David Scollard, said, “Although this disease is not common, it’s also not gone."]]> http://blog.tropika.net/tropika/2008/12/19/leprosy-in-the-usa-not-common-but-not-gone/ <![CDATA[Mobile phone minutes could motivate TB patients]]> MITNews. ]]> http://blog.tropika.net/tropika/2008/12/19/mobile-phone-minutes-could-motivate-tb-patients/ <![CDATA[Implications of Bamako Call to Action for Malawi]]> This article appears on TropIKA.net with the kind permission of The Nation Newspaper, Malawi.]]> http://blog.tropika.net/tropika/2008/12/18/implications-of-bamako-call-to-action-for-malawi/ <![CDATA[Reducing inequalities in health: does the private sector have a role?]]> report from the International Federation of Pharmaceutical Manufacturers says that the number of medicine and vaccine projects undertaken by IFPMA member companies has increased. Two pharma companies have also just announced their intention to market a new artemisinin-combination therapy (ACT) drug for malaria in Africa – see our news story. However, the proportion of industry research devoted to infectious diseases of poverty remains very, very small. As the IFPMA report acknowledges, nearly all the projects currently under way have only been made possible because they involve public-private partnerships. The new ACT antimalarial, Eurartesim, is a case in point, as it was developed jointly with the Medicines for Malaria Initiative. The role of the private sector in the delivery of care has always been hotly disputed. We link to a debate article on the topic published in PLoS Medicine. Perhaps the biggest doubt as regards what can be achieved through private health care is whether the public sector could ever be able to help reduce health care inequalities. TropIKA.net is particularly concerned with the issue of inequalities and we highlight a review article which discusses the evidence on this question that has been assembled by the knowledge networks set up by the Commission on the Social Determinants of Health. Reducing inequalities is also central to the health reforms which have been taking place in Venezuela in recent years. As discussed in a TropIKA.net blog, the journal Social Medicine has devoted an entire issue to a discussion of the Venezuelan experience. Lessons from the experiences of nine countries in health financing are presented in a 530-page report from the World Bank. Community-based health insurance is one approach to financing that has been advocated, with reducing inequalities particularly in mind, but a new study has found that more evidence will be needed before the effectiveness of such schemes can be ascertained. When health inequalities are discussed it is the differences between rich and poor that one thinks of first. However, gender issues are also of great concern. Another recent study we have highlighted concerns gender difference in knowledge of tuberculosis and associated health-care seeking behaviours. Recently on TropIKA.net, we have been expanding the number of items added to our blog. We hope that our readers find these usually very brief items to their liking. One advantage of blogging is the interactive aspect. It is very easy to respond to a blog and to maintain a discussion. One recent blog was a response to a request from the Faculty of Medicine Universitas Muhammadiyah Yogyakarta, Indonesia to help make better known their innovative International Tropical Medicine Summer School. The summer school is looking for potential visiting lecturers. Can you help? Finally, as South-South cooperation is another issue of interest to TropIKA.net, we are very pleased to have published a news story describing the launch of the West African Viral Surveillance Network, which will greatly facilitate cooperation between researchers in that part of Africa. ]]> http://blog.tropika.net/editorschoice/2008/12/15/reducing-inequalities-in-health-does-the-private-sector-have-a-role/ <![CDATA[Neglected infections of poverty in the USA]]> PLoS Neglected Tropical Diseases also focuses, as one would would expect, on infectious diseases in developing countries. However, a review article published in the journal a short time ago pointed out that some of these same infectious diseases are a significant (and as always neglected) problem for poorer communities in the USA. The diseases include the helminth infections, toxocariasis, strongyloidiasis, ascariasis, and cysticercosis; the intestinal protozoan infection trichomoniasis; some zoonotic bacterial infections, including leptospirosis; the vector-borne infections Chagas' disease, leishmaniasis, trench fever, and dengue fever; and the congenital infections cytomegalovirus, toxoplasmosis, and syphilis. These diseases occur predominantly in people of colour living in the Mississippi Delta and elsewhere in the American South, in disadvantaged urban areas, and in the US–Mexico borderlands, as well as in certain immigrant populations and disadvantaged white populations living in Appalachia. Preliminary disease burden estimates indicate that tens of thousands, or in some cases, hundreds of thousands of poor Americans are affected by these infections, representing some of the greatest health disparities in the United States. Research funding budgets do not, however, address the situation. As the article points out: 'Of the selected disease-specific areas targeted for funding by the National Institute of Allergy and Infectious Diseases (NIAID) in their published annual report, none specifically mentions a neglected infection of poverty.' ]]> http://blog.tropika.net/tropika/2008/12/15/neglected-infections-of-poverty-in-the-usa/ <![CDATA[‘Alma Ata is alive and well in Venezuela’ ]]> Alma Ata Declaration led to a number of calls for a renewed emphasis on primary health care in the delivery of health services in developing countries, as discussed in a TropIKA.net news story. Many people take the view that 'vertical' health programmes have become dominant in recent years and that a return to the Alma Ata principles is needed if progress is to be made in reducing health inequalities. Over the last five years, Venezuela has restructured its health system with an emphasis on primary health care. A special issue of the journal Social Medicine / Medicina Social is devoted to articles discussing the Venezuelan experience, particularly with regard to the Misión Barrio Adentro ('inside the neighborhood') approach that has been adopted. An editorial commends the Venezuelan government for its commitment to the programme, claiming that 'In a period of 5 years the Misión has created a health system – ranging from primary to tertiary care – that is both free and accessible to all Venezuelans.' Other issues examined in articles in the journal include: public health education, the national training programme for comprehensive community physicians, South-South collaboration, and the perspective of the ALAMES Social Determinants Working Group. The changes made in Venezuela reflect of course the wider and often controversial political changes that have taken place in the country over the same period. It would be interesting to hear whether readers of TropIKA.net share the very positive assessment made by the authors of the articles in this journal. Without data as to whether the Venezuelan policy has had an impact on the disease burden, is the journal being somewhat premature in its claim that 'The Venezuelan example holds great promise for countries struggling to develop sustainable primary health services'? ]]> http://blog.tropika.net/tropika/2008/12/15/%e2%80%98alma-ata-is-alive-and-well-in-venezuela%e2%80%99/ <![CDATA[Translational research for neglected diseases]]> More details, in Portuguese, can be found in the website of the Brazilian Ministry of Health. ]]> http://blog.tropika.net/tropika/2008/12/15/translation-research-for-neglected-diseases/ <![CDATA[Could a fungus help control malaria? ]]> Daily News. Dr Abdulla says that there have already been some encouraging preliminary findings and that over the next two years trials will take place at household level, village level and then on a larger scale. He commented that, “If it will become a success, it could become one of the easiest, safe and effective interventions of controlling malaria infections in the country”. Dr Abdulla named the species of fungi it is investigating as Beauveria bassiana and Metarhizium anisopliae. This is not the first time that the use of these fungi as biological insecticides has been proposed. The article (which can be accessed here) also discusses some of the Institute's other activities, including its work against schistosomiasis and sexually transmitted infections.]]> http://blog.tropika.net/tropika/2008/12/12/could-a-fungus-help-control-malaria/ <![CDATA[Australia must show commitment to eliminate trachoma]]> SAFE' strategy for trachoma elimination. It is ironic that the disease is still a problem in Australia as it was the home of one of the most distinguished of ophthalmologists working against blindness worldwide, Fred Hollows. The article may be read here.]]> http://blog.tropika.net/tropika/2008/12/12/australia-must-show-commitment-to-eliminate-trachoma/ <![CDATA[TB: "Who is affected, cannot live more days"]]> The New Nation. When diagnosed, a rickshaw driver said: ""Oh my God! How have I been infected TB? It's a serious disease. Who is affected, cannot live more days. I don't know what to do?'' He was unaware that treatment for TB is free in Bangladesh. The report emphasises the need to improve TB awareness in the community. According to the report (which can be read here) in 2006, a total of 87,381 patients were diagnosed with TB in Bangladesh. ]]> http://blog.tropika.net/tropika/2008/12/11/tb-who-is-affected-cannot-live-more-days/ <![CDATA[Malaria vaccine: approved and in use by 2012?]]> American Society of Tropical Medicine and Hygiene, it has been claimed that the RTS,S malaria vaccine could be licensed by 2011 and in use by 2012. The Los Angeles Times attributes the claim to Joe Cohen, vice president for vaccines for emerging diseases at GlaxoSmithKline, who has worked on RTS,S since its inception 22 years ago. Read the LA Times story here. The vaccine is about to begin a series of phase 3 clinical trials involving 16,000 children accross Africa - see TropIKA.net news story here. However, during the ASTMH meeting two smaller completed trials were reported. In the first, conducted in Kenya and Tanzania, 894 children aged 5-17 months were inoculated either with the three-dose experimental malaria vaccine or a rabies vaccine as a control group. In the eight-month follow-up period, researchers found that children receiving RTS,S had 53% fewer diagnosed cases of malaria. In the second study, conducted in Tanzania, the vaccine was given to 340 infants along with vaccines against polio, diphtheria, tetanus, pertussis (whooping cough) and Haemophilus influenzae B, without lessening the safety or effectiveness of the vaccines. The researchers found that infants who received the malaria vaccine had 65% fewer infections, over a six-month period than those who did not. Another story in the LA Times (here) cautions that more than one vaccine will be needed to control malaria and mentions some of the other vaccines under development. If - as seems likely - the effectiveness of malaria vaccines is going to be around the 60% level (a low figure for vaccine effectiveness), then there will still remain a need for other approaches to control of the disease, including effective drugs and vector control. - To mark the ASTMH meeting, TropIKA.net has published an exclusive interview with the organisation's President, Claire Panosian Dunavan.]]> http://blog.tropika.net/tropika/2008/12/11/malaria-vaccine-approved-and-in-use-by-2012/ <![CDATA[Blogs abounding]]> USPharmD), offers a selection of '100 Global Health Blogs That Will Open Your Eyes'. Some of these blogs will already be known to most readers of TropIKA.net, one example being Malaria Matters. Many others will be new - they are certainly new to me - and are worth at least a look. [A word of caution - many of the websites listed are not actually blogs. For example, Malaria Journal is not a blog; neither is PATH, or the Global Health Initiative, or SciDev.Net.] Your own professional and personal interests will determine which of the blogs you find the most useful. I am certainly pleased to learn for the first time of Essential Medicines News and Global Health Report. These are both blogs from organizations. Many of the others are blogs by individuals; a good example is 'Aetiology'. Some of the other blogs in this 'top 100' are not so impressive. They provide opinion but often this does not seem to be based on information or analysis. Some require an understanding of that odd mixture of internet jargon and US slang that seems to be favoured by so many bloggers. There is a tendency in these blogs (and in the responses to the blogs) for important issues to be trivialised. Most of the 100 blogs selected have at least some merits and the issues they cover are of great importance, but are we then to read all of them? Obviously few of us would have the time and there perhaps is the problem - there are now too many blogs for readers to keep up with all of them. It has been said that the 'blogosphere' (or maybe the internet as a whole) is becoming a place where everyone is talking and no one is listening. Blogging about the infectious diseases of poverty, and other global health issues, does not necessarily lead to more being done about them and whether blogging really does facilitate informed debate is still open to question.]]> http://blog.tropika.net/tropika/2008/12/10/blogs-abounding/ <![CDATA[Biomarker announces malaria presence]]> here. ]]> http://blog.tropika.net/tropika/2008/12/09/biomarker-announces-malaria-presence/ <![CDATA[Cholera and commitment]]> UNICEF says the figure will soon reach 600,000. According to WHO, the overall case fatality rate is 4% but it is 20–30% in remote areas. Many hundreds have died. The situation is now an international emergency. Zimbabweans are fleeing poverty, repression and disease in growing numbers, taking cholera with them to Bostwana, Zambia and South Africa. All visitors to TropIKA.net are people with an interest in the infectious diseases of poverty but what are we to do about Zimbabwe? The TropIKA.net mission is to "to share essential information and to facilitate identification of priority needs and major research gaps". Yes, more research is needed on cholera - see information on the Initiative for Vaccine Research here. However, the need for political commitment to safe water and basic health services is greater than the need for research. What can the research community do in such circumstances? Let us know your views. [For a WHO fact sheet on cholera see here.]]]> http://blog.tropika.net/tropika/2008/12/08/cholera-and-commitment/ <![CDATA[Legacy of leprosy isolation]]> New York Times describes the lives of the 24 remaining people with leprosy still living in the former leprosy settlement of Kalaupapa in Hawaii. For over 100 years leprosy patients were forcibly isolated in Kalaupapa. One resident was the Catholic Priest Father Damien who did much to improve the lives of the residents when he arrived in 1873. He subsequently contracted the disease. Another famous resident was Olivia Breitha who once wrote, 'Even if my skin is insensitive my heart and soul are not'. Hawaii eventually did away with its isolation laws in 1969. Earlier this year, the state’s Legislature formally apologized to the patients and their families for 'any restrictions that caused them undue pain as the result of government policies surrounding leprosy.' However, isolation settlements don't just disappear when legislation is changed. The 24 remaining leprosy patients (they prefer 'patients' to 'residents') are all over 60 and seem unlikely to leave Kalaupapa. The NYT article includes some of their memories of their lives in the settlement. The article can be seen here.]]> http://blog.tropika.net/tropika/2008/12/05/legacy-of-leprosy-isolation/ <![CDATA[Keeping up to date with TB]]> HealthDev.net. The newsletter is compiled in India by journalist Bobby Ramakant. The headlines in the latest issue (direct link here) are as follows: - Online discussion to emphasize the role of people with TB/HIV - Patients discontinue TB drugs after temporary relief - Stop TB Partnership Japan appoints a national Stop TB Ambassador - XDR-TB prevention starts with TB treatment - Emergence of XDR-TB, during treatment of MDR-TB: study HealthDev.net has other interesting content too. Another website, which focuses on development issues (not specifically health) is WorldFocus.org. A round-up of new developments in TB recently appeared in a WorldFocus blog. ]]> http://blog.tropika.net/tropika/2008/12/05/keeping-up-to-date-with-tb/ <![CDATA[Summer school in Indonesia]]> Summer SchoolThe central role of TropIKA.net is to allow people involved in the fight against infectious diseases of poverty to communicate and share ideas. In particular, it is good when we can share information about initiatives which might inspire others to do something similar. I was therefore very pleased to receive a message from Dr Mochamat Helmi describing the International Tropical Medicine Summer School organized annually by Faculty of Medicine Universitas Muhammadiyah Yogyakarta, Indonesia. The programme combines academic and student activities. The aim is to broaden students’ knowledge of tropical and emerging infections and to enable them to enhance their skills in physical examinations, laboratory work, diagnosis and treatment. Use is made of a modified problem based learning (PBL) system. The next summer school will be held 6th to 26th July 2009. The venue will be the Medical Faculty Universitas Muhammadiyah Yogyakarta and affiliated hospitals. The maximum quota will be 50 participants. The main topics will be: dengue haemorrhagic fever, malaria, typhoid, tuberculosis, avian influenza, helminthes. Further details can be found on the summer school's Facebook page: go to www.facebook.com and search for ITMSS. Dr Helmi also tells me that he would be very interested to hear from potential visiting lecturers for the summer school. He can be contacted on drhelmi@fk.umy.ac.id / emailhelmi@yahoo.com. We wish all those involved with the summer school every success.]]> http://blog.tropika.net/tropika/2008/12/05/summer-school-in-indonesia/ <![CDATA[Rural Indonesians still face TB treatment delays]]> here.]]> http://blog.tropika.net/tropika/2008/12/04/rural-indonesians-still-face-tb-treatment-delays/ <![CDATA[XDR-TB in Uzbekistan: a worrying report]]> New England Journal of Medicine describes how, of 87 patients receiving treatment with second-line TB drugs for multiple-drug resistant (MDR) TB, 18 (21%) developed ofloxacin resistance and 10 (11%) were classified as having XDR-TB. The spread of XDR-TB is often blamed on failure to adequately diagnose and treat MDR-TB. Yet here we have a situation where a high proportion of MDR-TB patients, despite receiving appropriate care, nevertheless developed XDR-TB during their treatment. This is a very worry finding. As the authors of report say, there are 'significant implications for the scale-up of multidrug-resistant tuberculosis treatment internationally'. The NEJM letter may be seen here. ]]> http://blog.tropika.net/tropika/2008/12/04/xdr-tb-in-uzbekistan-a-worrying-report/ <![CDATA[Vaccine research on the front line]]> here, large-scale trials of the RTS,S malaria vaccine in which 16,000 children will participate are about to begin in Africa. An excelllent report from Reuters looks at the trials from the perspective of those on the front line. The Reuters correspondent, Andrew Quinn begins with the comments of Dr Zena Mtajuka, 'an exhausted warrior on the frontlines of the fight against one of the planet's most devastating diseases' at Bagamoyo District Hospital north of Tanzania's capital Dar es Salaam. Bagamoyo is one of almost a dozen research sites where the RTS,S trials will take place. Scientists and health workers in Kilifi, Kenya were also interviewed for the report, which can be accessed here.]]> http://blog.tropika.net/tropika/2008/12/04/vaccine-research-on-the-front-line/ <![CDATA[Developing countries should have a greater say in local research agendas]]> BMJ, says that 'Developing countries should have a greater say in local research agendas'. The article includes positive comment from participants in the meeting. However, Robert Walgate notes that there was disappointment that the important issue of intellectual property was barely mentioned. The article is not open access but those with a subscription to the BMJ may see it here.]]> http://blog.tropika.net/bamako2008/2008/12/02/developing-countries-should-have-a-greater-say-in-local-research-agendas/ <![CDATA['Concern and commitment and creativity']]> Lancet editorial (1) has commented on the Bamako meeting and the Call for Action. The journal was a partner in the meeting and has now published a number of articles refering to it. The editorial takes a very positive view of the meeting saying that delegates dealt with the issues with concern, comiitment and creativity. It takes the view that substantial advances have been made on the previous meeting in Mexico and concludes that Bamako was, 'an example of what can be achieved through patient and persistent engagement. 2009 must be the year when the promises of Bamako are acted upon.' Reference 1. Editorial. The Bamako call to action: research for health. The Lancet, Volume 372, Issue 9653, Page 1855, 29 November 2008. doi:10.1016/S0140-6736(08)61789-4]]> http://blog.tropika.net/bamako2008/2008/12/02/concern-and-commitment-and-creativity/ <![CDATA[BMJ Editor's view on Bamako]]> here. Fiona Godlee seems sceptical about aspects of the meeting. She describes the Call to Action as being 'better than some had feared'. However, her own fear is that at the next meeting, in four years time, delagates will be having the same conversations.]]> http://blog.tropika.net/bamako2008/2008/12/01/bmj-editors-view-on-bamako/ <![CDATA[Malaria genome database updated]]> P. falciparum, P. vivax, P. yoelii, P. berghei, P. chabaudi, and P. knowlesi. The data on these species consist of microarray information, gene knock-out mutants of P. falciparum and of P. berghei, and gene expression and protein transcription on the multiple stages of P. yoelii, to mention a few. Also found in Plasmo DB is the EST information, collected from over 130 libraries. Besides the raw information that is available and the possibility of retrieving information by searching for an exact gene name, ID or product, the repository allows users to perform queries such as “Find sequence similarity using BLAST”, or “Identify gene expressed at specific life-cycle stages”, or “Identify genes with specific protein attributes”. Plasmo DB is an essential tool to anyone adopting a cellular or molecular approach to studying or understanding malaria. The database is free and open to anyone and can be found at http://plasmodb.org/plasmo/]]> http://blog.tropika.net/tropika/2008/12/01/malaria-genome-database-updated/ <![CDATA[The good, the bad and the encouraging]]> onchocerciasis are extremely alarming. In contrast, the appropriate use of innovative technologies is always encouraging and a story from South Africa of the introduction of miniature aircraft to transport clinical samples makes for interesting reading. News of the seizure of a vast supply of fake drugs in Southeast Asia is also encouraging, in that it shows the authorities are achieving some success against the counterfeiters, but sadly it underlines just how severe this problem has become. Amongst the drugs seized were many fake artemisinin treatments for malaria that did contain the active ingredient but only in very low doses, raising the risk of the development of resistance. Meanwhile, new moves are being taken to find ways of increasing the availability and affordability of artemisinin. We report on a recent conference of the Artemisinin Enterprise and on a new publication from this organization. Other reports published recently include a look at ‘supply-side’ issues in the antimalarials market in Uganda, produced by the Medicines for Malaria Venture, and a discussion of the spread of tropical infections from an Australian perspective published by the Lowy Institute. We continue our TropIKA.net Profiles series with an interview with malaria researcher Dr Chetan Chitnis of the International Centre for Genetic Engineering and Biotechnology. The work he and his colleagues are doing in New Delhi is a key part of international efforts to develop vaccines for malaria. When work of such importance is being conducted in a disease-endemic nation, there is certainly every reason to feel encouraged. ]]> http://blog.tropika.net/editorschoice/2008/12/01/the-good-the-bad-and-the-encouraging/ <![CDATA['A victory for equity over efficiency']]> here. Please draw our attention to other comments on the meeting which come to your attention, so that we may link to them from TropIKA.net.]]> http://blog.tropika.net/bamako2008/2008/11/27/a-victory-for-equity-over-efficiency/ <![CDATA[New director elected for WHO's Western Pacific region.]]> Reference 1. Cheng MH (2008). New director elected for WHO's Western Pacific region. Lancet; 372(9650):1621. ]]> http://blog.tropika.net/tropika/2008/11/26/new-director-elected-for-whos-western-pacific-region/ <![CDATA[Blogger attacks US priority voucher scheme]]> here.) However, the scheme is already under attack. One of its critics is blogger Merrill Goozner of the Center for Science in the Public Interest. He describes (here) the scheme as 'ill-conceived' and uses the example of a voucher that has been obtained by Novartis on the basis of its development of the antimalarial drug Coartem. Goozner points out that Coartem is already in widespread use in the countries which actually need it and obtaining approval for its use in the US serves no useful purpose. However, the company now holds a voucher that will allow it to obtain faster registration of a new 'blockbuster' drug for a first-world medical condition. (Alternatively it is allowed to sell the voucher to another company.) The FDA registration process is lengthy and, with a priority voucher, a company can get its products on to the lucrative US market some 6-18 months sooner. There is no doubt that this scheme is well intentioned but are its critics right when they say that it will be misused? Let us know your views.]]> http://blog.tropika.net/tropika/2008/11/26/blogger-attacks-us-priority-voucher-scheme/ <![CDATA[Bamako wrap-up]]> Andrew Kennedy (COHRED), Stephen Matlin (Global Forum for Health Research) and Carel Ijsselmuiden (COHRED) Lindiwe Makhubalo and Pakiso Netshidzivhani from South Africa Lindiwe Makhubalo and Pakiso Netshidzivhani from South Africa Representing the South East Asian region were Pornpit Silkavute of the Health systems research Institute in Thailand, and Vibha Varshney of the Centre for Science and Environment in India Representing the South East Asian region were Pornpit Silkavute of the Health systems research Institute in Thailand, and Vibha Varshney of the Centre for Science and Environment in India L-R: Gill Samuels, chair of the Global Forum for Health Research, Sue Kinn of the UK Department for International Development, and Robert Ridley, director of TDR L-R: Gill Samuels, chair of the Global Forum for Health Research, Sue Kinn of the UK Department for International Development, and Robert Ridley,director of TDR. Delegates give their views of the Global Ministerial Forum on Health Research as the meeting winds up in Bamako today:
“I found some of the cut and thrust of the questions helped me focus on what was missing which is about translating research into policy and delivery of healthcare. Lots of fine words have come out. But, as a wild thought, how would it be if each of the 42 ministers were to tell the conference what they intended to do in the next year in terms of applying research to service delivery and filling the gaps where the needs are? That to me would give the conference real bite.” Chris Bateman, News Editor – South African Medical Journal, South Africa
“We had a session on non-communicable diseases on the first day, and the conference was successful in that there were ministers of both health, and science and technology coming together to have ownership of a common cause. This is a unique feature of this meeting. One hopes this type of inter-ministerial dialogue will be widened.” Dr Shanti Mendis, WHO (Geneva)
“What was powerful was that the meeting seemed to pick up on gaps of previous declarations and calls to action and tried to identify where there had been no movement, and try to correct that. I thought that was important because we have been talking about these things for a number of years now, it’s really time to look at where the blockages are and try to move them. Some of the discussions did pick up on those issues, like the greater involvement of communities, civil society and certain aspects of industry.” Dr Lindiwe Makubalo, Ministry of Health, South Africa
“The conference was a special event, but there was too much separation between the ministers and the delegates. I think politicians should be accountable to people. The process of a declaration should be interactive. For the future, the challenge is how to get ministers to listen to audiences that becomes an iterative process in a meeting like this. Otherwise, I think the meeting was great for networking and motivating and infusing energy in the world of research and development.” Carel Ijsselmuiden, Director, COHRED (Geneva)
“The conference was a great success, achieving most of the objectives it set out to do, by looking at the critical areas of health research and trying to organize health research in such a way to benefit society. The meeting has come up with a communiqué which addresses the importance of involving civil society and co-ordinating and prioritizing health research issues and dissemination of information – so, the full participation of civil society. The other highlight is the issue of funding for health research and the importance of allowing countries to set their own priorities, with health research funders coming in to complement rather than to impose.” Edwin Muguti, Ministry of Health, Zimbabwe
“The atmosphere has been great, better than in previous conferences. It’s unfortunate that the ministerial process has been devolved from the body of the conference because some of the sessions which went on would have benefited from the ministerial input, and have the ministers hear the input from the delegates.” Andrew Kennedy, COHRED (Geneva)
“I’m pleased that this conference managed to deal with all the issues on the programme in the time allotted. I am very impressed and surprised at the research taking place in Mali. They have done so much, also with the help of a country like the USA and organizations. There were many panels covering the good results of their research. I’m happy that many African countries were able to participate fully at this meeting, unlike in Mexico where we couldn’t speak because it was in Portuguese and Spanish. Here there were lots of French-speaking countries participating; it was very good!” Dr Moussa Yarou, Ministry of Health, Benin
Some off-the-record comments were also offered by participants: “The representation appears to be broad and seems to include people from almost all parts of the world. This is a good thing. I only wish that the other Presidents (apart from the Malian President) were also available at this conference. I would have wished that the people gathered here included key decision-makers of health policy in their respective countries.” “The aspect of the conference that I am concerned about is the ownership of research. I wish those donating for health research would allow the recipient countries to have more power in the decision-making.” “I have always been concerned about who owns the knowledge that is generated, if there is anything like knowledge ownership. What I mean is that even though we are always meeting to discuss issues like setting the health agenda by developing countries themselves, even these meetings are to a large extent being funded by donors.” “There have been many declarations from meetings from the last decade or so. It would be interesting to know what proportion of those declarations have been adopted or implemented.” “Could there have been more representation from the groups we (researchers + communicators about health research) claim to represent? It would have been good to know the views of such groups as well.” “I think it is a good idea that so many people of diverse backgrounds are gathered in one place to share ideas about how to improve health through research. This in itself is a good start, apart from the fact that the forum offers incredible opportunities for people to network. Even interactions at such informal levels have tremendous capacity – in my opinion – to bring about change in the way people do things in their own countries.” Some comments were also offered about TropIKA.net: « Avant ce forum je ne connaissais pas TropIKA. Quand j’ai vu le badge TropIKA porté par des collègues du Mali, ma curiosité a été piquée. Du coup je suis allé leur poser des questions. Ils m’ont donne amples informations et ensuite je suis allé visiter le stand, et puis le site de TropIKA. J’avoue que c’est une bonne chose cette initiative, d’autant plus que lors des meetings on n’a pas la possibilité d’être présent partout à la fois. Mais si, en fin de journée, tu as déjà accès à un résumé complet des sessions, c’est très bien. Je pense que c’est à encourager beaucoup. » Dr Maiga (immunologiste, SEREFO, Bamako, Mali) “I knew TropIKA.net a while ago. It’s very important for meeting participants but also for people who for some reason were not able to attend. I like their daily report and I can tell that the reports are accurate since I have got to read report on session I attended. Big thanks to the TropIKA. net team. Keep the good job. Thanks.” Dr Francis (Kenya)]]> http://blog.tropika.net/bamako2008/2008/11/24/bamako-wrap-up/ <![CDATA[TB? Ask a rat]]> this from the Boston Globe. Diagnosis is a key issue in tuberculosis control and all potential new techniques deserve our consideration but this one certainly comes as a surprise. Bart Weetjens of the Pest Management Centre, Sokoine University of Agriculture, Tanzania has pioneered the use of giant pouched rats in the detection of landmines, for which purpose they are now deployed in Mozambique. They are credited with clearing 270 square miles of former farm and village land in southern Mozambique, allowing for the return of peasant families dislocated by the civil war of the 1980s. In what the Boston Globe calls 'a conceptual leap', Bart Weetjens is now using the rat's sharp olfactory in disease detection, starting with tuberculosis. Apparently, trained rats can evaluate saliva samples at a rate of 40 every 10 minutes. A rat signals with 'unmistakable paw motions' when it detects infected sputum. Scientists at Germany's Max Planck Institute are said to be trying to determine whether the rats are detecting the scent of the actual TB bacteria or some metabolic reaction produced by the infection. Some of the work of Weetjens and his colleagues has made it into the scientific literature (1) and one presumes that they are seeking formal peer-reviewed publication of the work they are undertaking on TB. It will be awaited with interest. Reference 1. Machang'u RS, Mgode GF, Assenga J, Mhamphi G, Weetjens B, Cox C, Verhagen R, Sondij S, Goris MG, Hartskeerl RA (2004). FEMS Immunol Med Microbiol; 1;41(2):117-121. Serological and molecular characterization of leptospira serovar Kenya from captive African giant pouched rats (Cricetomys gambianus) from Morogoro Tanzania.]]> http://blog.tropika.net/tropika/2008/11/24/tb-ask-a-rat/ <![CDATA[Blame the builders?]]> Joy Online that a recent workshop on malaria prevention '...identified the activities of road contractors ... as a major contributory to the increasing incidence of malaria in the country'. The workshop 'Mobilising against Malaria' was attended by community health volunteers and funded by Ghana Social Marketing Foundation (GSMF) in collaboration with Family Health International (FHI). The theory that road building activities can increase the total number of mosquitoes (and the number of mosquito bites!) sounds reasonable to me but it is worth remembering that Anopheles mosquitoes which transmit malaria favour clean water for breeding. Stagnant water is favoured by nuisance biting Culicine mosquitoes, which are not malaria vectors. Stagant water near dwelling places is not to be recommended, but the attribution to road builders of the blame for increased cases of malaria is likely to be misplaced. ]]> http://blog.tropika.net/tropika/2008/11/24/blame-the-builders/ <![CDATA['Tiger trap' could help control dengue fever]]> Aedes mosquitoes that spread dengue fever. The device, known as the 'Tiger Trap' exploits the mosquitoes behaviour of laying eggs in containers. Insects entering the traps are poisoned by small insecticide doses. This is considered preferable to broadcasting insecticide throughout the environment. The company describes the product as, 'A novel, patented mosquito-killing technology developed by US Army researchers under a long-term, joint-development agreement between the Walter Reed Army Institute of Research, the United States Army Medical Research and Materiel Command, and the U.S. Army Center for Health Promotion and Preventive Medicine'. It says it is manufacturing the trap 'for the Army, US mosquito abatement districts, and consumer sales.' Details here.]]> http://blog.tropika.net/tropika/2008/11/24/tiger-trap-could-help-control-dengue-fever/ <![CDATA[Buruli ulcer: the social issues]]> here. ]]> http://blog.tropika.net/tropika/2008/11/21/buruli-ulcer-the-social-issues/ <![CDATA[Trachoma and malaria: Ethiopia opts for an integrated approach]]> here. In the light of recent research in the Sudan (1-3) suggesting that trachoma may be much more common in the Horn of Africa region than previously recognised, it is also encouraging to see that it is malaria and trachoma activities that are being integrated. Reference 1. Ngondi J, Ole-Sempele F, Onsarigo A, Matende I, Baba S, et al. (2006) Prevalence and Causes of Blindness and Low Vision in Southern Sudan . PLoS Med 3(12): e477 doi:10.1371/journal.pmed.0030477 2. Ngondi J, Ole-Sempele F, Onsarigo A, Matende I, Baba S, et al. (2006) Blinding Trachoma in Postconflict Southern Sudan. PLoS Med 3(12): e478 doi:10.1371/journal.pmed.0030478 3. King JD, Ngondi J, Gatpan G, Lopidia B, Becknell S, et al. (2008) The Burden of Trachoma in Ayod County of Southern Sudan. PLoS Negl Trop Dis 2(9): e299. doi:10.1371/journal.pntd.0000299]]> http://blog.tropika.net/tropika/2008/11/21/trachoma-and-malaria-ethiopia-opts-for-an-integrated-approach/ <![CDATA[Profile of leader of Sudan's TB programme]]> here. TropIKA.net also of course publishes profile articles about key figures in the war against infectious diseases of poverty. If you have not already seen our Profiles section please do take a look here.]]> http://blog.tropika.net/tropika/2008/11/20/profile-of-leader-of-sudans-tb-programme/ <![CDATA[Leprosy: Australian doctors learn from East Timor]]> report from the Australian Broadcasting Corporation describes how a group of doctors visited East Timor, where the disease is sadly still common, to improve their diagnostic skills. The doctors are said to have found their visit 'extremely useful' and their Timorese colleagues were proud to be able to share their expertise. The report (text and a podcast) also includes information on the leprosy situation in East Timor, one of three countries worldwide where leprosy has not yet been reduced to a level where it is considered to have been eliminated as a public health problem. (The other countries are Brazil and Nepal.) It is hoped to achieve elimination levels within the next decade.]]> http://blog.tropika.net/tropika/2008/11/20/leprosy-australian-doctors-learn-from-east-timor/ <![CDATA[WikiPathways: Paving together the biological pathways]]> http://blog.tropika.net/tropika/2008/11/20/wikipathways-paving-together-the-biological-pathways/ <![CDATA[Celebrating the history, cultural diversity, and spirit of Mali]]> I think all the conference delegates can agree with me when I say the reception in Mali has been very warm and welcoming. We have been treated as royalty, from the VIP welcome on arrival at the airport to police escorts when we move around the various conference venues. The demeanor of the people is extremely open and friendly. My pathetic attempts to speak French has certainly kept our hosts and hostesses, conference organizers, taxi drivers, catering staff and security personnel amused. These courageous efforts of mine, I am sure are a great disappointment to my high school French teacher. But given the difficulties with language, we still manage to get around but maybe I owe this to the French speakers in the TropIKA team. My family and friends have been calling and emailing me, asking me what is Mali like? I still have not comfortably come up with an accurate description of Mali, Mali is all things at once, a melting point of old traditions and modern technology. There is a strong Muslim element to Mali that can be seen in the mosques that dot the city, the attire of people in the streets, and least I not forget the early morning call prayers that remind me, I only have a few more hours sleep. I work in veil of air conditioned comfort and only experience the soaring temperatures when I make a quick dash to a meeting room. The heat and aridity does not support much in terms of vegetation but the wide highways are lined with palm trees giving Bamako a tropical ambience. The landscape is mainly flat which is dissected by the extensive Niger River and low lying hills can be seen in the background. When crossing the street, one has to be careful to check the left side of the road and keep a look out for the motorbikes wheezing around at great speed. It appears there are more motorbikes on the road than cars and they daringly move in between the traffic at break necking speed. Bamako is a bright city not only because of the blaring sun but the beautifully colored attire that people wear. The female dress is majestic while the men’s is stately and imposing. The anniversary dinner at the National Museum last night, was a lavish display of culinary treats from across Mali. It was a wild adventure for my taste buds and a fascinating gastronomic experience far removed from the Western cuisine being served during the conference lunch.  We have been treated to various musical displays during the opening ceremony and the anniversary dinner. Malian music is performed with both traditional and modern instruments. It is pleasing to the ear, rhythmic, melodic and hypnotic All of this I have only been able to view from the window of my hotel room, taxis and buses, and experience within the confines of the conference centre. I look forward to my day off on Thursday when I will be able to trade my skirt and jacket for shorts and sneakers, grab my English-French book and explore the streets of Bamako. The guide book highlights the botanical gardens, prehistoric grottos with cave paintings, traditional “Pinasse” boat excursions, and Ali Baba style markets. Tomorrow, I will thoroughly immerse myself in the spirit of Mali, sample the food, dance to the music, fashion myself in local attire, and engage with the people.]]> http://blog.tropika.net/bamako2008/2008/11/19/celebrating-the-history-cultural-diversity-and-spirit-of-mali/ <![CDATA[Under attack: the Affordable Medicines Facility for Malaria (AMFm)]]> Independent newspaper has published an attack on the Affordable Medicines Facility for Malaria (AMFm). AMFm is an initiative to increase access to effective malaria treatment for people in endemic countries, by making artemisin combination therapies (ACTs) available at a much lower price. The article (which can be read online here) argues that the initiative is expensive and there is no evidence that it will cut infant mortality and general sickness or that it will be cost-effective or maintain quality control. The author is Roger Bate who is a Resident Fellow of a right-wing think-tank known as the American Enterprise Institute, which says its purposes are 'to defend the principles and improve the institutions of American freedom and democratic capitalism - limited government, private enterprise, individual liberty and responsibility, vigilant and effective defense and foreign policies, political accountability, and open debate.' Bate is particularly concerned by AMFm's emphasis on locally produced drugs, which he argues are often of very low quality. He also points out that, '...in rural Africa, the availability of prevention and treatment is poor, regardless of price. Public dispensaries are rare and most people get their medicines from private shops and travelling traders. The AMFm would provide subsidised medicines through wholesalers to this rural private market, reaching far more people than any scheme working just with the public sector. Yet rural markets in Africa are not sufficiently understood.' Roger Bate says that the $2bn which AMFm will cost over the next five years '...could probably save many more lives in existing preventative efforts such as indoor insecticide spraying or treated mosquito nets.' There are many who will disagree with him. Getting effective treatment to those who need it is an essential part of malaria control and subsidising the cost of ACTs is surely the only way this can be done. If proper safeguards are put in place, then the quality of locally produced drugs can hopefully be assured. Do you share the views expressed in this article? Let us know by responding to this blog.]]> http://blog.tropika.net/tropika/2008/11/18/under-attack-the-affordable-medicines-facility-for-malaria-amfm/ <![CDATA[The road to Bamako and beyond]]> Ania Grobicki A unique meeting is taking place in Africa today. The Global Ministerial Forum on Research for Health, hosted by the Republic of Mali, is being held in Bamako, and is the first of its kind to be held in Africa. It is the first time, too, that a unique assembly of partners has come together with a common vision to promote the importance of research for health. The World Bank, World Health Organisation, and the United Nations Education Scientific and Cultural Organisation are joining together with two civil society non-governmental organizations – the Council on Health Research for Development (COHRED) and the Global Forum for Health Research – in what the conference organizers hope will be the birth of a multi-stakeholder governance mechanism. “One of the achievements for Bamako 2008 is to get the partner organizations working together to try to develop a multi-stakeholder governance mechanism for research for health, because no one organization can do it alone This is being discussed as a platform to take Bamako beyond 2008. It has to be inter-sectoral, involving lots of stakeholders including civil society,” says head of the conference secretariat, Ania Grobicki. “It would not necessarily a new organization because in this day and age, we’ve got virtual networks and they’re the way to go - but they need to work. There is now a real opportunity for these organisations to work together, through networking and inter-sectoral action,” she said. “Research for health is broad, across the spectrum, so there’s lots of networking needed. Technology is now available to do this, to help improve implementation of research results and policies to improve people’s lives on the ground. We need research to provide long-term vision for the way in which things can be done.  It allows us to prioritize and structure how future health can be safeguarded. People are beginning to appreciate the long-term vision is more important; short-term action can be valuable but can cause a lot of waste, duplication and unintended consequences such as the weakening of health systems because of vertical programmes. A long-term vision can forestall that.” She said it had been a long road since Mexico in 2004 when the first ministerial summit was held. That conference provided the push for WHO to develop a strategy on research for health which is going to be discussed here at Bamako and which will go to the World Health Assembly next year. Health systems research has been strengthened, and a number of preparatory meetings have been held in regions building up to Bamako. “I really hope that people will see that the process has generated a momentum that would not otherwise have been there. By 2012 perhaps once the multi-stakeholder governance mechanism is working, it will be possible for the international community to use that mechanism to start to look at some of the urgent crisis issues such as environmental health, climate change,” said Ms Grobicki. The conference will focus on the process and the systems that are needed.]]> http://blog.tropika.net/bamako2008/2008/11/17/the-road-to-bamako-and-beyond/ <![CDATA[Civil society vision for Bamako 2008]]> Michael Devlin, COHRED Susan Jupp (Global Forum for Health Research) and Jamie Guth (WHO) Susan Jupp (Global Forum for Health Research) and Jamie Guth (WHO) Civil society needs to be involved in the research process in a practical way, urging governments and decision-makers to apply the results of evidence-based research for the benefit of health. This call has been made by the Council on Health Research for Development (COHRED) and the Global Forum for Health Research, two non-governmental organizations who jointly organized the Global Ministerial Forum on Research for Health along with WHO, UNESCO, the World Bank and the Republic of Mali. COHRED’s Michael Devlin said he hoped the final declaration of the conference would strongly recognise the value civil society organisations could add to research efforts of big funders, organisations and governments. “Everyone wants to know what impact they’re having. Well, the NGOs have put a declaration on the table to say that we can add value to what’s being done in these areas. Our view is that the big players need to think about focusing their work on country priorities and be better organized to play a role in improving health research. There should be a clear statement on harmonisation – it shouldn’t be lip service.” He stressed that there should also be a strong emphasis on the alignment of health research on country priorities and how that should be done. Big vertical programmes should require themselves to build capacity to have a huge lasting effect on the millions being poured into countries. “It’s about leaving a legacy behind,” he said. Echoing the sentiments of moving beyond lip service, Susan Jupp of the Global Forum on Health Research hopes that instead of a meeting of which there is lots of discussion, some of the lessons can be taken forward. “We can understand what some of the questions are and put some pressure on governments based on the evidence which will be demonstrated here to apply some of the very good lessons of the work going on in Mali and take them out to other countries,” she said. Mali has a government policy that makes equitable access to health care a national ambition, supported by a strong grassroots demand for quality care, close to homes. The World Health Report 2008 singles out Mali’s progress towards universal coverage as an example of what can be achieved when policy engages community participation, and uses health as an entry-point for broader community development. Health policy in Mali has been strongly guided by evidence generated during numerous internal and external evaluations, plot studies and research projects.]]> http://blog.tropika.net/bamako2008/2008/11/17/civil-society-vision-for-bamako-2008/ <![CDATA[Good news on malaria ...from Canada]]> A recent article in Canada's Globe and Mail, which focuses on the encouraging reduction in malaria cases in Kenya, is therefore well worth a look. Have you seen any similar articles? Share them with TropIKA.net readers by responding to this blog.]]> http://blog.tropika.net/tropika/2008/11/17/good-news-on-malaria-from-canada/ <![CDATA['Solving the malaria epidemic']]> A report on the Voice of America website sums up the meeting. Of note is the finding that a search of three major US newspapers over a period of three months found 120 mentions of the word 'malaria'. Something that would have been unthinkable a few years ago. This, and indeed the AAAS Forum itself, does show an increased US awareness of the disease and this is most encouraging. It would of course be interesting to know how many times those newspapers mentioned words like 'leishmaniasis' or 'Chagas disease'! The neglected diseases, with their massive combined morbidity and mortality, are surely also worthy of a Forum.]]> http://blog.tropika.net/tropika/2008/11/17/solving-the-malaria-epidemic/ <![CDATA[Barely noticed?]]> African Press Organization and China View (article available in French only). What can be done to get the media to take more notice of events like this one and the issues which they seek to address? Respond to this blog to make your views more widely known.]]> http://blog.tropika.net/bamako2008/2008/11/17/barely-noticed/ <![CDATA[New features on TropIKA.net]]> here. We have also introduced a new section called ‘Toolkits’. Under the Health Research Systems Analysis (HRSA) Initiative, the World Health Organization (WHO) consulted with a range of partners to develop concepts and tools to describe, analyse, and benchmark national health research systems. The collection of tools provides information and resources for systematically collecting health research and national health research systems data. Details will be found here. A few months ago, I spoke with a leading researcher who is also a user of TropIKA.net and he wondered whether one of our most useful functions might turn out to be alerting the infectious disease community to the publication of new reports. His point was that new journal articles can be located on PubMed and other databases but reports may easily go unnoticed. This is indeed case now that an increasing number of organizations are involved in our field. Within the last few days, we have highlighted four new reports: - The Global Burden of Disease. The latest update of WHO’s comprehensive assessment of the health of the world’s population. - The International Response to Highly Pathogenic Avian Influenza: Science, Policy and Politics. A report from the Social, Technological and Environmental Pathways to Sustainability (STEPS) Centre. - Global Climate Change and Extreme Weather Events: Understanding the Contributions to Infectious Disease Emergence. This document arises from discussions at a workshop held by the Forum on Microbial Threats. - Ending the R&D Crisis in Public Health: Promoting pro-poor medical innovation. A new analysis by Oxfam. The content of the other sections of TropIKA.net continues of course to expand. Please visit our News section, where there is good news to be found on declines in malaria prevalence in several African countries, and our Research section where genetics and mathematical modelling are among the recent topics. ]]> http://blog.tropika.net/editorschoice/2008/11/17/new-features-on-tropikanet/ <![CDATA[Oxfam report should contribute to the debate]]> Crisis in Public Health: Promoting pro-poor medical innovation Oxfam says money is still being misspent and calls for new approaches to be developed. According to the report: "...it is a combined responsibility of all countries to find ways to ensure global R&D is organized to improve human health; inability to pay should not disenfranchise a large majority of the world’s population from access to effective healthcare." The report will be considered in more detail on TropIKA.net shortly. Meanwhile an Oxfam press release is available here and the report in full may be accessed here. ]]> http://blog.tropika.net/bamako2008/2008/11/14/oxfam-report-should-contribute-to-the-debate/ <![CDATA[Will the media take note?]]> here. ]]> http://blog.tropika.net/bamako2008/2008/11/14/will-the-media-take-note/ <![CDATA[Bamako: a ‘featured meeting’]]> here. Since then we have also featured the 2008 Algiers Ministerial Conference on Research for Health in the African Region and the First Meeting of the African Network for Drugs and Diagnostics Innovation (ANDI). Now we are delighted to be featuring the 2008 Global Ministerial Forum on Research for Health, which is taking place in Bamako, Mali, 17-18th November. As described in a TropIKA.net news story and discussed in an editorial, this is a meeting of considerable importance. We wish all the participants an enjoyable and enjoyable meeting. Our team which includes six journalists and ten rapporteurs will provide: daily summaries of the sessions, interviews with speakers, participants and leaders in the field, and a blog covering all areas of the meeting. We hope this will be of service both to those in Bamako and, crucially, to those who couldn’t make it. We hope to expand the number and range of our Featured Meetings and we welcome feedback on both the concept and how we are performing in practice. Please let us know. Paul Chinnock Editor-in-Chief, TropIKA.net ]]> http://blog.tropika.net/bamako2008/2008/11/13/bamako-a-%e2%80%98featured-meeting%e2%80%99/ <![CDATA[Bark out loud]]> http://blog.tropika.net/tropika/2008/11/13/bark-out-loud/ <![CDATA[TB goes shopping, or does it?]]>