According to a Reuters report the Global Fund to Fight AIDS, Tuberculosis and Malaria is facing a budget hole of about $3 billion, resulting from the worldwide economic decline.

A spokesperson said the money would have to be found in order to meet commitments to programmes for 2010.

One concern, should the Global Fund not be able to meet its commitments, is that it might mean many TB patients would not be able to continue with their treatment, and this would encourage the development of drug resistance.

As of the end of last year, the Global Fund had provided AIDS treatment to 2 million people and tuberculosis treatment to 4.6 million people, and distributed 70 million insecticide-treated bed nets worldwide.

Ultimately, the aim of control programmes for infectious diseases is global eradication. Smallpox is the only instance of a disease where this has been achieved. Polio (like guinea worm) continues to move towards eradication but frustratingly there have been setbacks, particularly in Nigeria and in India.

An article in the American Journal of Public Health (sadly, not an open-access publication) reminds us that India made little progress against smallpox during the 1950s and 1960s, and was regarded as one of the major barriers on the road towards eradication of the disease worldwide. It took a change in the way the eradication programme was run in India before progress was made.

The article describes how “the campaign was converted from a project in which a handful of officials tried to impose their ideas on a complex health bureaucracy to one in which its components were constantly adapted to the requirements of a variety of social, political, and economic contexts”. The change was achieved in the 1970s mainly through the active participation of workers drawn from local communities.

As the authors point out, there are many differences between smallpox and polio. Nevertheless, there are lessons from the experience of smallpox eradication in India that should not be forgotten in today’s efforts to eradicate polio.

One of the authors of the article, Sanjoy Bhattacharya, is involved in the organization of a series of seminars on the history of tropical diseases that is being broadcast over the internet - see TropIKA.net News.

Reference
1. Bhattacharya S, Dasgupta R (2009). A tale of two global health programs. Smallpox eradication’s lessons for the antipolio campaign in India.Am J Public Health99(7):1176-1184.

US researchers have used computer models to look for established drugs that might be of use in treating resistant forms of TB. They have concluded that two drugs used in the treatment of Parkinson’s disease could also have activity against Mycobacterium tuberculosis.

The two drugs - Comtan and Tasmar - are presently used to boost the effectiveness of the Parkinson’s drug levodopa. They block a brain chemical called COMT, stopping it from breaking down levodpa, but their molecular structure also allows them to block a compound needed by M. tb’s protective cell wall.

One of the researchers, Philip Bourne of the University of California, San Diego, says that Tasmar can damage the liver but Comtan is safer and has the potential to become a TB drug.

The study is published in PLoS Computational Biology and is discussed in a news story from AFP.