Addressing critical needs in the fight to end tuberculosis with innovative tools and strategies
Mark Hatherill et al.,
More than 130 years after Koch first described the tubercle bacillus and its etiologic role in tuberculosis (TB) to the Physiologic Society of Berlin, TB is still responsible for an appalling human toll and is the leading single infectious cause of death worldwide. It is clear that the modest decline in global TB incidence and mortality in recent years needs to be accelerated to reach the “End TB” targets for 2035. This can only be achieved if the implementation of current approaches to TB control is optimized and new tools and strategies for TB prevention, screening, diagnosis, and treatment are developed. This special issue highlights the breadth of the approaches currently available, promising new developments as well as identifying some of the challenges still ahead.
Predicting and Designing therapeutics against the Nipah virus
Neeladri Sen et al.,
Though every outbreak of the Nipah Virus has resulted in high mortality rates (>70% in Southeast Asia), there are no licensed drugs against it. In this study we have considered all 9 Nipah proteins as potential therapeutic targets and computationally identified putative peptides (against G, F, and M proteins) and small molecules inhibitors (against F, G, M, N, and P proteins). Our strategy was to tackle the development of therapeutics on a proteome wide scale and the lead compounds identified could be attractive starting points for drug development. To counter the threat of drug resistance, we have analyzed the sequences of the viral strains from different outbreaks, to check whether they would be sensitive to the binding of the proposed inhibitors.
The future of global health procurement: issues around pricing transparency
Mikel Berdud et al.,
This paper focuses on the role that price transparency may play in the efficient and effective procurement of medicines by middle- and low-income countries. Will making prices publicly available make procurement more efficient and cost-effective medicines more accessible? The authors conclude that transparency of the procurement process significantly lowers costs by encouraging bidders. They do not recommend price transparency for on-patent medicines as the effect will be to slow the diffusion of innovative products to low-income countries. Differential pricing is important and can best be achieved in the current environment via confidential discounts. Developing country markets are, however, dominated by generic products. Price transparency for off-patent products could improve market efficiency if capacities are there to use the data to inform procurement decisions whilst protecting against supplier collusion.
Pooled procurement of drugs in low and middle income countries
Pierre Dubois et al.,
The authors use data from seven low and middle income countries with diverse drug procurement systems to assess the effect of centralised procurement on drug prices and provide a theoretical mechanism that explains this effect. The empirical analysis is based on exhaustive data on drug sales quantities and expenditures over several years for forty important molecules. It is found that centralised procurement of drugs by the public sector allows much lower prices, but that the induced price reduction is smaller when the supply side is more concentrated.
UN report calls for urgent action against antimicrobial resistance
That's the conclusion of a report out today from the United Nations (UN) Interagency Coordination Group (IACG), a panel of global experts formed to provide guidance and ensure sustained global action on antimicrobial resistance (AMR). The report by the IACG, which was convened to help UN member states fulfill and implement the pledges made at the UN's 2016 high-level meeting on AMR, is the culmination of a series of meetings, country visits, and stakeholder interviews conducted from March 2017 to December 2018. The aim of the group was to develop a blueprint to help countries respond to the alarming levels of AMR that have been reported in countries of all income levels. Emphasizing a One Health approach, the report calls on UN member states to accelerate national response plans to the AMR crisis, increase and encourage investment in development of new antibiotics and programs to combat drug resistance, collaborate with civil society groups and other stakeholders, and strengthen accountability and global governance.
Viral factors associated with the high mortality of human infections with clade 2.1 influenza A/H5N1 virus in Indonesia
A new study in Clinical Infectious Diseases uses nasal and fecal samples to estimate viral loads in human patients with avian influenza H5N1, finding that higher viral loads are linked to fatal cases. Researchers collected specimens from 180 H5N1 patients between 2007 and 2015, representing 90% of all Indonesian patients and 20% of reported H5N1-infected patients globally. Feces and blood had the highest concentrations of H5N1 RNA, and higher viral loads correlated with fatal cases. Genes that conferred resistance to antivirals were also more prevalent in fatal cases. Detailed clinical virological analyses were performed in specimens from 180 H5N1 patients, representing 90% of all Indonesian patients and 20% of reported H5N1-infected patients globally. These observations confirm the association of viral load with outcome of human H5N1 infections and suggest potential differences in virulence and antiviral responses to oseltamivir that may explain the exceptionally high mortality of clade 2.1 H5N1 infections in Indonesia.
Public health law coverage in support of the health-related sustainable development goals (SDGs) among 33 Western Pacific countries
Yuri Lee et al.,
A resilient health system is inevitable in attaining the health-related Sustainable Development Goals. One way of strengthening health systems is to improve the coverage of public health laws for better health governance. The aim of this study is to describe the public health law situation in the Western Pacific Region, and analyse the association of public health law coverage with health-related SDGs statistics.
Inter-species transmission of avian influenza virus to dogs: 10 years experience
Daesub Song et al.,
Influenza viruses have continuously evolved into multiple mutant strains from several regions, resulting in aggravated endemic or epidemic outbreak conditions. In the 2000s, several outbreaks of inter-species transmission were reported, such as, the avian H3N2 influenza virus that crossed the host barrier to dogs. Studies on sero-prevalence and artificial infection suggested the possibility of co-infection of and reassortment between the two viruses in dogs; later, H3N1 and variants of M-variant H3N2 reassortants between pandemic H1N1/2009 and prototype H3N2 CIV were isolated. Our findings emphasized the necessity of intensive monitoring for influenza infection in companion animals for investigating the potential for the emergence of novel human influenza strains.
Dengue in Central Visayas nearing epidemic stage
After ending its measles vaccination campaign, the Department of Health (DOH) in Central Visayas is turning its attention on the rising number of dengue cases. In a weekly media forum, DOH regional medical officer Dr. Ronald Jarvik Buscato said the rise in dengue cases in the region for the period from January 1 to March 30 was alarming. Based on DOH’s comparative analysis, dengue cases usually increase every two years. Buscato said the five-year average number of cases is 10 percent higher than is recommended to declare an epidemic.
Southeast Asia Strategic Multilateral Dialogue on Biosecurity
Anita Cicerot al.,
Numerous risk factors in Southeast Asia increase the vulnerability of this region to natural, deliberate, and accidental biological threats. Countries in the region have made major progress in fighting infectious diseases within their own borders; however, the widespread geographic population distribution—ranging from remote, rural villages to densely populated cities—combined with highly mobile populations (e.g., tourists, migrant workers, displaced persons) and areas of porous international borders create a dynamic human–animal–plant–environment (i.e., One Health) interface that enhances the susceptibility of the region to the emergence and spread of infectious diseases.