A new, cheap, easy-to-take pill to treat malaria is being introduced today, the first product of an innovative partnership between an international drug company and a medical charity.
The medicine, called ASAQ, is a pill combining artemisinin, invented in China using sweet wormwood and hailed as a miracle malaria drug, with amodiaquine, an older drug that still works in many malarial areas.
A treatment will cost less than $1 for adults and less than 50 cents for children. Adults with malaria will take only two pills a day for three days, and the pill will come in three smaller once-a-day sizes for infants, toddlers and youngsters.
Needless to say, this is a very good thing, and a team effort as well:
“This is a good thing,” said Dr. Arata Kochi, chief of the World Health Organization’s global malaria program, who has publicly demanded that drug companies stop making pills that contain artemisinin alone because they will lead to resistant strains of malaria. “They’re responding to the kind of drug profile we’ve been promoting.”
[…]Sanofi-Aventis, the world’s fourth-largest drug company, based in Paris, will sell the pill at cost to international health agencies like the W.H.O., Unicef and the Global Fund for AIDS, Tuberculosis and Malaria.
The rollout of the drug is the result of a two-year partnership between Sanofi and the Drugs for Neglected Diseases Initiative, a campaign started by the medical charity Doctors Without Borders to find new drugs for tropical diseases.
Doctors Without Borders, better known by its French name, Médecins Sans Frontières, has long been one of the harshest critics of the pharmaceutical industry, charging that it spent billions on drugs like Viagra, Ambien and Prozac for rich countries and almost nothing on diseases killing millions of poor people.
But, recognizing that new drugs would have to come from the industry’s major players, Doctors Without Borders founded the initiative in 2003 and began seeking partnerships. This is the first to come to fruition.
See, ain’t that the way to do things? Major disagreements, but communication is still open, and compromise. I know a government or two that could apply these principles into practice.
NAIROBI - The world’s poor, who are the least responsible for global warming, will suffer the most from climate change, UN Secretary-General Ban Ki-moon told environment ministers from around the world on Monday.
“The degradation of the global environment continues unabated … and the effects of climate change are being felt across the globe,” Ban said in a statement after last week’s toughest warning yet mankind is to blame for global warming.
In comments read on his behalf at the start of a major week-long gathering in the Kenyan capital Nairobi, Ban said all countries would feel the adverse impact of climate change.
“But it is the poor, in Africa and developing small island states and elsewhere, who will suffer the most, even though they are the least responsible for global warming.”
Why Africa will be one of the most affected is not secret:
Experts say Africa is the lowest emitter of the greenhouse gases blamed for rising temperatures, but due to its poverty, under-development and geography, has the most to lose under dire predictions of wrenching change in weather patterns.
New statistics out today show disasters killed 21,342 people worldwide in 2006, compared with 82,061 the year before. Economic losses caused by natural hazards also fell, to just $19 billion in 2006, compared with $210 billion the year before.
These heartening figures, released by the Centre for Research on the Epidemiology of Disasters (CRED), are a reflection of what didn’t happen in 2006. No massive temblors like the Kashmir earthquake of 2005 that killed 73,338. And certainly nothing like the Indian Ocean tsunami in 2004, which left 230,000 dead or missing. Nor were there hurricanes to rival Katrina, Wilma or Rita that together racked up $166 billion in damages in the United States.
That’s the good news - and news that confirms a trend observed since 2000.
“The number of people killed by disasters has been decreasing, if we do not take into account the two mega events: the tsunami in the Indian Ocean and the earthquake in Pakistan,” said Debarati Guha-Sapir from CRED.
The bad news is that even as disasters are claiming fewer lives, the number of people affected by them remains staggeringly high at 134.5 million in 2006. That’s down a bit from 158 million in 2005 (again, a number inflated by the Kashmir quake) but far higher than in decades past.
So what you might say? So the magnitude of disasters come and go. But it is not just as simple as watching the weather forecasts. We need to connect the dots between natural disasters, global warming, poverty, and health & human rights.
Thankfully, the article made them for me!
That said, it’s still people in Africa and Asia who bear the brunt of disasters due to an intrinsic link between poverty and vulnerability to risk - a link that explains why an earthquake that hits Los Angeles, say, is likely to kill far fewer people than a quake of similar magnitude that hits Java or Bam.
That’s because poor countries often lack the resources to mitigate against hazards, whether by setting up early warning systems, protecting livelihoods or building risk-reduction strategies into their development plans. Again the figures bear this out.
Last year the United States was hit by more natural disasters than any country except China (26, compared with China’s 35). But if you rank countries by the number of people killed or affected per 100,000 inhabitants, the U.S. hardly even figures.
By this count, Malawi tops the list with 34,331 per 100,000 people, followed by Burundi (26,778) and Kenya (11,935).
That these three nations are among the poorest countries in the world - and thus among the least able to take the impact of climate change in their stride - is surely no coincidence.
Courtesy of CRED (and from the same article), here’s a breakdown of the world’s 10 deadliest disasters in 2006, followed by a list of countries most hit by disasters and numbers killed or affected per 100,000 inhabitants:
Disaster Country Toll Earthquake (May) Indonesia 5,778 Typhoon Durian (Dec) Philippines 1,399 Landslide (Feb) Philippines 1,112 Heat wave (July) Netherlands 1,000 Heat wave (July) Belgium 940 Typhoon Bilis (July) China 820 Tsunami (July) Indonesia 802 Cold wave (Jan) Ukraine 801 Flash flood (Aug) Ethiopia 498 Typhoon Samoai (Aug) China 373
Natural disasters per country - 2006
China 35 United States 26 Indonesia, Philippines 20 India 17 Afghanistan 13 Vietnam 10 Australia, Burundi, Pakistan 8 Ethiopia, Mexico, Romania 7 Germany 6
Victims (killed or affected) of natural disasters per 100,000 people - 2006
Malawi 34,331 Burundi 26,778 Kenya 11,935 Philippines 9,097 Afghanistan 7,194 China 6,753 Somalia 5,490 Thailand 5,040 Guyana 4,562 Vietnam 3,969
So what was so interesting about it that Truly Equal decided to write about it in a supposedly human rights blog? Larry Charles made an excellent point about Borat and some other movies and TV shows (emphasis is mine):
RT: You’ve worked with Borat, and before that, Bob Dylan in “Masked and Anonymous.” Both of them, in their own strange way, are sort of spokesmen, revealing some weird truths about America.
LC: Absolutely. The question I ask myself before I get involved in anything, be it TV or movies, is, “Does this need to be made? Does this need to be out there?” There’s so much s— out there that I can’t understand why people would spend tens of millions of dollars to make something that’s not going to come out good. So I ask myself, “Do we need this movie? Do we need this TV show? Will this somehow expand the dialogue, expand the discourse about the way we live and what’s important to us in out lives?” I felt in both the Bob Dylan movie and the Borat movie that these were urgent ideas and provocative ideas that might create interesting dialogue about ourselves, and about our world, about our lives, about philosophies, our beliefs. Also, they were low-budget movies, and I’m a big believer that we shouldn’t need to spend $100 million to make a great movie. If you have $100 million, you should probably be saving an African country. But for $4 million or $5 million or $10 million, you can make a great movie, and politically, you’re making a statement by making a low budget movie like that as well. On all those levels, it appeals to me.
We don’t need to see $100 million plus movies, regardless of how fantastic the idea or series is - Lord of the Rings fans, ya’ hear me? There are more important things in the world that need our attention. Don’t get me wrong, I love going to the movies just like anyone else, and sometimes leave the theater in disbelief (which reminds me, more people need to see Children of Men), but you know how many lives we can help with $100 million? That’s 8 fucking zeros! You don’t need to be as rich as Bill Gates or as influential as Bill Clinton to help the world. But you do need to have some fucking common sense!
My only wish is that Borat would say so himself - maybe George W. Bush will listen to him instead.
Last month, scientists invented the AIDS vaccine. Missed it? Perhaps that’s because you were still seeking the vaccine fantasy: the magic bullet, the impenetrable shield that finally pitches this disease into the trash bin, the shot that will end not only the AIDS epidemic but our anxiety about the AIDS epidemic as well.
[…]The vaccine that arrived last month was not actually a vaccine. It was, instead, a confirmation of what scientists had long suspected: circumcision helps protect men from AIDS infection. For years, AIDS researchers have observed that many African tribes that circumcise boys or young men had lower AIDS rates than those that don’t, and that Africa’s Muslim nations, where circumcision is near universal, had far fewer AIDS cases than predominantly Christian ones. The first research proof came in 2005, when a study in South Africa was stopped early in the face of evidence that the men who had been randomly assigned to be circumcised were getting 60 percent fewer H.I.V. infections than the men assigned to the control group. Last month, ethics boards halted two similar studies, in Uganda and Kenya, when they found similar results. In both, the circumcised men caught the AIDS virus half as often as the uncircumcised control group.
I don’t have a problem with the results of the research itself, besides the obvious ethical questions, such as letting men have unprotected sex with HIV-positive women: if it is no biggie, then why didn’t the researchers try this little experiment somewhere in the U.S.? Ethics rule #1: if an Institutional Review Board (IRB, the one that regulates all research in every institution) would object to a certain experiment in your country, it is probably unethical to do so in another country as well. In layman’s terms, such research would never be allowed in the U.S.
But I digress. I don’t have a problem with the results of the studies. My problem is that because of these results, some people think that cutting part of their wiener is all it takes to fight AIDS. Thankfully, the New York Times article does tackle those issues, such as:
1) Will knowledge of circumcision’s protective status increase dangerous and ill-informed sexual behavior in men? 2) Does this protective status extend to the women circumcised men have sex with? 3) Will it increase or decrease research efforts for an AIDS vaccine? 4) How on Earth are we going to mass circumcise men in Africa? (really, what the hell do people think circumcision is?) 5) Who will train the medical personal?
You have to keep in mind that Africa’s health systems are very delicate - sometimes there is no sterilized equipment, or no autoclave machine, or surgical kits, or for that matter, very few medical personnel - and just cutting wieners left and right is not going to help in fighting AIDS.
Circumcision is a surgical procedure, however, and in the hands of traditional ritual circumcisers, it has a high rate of infection and mishap. The solution is to train these circumcisers and give them decent tools, and at the same time encourage men to come to clinics. Since men in studies say that cost is the biggest reason they are not circumcised, the operation must be free. Countries will also have to equip these clinics and train counselors and medical circumcisers, who don’t have to be doctors.
As you can gather, I oppose circumcision. It is a barbaric practice of ancient times, and you won’t see many docs offering circumcisions (unless you are Jewish). Here is another question for you: are we going to mass circumcise African children now? I really, really don’t want a religious crackpot to dictate that all those poor African children must be circumcised to prevent HIV.
You can read the rest of the article here. The article compares circumcision to a vaccine, and even though it is clear to make the distinctions, I don’t like it one bit. The best way to prevent HIV/AIDS is through education. Education, education, education! Not prayer, certainly not wishful thinking - education.
Either you don’t have sex (you’re not going to last long in this group), you use condoms and protect yourself and your partner, or are faithful to your partner (once you have an honest dialogue, both are faithful to each other, and of course none of them have HIV). That’s the foolproof method. You need to be educated about your own body, and respectful of your partner(s).
Of course, the biggest question to me is that while circumcision is protective only 50%, perhaps 60%, of HIV in each sexual encounter the individual has, you are out of luck the other half of the time. You really are going to take your chances? Who is going to protect you the other 50% of the time? It’s basic statistics - in this case, almost like a coin toss. And it’s also common sense - a condom, or a circumcision? Thanks but no thanks Mohel, you can keep your Metzitzah b’peh to yourself. You can cut part of your wiener, but if you have unprotected sex with someone who has HIV/AIDS, trust me, you will eventually get HIV.
The Setshaba Research Centre is one of three sites in South Africa where a microbicide gel named Carraguard is being tested in phase 3 clinical trials, the last phase of drug testing on humans before approval for marketing.
More than 5,000 women are trying out the vaginal gel to determine if it really protects against HIV; most of them are from poor, neighboring areas.
“Studies done in the laboratory show that this agent might help in preventing HIV transmission,” Dr. Khatija Ahmed, principal investigator at the research center, told Women’s eNews. “It lines the vaginal mucosa so that the HIV virus cannot penetrate the mucosa and get into the human cell.”
This is an intriguing article linking conflict, the arms trade, poverty, disease and climate change all into one. Think this is far-fetched? Welcome to the real world, where everything is interconnected. The title, “Climate Change Clash in Africa” is not just change in the environment:
It’s been a bloody first half of the dry season in Uganda’s Karamoja region. October to February is the time when grass turns brittle, mud dries and cracks, and competition for scarce resources increases. More than 40 people have died in recent weeks in fighting between Karimojong warriors and the Ugandan Army in the arid northeast of the country.
The semi-nomadic Karimojong are pastoralists who protect their cows, violently if necessary. The warriors are well-armed, and this has put them on a collision course with Uganda’s government. But the recent clashes are a symptom of more universal problems.
As elsewhere in Africa, the population in eastern Uganda continues to grow as the environment deteriorates, putting more and more pressure on a land that grows ever drier. At a United Nations conference on climate change held in neighboring Kenya last month, environmentalists warned that Africa would bear the brunt of global warming.
With more people forced to share fewer resources, experts warn that conflict will increase. “Climate change will hit pastoral communities very hard,” says Grace Akumu, executive director of environmental pressure group Climate Network Africa. “The conflict is already getting out of hand and we are going to see an increase in this insecurity.”
First, as you now know, the long effort by King Leopold II of Belgium to bring Congo under his control was driven by his avid quest for a commodity central to industry and transportation: rubber. Does that remind you of anything?
What’s more, the king justified his grab for Congo’s natural resources with much talk about bringing philanthropy and Christianity to darkest Africa. Now what did that remind you of?
Leopold cleared at least $1.1 billion in today’s dollars during the 23 years he controlled Congo, and his businessmen friends made additional huge sums. Much of the money flowed into companies with special royal concession rights to exploit the rain forest. Final question, for extra credit: Do those companies remind you of anything? If you mentioned Halliburton or DynCorp, you’re right again.
As a reader of history, you must have been interested, I’m sure, in something else in the Congo story: the case of another world leader facing his own Abu Ghraib scandal.
Then why Hochschild’s op-ed? Because George W. Bush supposedly read his book. So Mr. Hochschild was very pleased that Dubya read his book, and he not only compares Dubya with King Leopold, but has a couple of suggestions for Bush as well:
For your next assignment, Mr. President, how about a different sort of reading? Ask Laura to stuff your Christmas stocking with books about people who’ve had the courage to change their minds. One former tenant of the house you live in, Lyndon B. Johnson, entered politics as a traditional segregationist but ended up doing more for civil rights than any American president of his century. Another, Dwight D. Eisenhower, spent half his life in the U.S. military but gave us (a little late) an eloquent warning about the military-industrial complex.
Another ex-military man, Maj. Gen. Smedley Butler of the U.S. Marine Corps, won the Medal of Honor twice, but then ended up denouncing the oil companies and agribusiness corporations he realized that he had been fighting for in U.S. interventions in Central America.
You think Bush is going to listen to Hochschild? Of course not - the man barely listens to what the American people say of him.
According to the Guttmacher Institute, a sexual and reproductive health nongovernmental organisation (NGO), research in both the developed and developing world suggests that HIV status does not significantly dampen people’s desire to have children. As more and more HIV-infected South Africans access life-prolonging antiretroviral (ARV) treatment, the question of whether or not to have a child, and how to do so as safely as possible, is bound to become more common.
Here is some more:
The disapproval of friends and family, and even some health workers, may deter those less well-informed than Madonsela from learning more about their options. “Most people think if you’re positive you don’t have the right to be in a relationship, or to have a baby,” she said.
HIV-positive pregnant women in many countries face pressure by health workers to have abortions or to be sterilised, according to the International Community of Women Living with HIV (ICW).
Despite these obstacles, a small but growing number of HIV-positive men and women are deciding to have children. In the developed world there are a number of options: a process called ’sperm washing’, which separates sperm from HIV-causing agents before being used for insemination, is safest for couples where a positive man wants to avoid the risk of infecting his negative female partner or reinfecting his positive partner; artificial insemination is the safest way of conceiving for couples with a positive woman and a negative man.
In a paper published in the journal Science, researchers looked at health records from Kisumu, Kenya, a city of 200,000 with high levels of both diseases. They calculated that the interaction of the diseases increased AIDS cases by 8 percent and malaria by 13 percent. Over 25 years, that meant 8,500 additional AIDS cases and almost a million extra cases of malaria. The researchers drew on earlier findings that H.I.V.-positive people who get malaria experience a six- to eight-week spike in the level of the AIDS virus in their blood. During that spike, they are supercontagious, with double the usual chance of infecting a sexual partner. People with H.I.V. have also been proved more likely to catch malaria.
Mounting evidence has revealed pathological interactions between HIV and malaria in dually infected patients, but the public health implications of the interplay have remained unclear. A transient almost one-log elevation in HIV viral load occurs during febrile malaria episodes; in addition, susceptibility to malaria is enhanced in HIV-infected patients.
Of course, the bigger picture here is not just an AIDS-Malaria connection. We know there are other factors involved, such as poverty and the lack of education, both basic education and more direct education regarding hygiene, disease, etc. Also, maternal education here is important, as a mothers’ malaria appears to enhance spread of AIDS virus (from the journal Science also):
For the first time, a study of HIV-infected pregnant women has found that coinfection with malaria significantly increased a mother’s risk of transmitting the AIDS virus to her baby before or during birth.
It’s great that the mainstream media is finally taking a good, hard look (albeit a brief one) at the existing global health problems - all the more reason why we, as future medical professionals and global health advocates, need to push hard and continue lobbying and informing people.