Monthly Archives: November 2010

The urgent need for new TB diagnostics

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The Global Center’s David Bryden is reporting from the 41st Union World Conference on Lung Health, this week in Berlin.

The recent article in The New Yorker by Michael Specter, “Letter from India: A Deadly Misdiagnosis,” is required reading for anyone interested in global health, drug resistance and expanding access to affordable tuberculosis services. The problems it reveals, including the irresponsible use of serological testing for TB in India, have been much discussed here in Berlin at the Union World Conference on Lung Health.

TB kills about 900 people per day in India, or about two people every three minutes. And each year there are 99,000 cases of multi-drug resistant TB. Nearly five percent of the incident cases there are HIV-positive.

Potential Shorter, Simpler TB Treatment Heads to Phase II Trials

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The TB Alliance announced this week enrollment of a Phase II trial, NC001 (or New Combination 1), testing the new TB drug candidates PA-824 and moxifloxacin in combination with pyrazinamide, an existing antibiotic commonly used in TB treatment today. The 14-day, inpatient study will be conducted with 68 patients in two clinical sites in South Africa. The drugs were separately tested for safety and efficacy in patients alone before entering the combination trial.

Science Speaks asked Carl Mendel, MD, Senior Vice President of Research and Development at the Global Alliance for TB Drug Development (TB Alliance), some questions about the trial:

In TB, breakthroughs possible for new tests

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After speaking about new tools to diagnose TB and other diseases, Dr. Giorgio Roscigno walked off the stage at the American Society of Tropical Medicine and Hygiene last week in Atlanta only to face a long line of people waiting to talk with him. He stayed until organizers of the next session finally had to shoo him out of the room.

These are heady times for Roscigno. His Geneva-based group, the Foundation for Innovative New Diagnostics (FIND), has helped shepherd a series of new discoveries, including one pending TB test that several experts believe could revolutionize the treatment and care of the ancient disease.

Goosby works to integrate AIDS, family planning services

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Every year, the US Office of the Global AIDS Coordinator sends out what it calls Country Operational Plan (COP) guidance to embassies around the world. You could think of COP as a cop: It tells the hundreds and hundreds of US government health experts the goalposts ahead, including a list of things that can’t be done.

One COP piece of guidance this year has caused some distress in the field: Family planning can be integrated into HIV programs, but no US government money can buy family planning commodities, including contraceptives, due to US regulations.

So in some countries a women receiving help in preventing transmission of HIV to their child during birth can’t later receive free contraceptives with PEPFAR money.

Dr. Eric Goosby, the global AIDS coordinator, said in an interview with journalists Thursday that he and his staff have been trying to find a way to allow women to be able to get those commodities. He said he is trying to sort through political and bureaucratic issues.

WHO releases global TB update

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The World Health Organization (WHO) issued its 2010 annual report outlining global “control” of tuberculosis on Thursday. This is the most comprehensive report ever on the progress made combating TB globally, according to the WHO press release. Some of the startling statistics given in the report include that there were 9.4 million new TB cases […]

Global Health Initiative deputies update the community; announce plans for more focus countries

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At a meeting convened by the Global Health Council Monday afternoon, deputy principals from the Office of the Global AIDS Coordinator (OGAC), United States Agency for International Development (USAID) and the CDC updated members of the global AIDS community on the progress of the Global Health Initiative (GHI) – the Obama Administration’s $63 billion, six-year […]

What We’re Reading

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A study released in this month’s issue of AIDS found that men and women undergoing a highly active antiretroviral therapy (HAART) regimen in South Africa were less sexually active than those who had not initiated HAART. Researchers followed more than 6200 HIV-positive men and women for seven years.  Treatment also reduced the number of partners and the frequency of unprotected sex.

A new mobile phone-based technology cuts diagnosis time for HIV-infected babies from three months to two weeks, maximizing their chances for survival. According to a story from SciDev, blood samples from infants are sent to a centralized laboratory for testing, and the Early Infant Diagnosis (EID) system allows these labs to send test results to local clinics instantly via short message service (SMS) to cell phones. The pilot program in Uganda, where there are only seven labs equipped to test for HIV, has more than doubled treatment rates in HIV-positive infants.

Another piece on the Center for Global Development blog analyzes why mobile phones have been successful in international development.

A study from Oxford University and South Africa’s University of the Witwaterstrand finds that children with caregivers suffering from AIDS…

DeCock: “We dismiss routine TB control at our own peril”

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Kevin DeCock, MD, Director of the CDC’s Center for Global Health, has a lot on his plate these days. He oversees 900 people in CDC’s Atlanta headquarters and 1,500 people around the world. But he is not just monitoring efforts involving infectious diseases, he’s increasingly investigating ways to battle non-communicable diseases.

Still, with all of that, one of the things that worries him most is multi-drug resistant tuberculosis (MDR-TB).

Guest post: “Treating MDR-TB is imperative”

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This is a guest post by two doctors with vast experience in treating multi-drug resistant tuberculosis (MDR-TB), Drs. Salmaan Keshavjee and Paul Farmer. Farmer is co-founder of Partners In Health and Keshavjee has treated MDR-TB patients through Partners In Health programs for the last decade. Until three months ago, Keshavjee was the chairman of the Green Light Committee of the Stop TB Partnership, which oversaw the distribution of second-line TB drugs to countries. They wrote this post in response to an interview on Science Speaks with Dr. Ezekiel “Zeke” Emanuel, a senior Obama administration official at the Office of Management and Budget. (Emanuel’s interview can be found here.)