Jane Parry

At last a global response to viral hepatitis.

A million people die from viral hepatitis every year, yet until now the public health response has been patchy and piecemeal, overwhelmed by the sheer scale of the problem. Jane Parry reports.

Controversial new vaccine to prevent cervical cancer.

Almost half a million women develop cervical cancer every year; more than half of them die as a result of their condition. More than 80% of the burden of this easily detectable and preventable disease is borne by developing countries where cervical cancer accounts for 15% of all cancer deaths but which have only 5% of the worlds cancer resources. A woman in the United States has a 70% chance of surviving cervical cancer thanks to relatively easy access to Pap smears or tests to detect early signs of cancer as well as follow-up treatment. Not so for her counterpart in Thailand who has a 58% chance of survival or India where there is only a 42% chance of beating cervical cancer; in sub-Saharan Africa the survival rate drops to 21%. While 61% of women with cervical cancer in the developed world will survive because they have access to testing and treatment only 41% of their developing world counterparts will get the treatment they need to survive. The good news is that cervical cancer has joined a growing list of cancers that can be ascribed to infectious diseases which can be identified and treated. (excerpt)

New vaccines to boost child care in developing countries

By the age of three years most children in the world have been infected with rotavirus. In the developed world many cases need nothing more than attentive treatment and rest at home but in about 5-10% of cases children become so dehydrated due to gastro-enteritis they may need hospital care. The picture is more grim in developing countries where three-quarters of infants have had their first clinically serious rotavirus infection by their first birthday. Worldwide rotavirus accounts for an estimated two-fifths of all severe diarrhoea cases and causes up to a third of the 1.9 million deaths a year among under-fives due to diarrhoea. Ninety percent of these deaths occur in the developing countries where access to lifesaving treatment is limited and where a vaccine would offer the best hope for preventing countless deaths. Finding a safe and effective rotavirus vaccine has been a priority for the World Health Organization (WHO) in the 1990s. But the search got off to a false start. In mid-1998Wyeths RotaShield was licensed for sale in the United States of America (USA) and rapidly introduced into routine childhood vaccination programmes. Within nine months cases of vaccine-related intussusception a serious condition that causes bowel obstruction were reported among some one million children who had been vaccinated. The manufacturer voluntarily withdrew the vaccine and the US Advisory Committee for Immunization Practices withdrew its recommendation for its use. (excerpt)

Global Fund withdraws grants to Myanmar

Discussions are underway with donors in Norway Australia the United Kingdom and Japan to try to secure the survival of a project which began in January to tackle tuberculosis and initiatives in HIV/AIDS and malaria which commenced in April. Collectively the projects were to have received US

China's pragmatic approach to AIDS

98.4 million from the Global Fund over five years US

China enters the global vaccine market.

11.8 million of which has already been disbursed. WHO is also looking at ways to redistribute existing funding to make money available for Myanmar and the Democratic People’s Republic of Korea (DPR Korea) which has faced similar funding withdrawals from the Global Fund. “We are doing everything we can to get resources now for Myanmar and DPR Korea. We are promoting horizontal cooperation between WHO country offices which means that countries like India and Indonesia which have extra funds transfer them to these countries” said Dr Samlee Plianbangchang Regional Director of WHO’s Regional Office for South East Asia. (excerpt)

No vaccine for the scaremongers.

International public health experts are praising China for a new openness that will be key to effective control of HIV/AIDS. Despite a recent downward revision of its HIV/AIDS estimates China faces a growing epidemic. Its ambitious public health plans include free HIV testing and AIDS treatment and a nationwide rollout of methadone therapy to help drug users lower their risk of contracting HIV. (excerpt)

Clipping the wings of avian influenza.

China is gearing up to supply the world with affordable vaccines that fulfil all efficacy, safety and quality requirements. Jane Parry reports.

Health amid a financial crisis: a complex diagnosis.

For most children in the developed world, immunization against a range of infectious diseases is a form of health protection often taken for granted. These children benefit from vaccines against more than 20 diseases, while new vaccines continue to be developed, most recently for rotavirus and human papillomavirus. In developing countries, however, getting routine vaccinations to the people who need them remains a key public health challenge, with the lack of health-care infrastructure, high costs and delays between their introduction in developed countries and their rollout in the developing world cited as the main barriers. Despite these barriers, global vaccination has evolved as a result of rigorous scientific research. According to the World Health Organization (WHO) and the United Nations Childrens Funds (UNICEF) 2007 Immunization Summary, more than 2.5 million deaths a year are prevented in all age groups owing to vaccination against four diseases--diphtheria, tetanus, pertussis (DTP) and measles. Global coverage of infants with the DTP vaccine reached 79% in 2006, up from 20% in 1980, while the uptake of several under-used vaccines, including hepatitis B, rubella and yellow fever, is increasing. Smallpox has long been hailed as the ultimate vaccination success. It was declared eradicated in 1979, the only disease affecting humans to be eliminated deliberately. Polio has been eradicated in WHOs American, European and Western Pacific Regions, while the number of countries where polio is deemed a serious public health problem has dropped from 125 in 1988, when the eradication drive was launched, to only four--Afghanistan, India, Nigeria and Pakistan--where the disease remains endemic. There have been many other successes, such as the 99% reduction in the incidence of bacterial meningitis caused by Haemophilus influenzae in the United States of America (USA) which introduced vaccination against the disease in 1988, according to its Centers for Disease Control and Prevention. The Republic of Korea, with 99% vaccination coverage for measles, declared the killer disease eradicated in 2006. Despite these successes, vaccine anxieties continue to periodically impede this highly effective public health measure. In certain industrialized countries, most notably the USA, public concern has shifted its focus from the diseases vaccination can prevent, to the risks of the vaccines themselves. The Internet has become a significant channel for anti-vaccination views. The popular video-sharing web site YouTube offers a plethora of anti-vaccination dips. The Internet has also become a forum for alternative medicine practitioners to present their anti-vaccination ideas and promote alternative products. While parents in developing countries have, for example, first-hand experience of measles and welcome vaccination against it, the uptake by parents for the combined measles,. mumps and rubella vaccine in many developed countries has yet to recover almost 10 years after a study linking it to autism, even though the original study has long since been discredited and there is overwhelming scientific evidence that refutes the link. [ILLUSTRATION OMITTED] A similar scare linking the mercury compound vaccine, thiomersal, to autism led to its elimination from most USA and European vaccines that contained it, despite the lack of scientific evidence to support this measure. Indeed, five large-scale studies failed to find a link between thiomersal and autism, and, according to some studies, the incidence of autism has risen after discontinuation of thiomersal use in vaccines. Anti-vaccination scares can have lasting, harmful effects. Pertussis (or whooping cough) vaccination was halted in Japan in the mid-1970s owing to public concerns over adverse neurological effects. At that point, Japan had brought the disease under control after introducing immunization in 1947. …

Vaccinating against cervical cancer

Up to now, the threat of avian influenza has been lessened by effective animal husbandry methods. However, the public health community is trying to ensure enough measures are in place to prevent a possible pandemic. Jane Parry reports.