President Obama released a letter to Congress on Wednesday asking it to consider allocating $6.18 billion in order to respond to the Ebola crisis in West Africa. From his letter:
My foremost priority is to protect the health and safety of Americans, and this request supports all necessary steps to fortify our domestic health system and prevent any outbreaks at home. Over the longer term, my Administration recognizes that the best way to prevent additional cases at home will be to contain and eliminate the epidemic at its source in Africa.
Specifically, the request includes resources for domestic hospital and State and local preparedness; resources to support training as well as the acquisition of appropriate protective equipment; medical and non-medical management of Ebola treatment units and community care centers; infection control; contact tracing; laboratory capacity; disease surveillance; emergency operation centers; education and outreach; burial teams; addressing food insecurity and other adverse impacts of the outbreak in affected areas; and testing and development of new vaccines, therapeutics, and diagnostics.
The request also includes resources to strengthen global health security by reducing risks to Americans by enhancing the capacity of vulnerable countries to prevent disease outbreaks, detect them early, and swiftly respond before they become epidemics that threaten our national security. The Global Health Security Agenda will accelerate and expand international capabilities to deter infectious disease threats like Ebola, by: standing up emergency operations centers; providing equipment and training needed to test patients and report data in real-time; providing safe and secure laboratory capacity; and developing a trained workforce to track and end outbreaks before they become epidemics. These are the same activities that are necessary to combat the spread of Ebola and reduce the potential for future outbreaks of infectious diseases that could follow a similarly devastating, costly, and destabilizing trajectory.
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Global Health and Development Beat
Plans are progressing to introduce an unusual method of mosquito control in South Sudan which involves sprinkling powdered plant extracts on swampy mosquito nurseries.
At least 800,000 people in the Caribbean and surrounding nations have contracted the chikungunya virus this year. It is rarely fatal, but some people suffer debilitating muscle pain for months or years, reports the New York Times.
Psychosocial support to the people and communities affected by Ebola, is a difficult but indispensable task in responding to the epidemic, says MSF.
The number of Ebola cases is surging in Sierra Leone as the country suffers from a lack of treatment centres, while lack of food and basic goods is forcing some people to leave quarantine areas, the United Nations said.
Meanwhile, the WHO said the number of new Ebola infections in West Africa is about the same as it was the week before, with a rise in some areas and a decline in others. Reports from Sierra Leone found the number of new Ebola cases has risen drastically in the past weeks.
The Sierra Leone Association of Journalists has called on President Ernest Bai Koroma’s government to either release radio talk show host David Tam Baryoh or hospitalize him because they say his life is at risk.
The fight against the deadly Ebola epidemic ravaging West Africa seems to be hanging in the balance as Sierra Leone’s Minister of Health and Sanitation Dr Abubakar Fofana told IPS that the government is overwhelmed by the outbreak.
The European Union and drugmakers pledged on Thursday to invest $350 million in Ebola research, with the lion’s share going to the testing and manufacturing of potential vaccines.
Two new U.S. Ebola treatment facilities are expected to open in Liberia over the next week. One is a 25-bed field hospital near Monrovia’s airport, specifically to treat local health care workers who get infected. The other is a 100-bed Ebola treatment unit in the town of Tubmanburg, north of Monrovia.
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Spotlight on PSI
The Impact blog describes the lessons learned from PSI’s work with the private sector to improve the management of malaria cases. An excerpt:
In a recent Newsweek article, Amy Maxmen highlighted PSI’s efforts to create a private-sector market for rapid diagnostic tests to diagnose fever in Tanzania.
The project highlighted in the article is being funded by the financing mechanism UNITAID. PSI is the lead implementer, in partnership with Foundation for Innovative New Diagnostics (FIND), Malaria Consortium (MC) and the World Health Organization (WHO).
Currently underway in Kenya, Madagascar, Nigeria, Tanzania and Uganda, it creates a private sector market for malaria RDTs, by (i) increasing both access to and demand for quality-assured RDTs, (ii) improving private providers’ fever case management skills and (iii) developing and implementing a roadmap for public-private engagement that will guide policy and regulation.
PSI is implementing this project in Kenya, Madagascar and Tanzania and is doing the following:
- Increasing access to RDTs: PSI makes sure the supply chain functions reliably to deliver quality RDTs at the lowest possible price with the lowest possible margins.
- Increasing demand for RDTs – from both the provider and the consumer:
- ‘It’s good for me’: PSI informs consumers about the importance of being correctly diagnosed before being given a drug through behaviour change communications activities, such as road shows, radio advertisements and point of sales advertising. PSI also carries out research to better understand how consumers seek treatment for fever, and how they are managed by private sector providers.
- ‘It’s good for business’: By using RDTs and adhering to WHO guidelines, providers improve their case management skills and increase their credibility in the community, which results in more customers.
- Ensuring quality of service: By training providers and carrying out supportive supervision, PSI helps them improve their case management skills – e. only giving an ACT when the patient has malaria. This is done using innovative monitoring techniques, as well as carrying out mystery client interviews.
Finally, PSI and its partners are working with Ministries of Health to develop and disseminate a roadmap to assure that affordable, quality-assured RDTs continue to be made available in the private sector by leveraging the systems, learning and evidence generated by the project.
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Buzzing in the Blogs
The lack of Ebola vaccine, and vaccine for other things like malaria, illustrates the gaps in the way drugs are developed, argues economist Jim Stanford in the Globe and Mail. He writes:
A frightening example of research mismanagement is the case of drug-resistant bacteria. Mutated bacteria pose an enormous public-health threat; if unchecked, they could recreate the misery and early death of pre-penicillin times. Yet private drug companies invest little in the search for new antibiotics, partly because antibiotic prescriptions (typically lasting just a few days) are not especially profitable. So new antibiotic development has slowed dramatically, even as the threat of antibiotic resistance grows. England’s chief medical officer, Sally Davies, summed up the problem bluntly in a recent Canadian speech (reported by The Globe and Mail’s André Picard): “The market system is broken.”
Many public-health experts now believe drug research should be funded through public grants. This allows health planners to consciously allocate top-priority attention to the most dangerous diseases. Then, since new formulas are public property, they can be commercialized at the cost of production (or less). Salaried scientists working in universities, hospitals and public institutions are just as productive as those working in private labs. But a more rational focus for their research, and wider accessibility to the treatments they develop, would save millions of lives.
Canada’s outstanding work to invent one of the world’s most promising vaccines against Ebola perfectly epitomizes both the promise of public research, and the perverse incentives of the for-profit industry. Early this century Health Canada recognized the need for an Ebola vaccine, and assigned scientists with the Public Health Agency of Canada to find one. Almost a decade ago they patented a vaccine that prevents Ebola in monkeys. Canadian researchers should have been hailed as heroes.
Unfortunately, the government snatched defeat from the jaws of victory by handing over this important invention to the private sector – for a pittance. In 2010 Ottawa licensed the Ebola vaccine to a small U.S. firm called NewLink Genetics. I’ve been asking Health Canada to explain how the licensing was negotiated, and how much Canada was paid; I have yet to receive an answer. NewLink’s financial filings report it paid Canada an initial patent and signing fee, and a “milestone” payment of up to $205,000; “low single-digit” royalty fees will be payable on future commercial sales.
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Capital Events
Friday
7:30 AM – World Affair Councils of America 2014 National Conference (Day 2) – WACA
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By Mark Leon Goldberg and Tom Murphy
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Disclaimer: Opinions presented in this email do not necessarily reflect the views of PSI.