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Posts Tagged ‘vaccines

Vaccine Diplomacy: The Key to Eradication

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By Juan Ignacio Moliva, PhD

Directors of Global Smallpox Eradication Program. From left to right: J. Donald Miller, William H. Foege, and J. Michael Lane.
Source: Wikipedia

In a rapidly connecting world, scientific diplomacy has grown into an important tool in foreign policy’s mission to maintain worldwide stability. Broadly described as the collaboration between nations to address common problems across all branches of science, scientific diplomacy is relied upon to help address multinational scientific challenges. The goal of science diplomacy is to build technical, research-based partnerships, both formal and informal, to further advance humanity’s understanding of the world. Collaborations between nations are required to achieve global solutions – whether those countries be rich or poor, big or small, stable, or unstable. While recent accomplishments of this branch of diplomacy include the Paris Climate Agreement and the Iran Nuclear Deal, arguably the greatest scientific diplomacy success is the eradication of smallpox. This was accomplished through a branch of scientific diplomacy, vaccine diplomacy, a derivative whose goal is to promote vaccination to achieve global health goals and common foreign policy objectives that deal with the eradication of disease.

Before its eradication, smallpox was one of the world’s worst diseases; a virus that killed 30% of those infected. The eradication of smallpox exemplifies a worldwide collaboration to solve a deadly problem. The first multinational attempt to eradicate smallpox occurred in 1950 by the Pan American Health Organization. Though the initial campaign was largely successful, it failed to eliminate the virus. A global effort was then initiated by Viktor Zhdanov, a scientist from the USSR, who suggested a worldwide program of eradication in 1958. The success of this project depended on the collaboration between the United States and the Soviet Union, two countries in the midst of a cold war. With the backing of the international community, the WHO launched the Intensified Smallpox Eradication Programme in 1967, and the last case of smallpox, a Somali hospital cook named Ali Maow Maalin, was recorded in 1977. Global cooperation not only enabled the eradication of smallpox but was necessary for its success. 

In an attempt to replicate the success with smallpox, multinational organizations have partnered to eradicate other deadly or debilitating diseases via vaccination, including polio, malaria, and measles amongst many others. Although considerable progress has been made (polio and measles have been reduced by >99%), several factors have prevented complete eradication. Polio remains endemic to three countries, Pakistan, Nigeria, and Afghanistan, and its eradication has been inhibited primarily due to armed conflict. Eradication of measles, on the other hand, which has re-emerged due to the anti-vaccination movement in developed countries, remains tied to weak health systems and poor sanitation in rural parts of the world. Malaria, though more prevalent than polio and measles, has also been targeted by the WHO for eradication. However, weak health systems, drug and insecticide resistance, climate change, and lack of funding remain major obstacles. 

The major branches of vaccine diplomacy are the allocation of resources and the establishment of international partnerships that will be beneficial for the eradication of disease and allow for rapid responses to outbreaks. To achieve these goals, vaccine diplomacy promotes the use and availability of vaccines in regions of the world where resources may be limited and works to enable access and affordability of vaccines to low-income populations that are at risk. Vaccine diplomacy also aims to strengthen international collaboration. Failure to share biological samples of pathogens has the risk to hinder the global response to emerging diseases. Indeed, this occurred in 2007 when the government of Indonesia decided to stop sharing H5N1 influenza samples, which endangered the WHO’s Pandemic Influenza Preparedness Agreement. Finally, another critical component of vaccine diplomacy is to emphasize honesty and cooperation during outbreaks. The worldwide outbreak of a novel coronavirus (COVID-19) that began in China raised concerns that the Chinese government was not being honest about the number of cases. The fact is infectious diseases do not respect national boundaries. In the past ten years, the world has experienced multinational outbreaks of influenza, measles, Ebola, Middle Eastern Respiratory Syndrome (MERS), Zika, cholera, Chikungunya, and others. With the ever-increasing human population, it is becoming easier for newly emerging pathogens to spread. Honesty and cooperation will be critical to ensure a rapid response and prevent mass loss of life. 

How can vaccine diplomacy help use finally eradicate some of these lingering infectious diseases? Effective vaccine diplomacy must meet the following conditions: First, and most important, is increasing access to free, effective, and easily administrable vaccines to regions of the world where the disease is endemic. The most effective solution to eliminating diseases is to provide the vaccine at no cost. This will require international support and coordination between multinational agencies and low-income countries. Second, efforts should center on enhancing surveillance and effective communication of the disease to ensure a rapid and appropriate turnaround from detection to neutralization. This will involve mobilizing community leaders and assisting individuals that may have been displaced due to natural disasters or civil unrest. Third, to eliminate the spread of disease, access to clean water and improvements to sanitation must be prioritized in developing nations. Fourth, vaccine diplomacy must include effective health promotion and communication to the public. The rise of skepticism in vaccines has brought back dangerous pathogens from the brink of extinction in the developed world. Eradication will depend on effective educational campaigns that stress the importance and safety of vaccines. 

Why should we eradicate these diseases? The vision of eradication has a significant worldwide impact and showcases international collaboration. Eradication can also be seen as a cost-effective solution to diseases. When a disease is eradicated resources are no longer needed to prevent or treat that disease. Additionally, those individuals that would have been affected by the disease can then contribute to the economy. It’s estimated that the global benefit-cost ratio for smallpox eradication was 450:1, meaning that every $1 invested in smallpox eradication brought $450 in economic gain. Eradication of disease also fits under social justice and equality. Echoed by Melinda Gates, “… we have not had malaria transmission in the United States since the mid-1930s. Our kids don’t die of malaria. We have the tools to eliminate it [worldwide]. How is it justifiable that we don’t?” The benefits outweigh the costs and trained vaccine scientists with diplomatic experience must lead the way to finally rid the world of preventable diseases. 

Written by sciencepolicyforall

April 24, 2020 at 2:13 pm

Science Policy Around the Web April 14th, 2020

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By Andrew Wright, BSc

Image by Angelo Esslinger from Pixabay

United States wants to end most payouts for leading vaccination-related injury

The National Vaccine Injury Compensation Program (VICP), was established by Congress in 1986 to provide relief to vaccine companies from personal injury lawsuits in an effort to maintain a viable vaccine supply. Under this law, an individual who has suffered an injury from an approved vaccine can utilize a special court process that involves a Health and Human Services (HHS) medical review board and that covers the individual’s private attorney fees. During the Obama administration, the guidelines for this program as they pertain to shoulder injuries were changed so that individuals no longer need to prove their injury was caused by the vaccine, but rather there is a clear difference in their shoulder health within 48 hours of the vaccine being administered.  Since that rule change, shoulder injuries have accounted for 54% of VICP claims.

In response to this increase in claims, the Trump administration is recommending that shoulder injury claims should be made ineligible for VICP and that those claims should be made in civil court. The argument behind this rationale relies upon shoulder injuries from vaccine administration being from poor needle placement, rather than an inflammatory reaction from the vaccine itself. According to an HHS proposal, moving the burden to a standard civil court might promulgate better training on proper injection technique and reduce the number of vaccine-based shoulder injuries. It also argues that the surge of VICP claims are providing ammunition to anti-vaccination groups.

Critics have noted that the HHS published research in 2010 that demonstrates antigenic material is what causes severe shoulder inflammation and long-term injury when it is injected into the shoulder joint. This was corroborated by studies done by the National Academy of Medicine. In an open letter to HHS secretary Alex Azar, Uma Srikumaran, a shoulder surgeon from Johns Hopkins, makes the distinction, “while needle injection is necessary to deliver the antigen into these structures, it is not sufficient to cause [shoulder injury] alone.” He also argues that limiting VICP could increase malpractice insurance rates and ultimately make vaccine administration more costly.

The stakes are particularly high given the severity of the current coronavirus epidemic. If a vaccine is made available, rapid and efficient administration of it to the global population will be necessary to have an effective impact.

(Meredith Wadman, Science)

‘A huge step forward.’ Mutant enzyme could vastly improve recycling of plastic bottles

The United States falls behind many countries in how much it recycles, and those numbers are often bolstered by the enormous export of plastic to other nations. “The US is the only developed nation whose waste generation outstrips its ability to recycle, underscoring a shortage of political will and investment in infrastructure,” according to analysis by the global consulting firm Verisk Maplecroft. At the same time US houses the two largest plastic producers in the world: Coca-Cola and PepsiCo and has worked to block global action against plastic pollution at the United Nations.  Under this startling backdrop of inaction and counteraction, it seems like a new strategy to tackle overwhelming loads of plastic pollution will be necessary.

Under the current recycling process, only about 30% of soda bottle plastic is recycled, and the final product often loses much of its strength and color. Recently, the enzyme leaf-branch compost cutinase (LLC) has been engineered by a partnership between the company Carbios and the University of Toulouse. According to research published in Nature, this new enzyme can break down 90% of the most commonly used plastic within 10 hours of exposure at high heat. Moreover, the resulting recycled product is just as strong as the material that is put in and can be customized to match specific colors. While the economic viability of large-scale LLC reactors is still being explored, this new method could provide a new avenue to establish plastic recycling infrastructure where it is lacking.

(Robert F. Service, Science)

Written by sciencepolicyforall

April 14, 2020 at 9:41 am

Science Policy Around the Web November 15th, 2019

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By Mohor Sengupta PhD

Image by David Mark from Pixabay

Rollout of Johnson & Johnson Ebola vaccine begins in Congo

To the African countries reeling with the second deadliest Ebola outbreak in history, two back-to-back launches of new vaccines may be a beacon of hope. On Tuesday this week, Merck’s vaccine Ervebo was pre-qualified by the WHO, meaning that it was declared safe for use. This occurred merely 48 hours after the European Commission granted conditional marketing authorization for the vaccine. The speed of this decision-making sheds light on the gravity of the situation at hand. 

The current outbreak in the Democratic Republic of Congo has killed more than 2,200 people. The previous Ebola outbreak, and the deadliest in living memory, rocked West Africa in 2013-16, claiming 11,300 lives. 

In addition to Ervebo, a new vaccine produced by Johnson & Johnson was approved yesterday. It passed several clinical trials, however it will now be tested for the first time in a real world setting in the village of Goma, on the Rwandan border with DRC. It will be administered to 50,000 people. 

The new vaccine by Johnson & Johnson is aimed at complementing Ervebo. While the later requires a single shot, the Johnson & Johnson vaccine will require two shots spaced at 8 weeks. Ervebo is being used as “ring-vaccination”, a strategy in which close contacts of Ebola-infected individuals will be vaccinated.  

(Reporting by Fiston Mahamba; Writing by Hereward Holland; Editing by Anna Pujol-Mazzini and Mark PotterReuters)

Written by sciencepolicyforall

November 15, 2019 at 4:35 pm

Should Vaccines be Mandatory?

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By: Juan I. Moliva, Ph.D.

Image by Angelo Esslinger from Pixabay 

The anti-vaccination movement has been gaining traction across the United States (U.S.) and the world. According to the Centers for Disease Control and Prevention (CDC), the number of measles cases in the first five months of 2019 surpassed the total number of cases per year for the past 25 years, with the number of children unvaccinated for preventable diseases quadrupling since 2001. The CDC also found an increase in the number of vaccine exemptions for kindergarteners across the U.S. While the numbers vary across the country mostly due to laws set in place by each state, in Mississippi, one of three states that do not grant exemptions due to religious or philosophical reasons, the rate of kindergartners with an exemption to one or more required vaccine was 0.1%. Compare that to Oregon, a state that grants exemptions to vaccines due to religious or philosophical reasons, where the rate of vaccine exemptions for kindergarteners is at 7.6%. As the number of individuals choosing not to get vaccinated or choosing not to vaccinate their children continues to increase, the debate as to whether vaccines should be mandatory has taken front stage.

Simply stated, a vaccine is a weakened or killed version of a pathogen that is delivered to the body with the sole goal of stimulating an immune response to protect you against the disease you are being vaccinated against. How is this accomplished? Your immune system has a subset of cells with “memory” that remember the pathogen and if you are later exposed to the pathogen these “memory” cells will eliminate the pathogen before it can make you sick. In the U.S. and most of the world, the general scientific consensus on vaccines is that they are safe and critical for maintaining healthy communities. The U.S. Senate Committee on Health, Education, Labor, and Pensions (HELP) strongly defended the case for vaccines. Chairman Lamar Alexander (R-TN) said, “The science is sound: Vaccines save lives – the lives of those who receive vaccines and the lives of those who are too young or vulnerable to be immunized.” Like any medication or medical procedure, vaccines do not come without risk, but the advantages vastly outnumber any disadvantages.

Not only do vaccines protect your body from dangerous pathogens, they also protect the community via a concept known as herd immunity. When a high enough percentage of the population is immune, pathogens have a harder time spreading. We rely on this principle to protect those who cannot receive a vaccine. However, vaccine opponents continue to argue that mandating vaccines is a slippery slope towards losing body autonomy. I have spent the last eight years studying vaccines, from basic research to pre-clinical testing through clinical trials and licensing. I have recently come to embrace the belief that the sole exemption for a vaccine that has been proven to be effective is a medical one – the case where you cannot receive a vaccine because your body responds negatively to the vaccine; this includes a weakened immune system that can be caused by chemotherapy or radiotherapy, a congenital condition that leads to an impaired immune system, or a history of serious adverse events related to vaccination such as an allergic reaction to one or more components in the vaccine.

The case against anti-vaxxers surrounds the choices they make on behalf of their children and how those choices affect their children and those in the community. If parents started claiming religious or philosophical exemptions against child safety seats or against buckling their children while driving, would we be arguing in their favor? Seatbelts and safety seats have been proven to save lives by preventing ejection from the vehicle after impact. Vaccines have been medically proven to save lives by preventing death or disability from infectious pathogens after exposure. While we expect not to be involved in a car accident, we rely on seatbelts in case we do. Vaccines work the same way; we do not want to be exposed to deadly pathogens but being vaccinated against these pathogens helps ensure we do not get sick if we do. Childrenare incapable of deciding if they want to be vaccinated as some vaccine regimens are initiated within the first year of life, thus their welfare is entrusted upon their parents. 

In the U.S. we have laws about providing proper nutrition, schooling, clothing, cleanliness, shelter, and many more that protect children’s welfare. Providing vaccines on time should be included as a basic necessity and be treated no different than other child welfare offenses. If an unvaccinated child contracts a preventable disease and is significantly affected to the point of disability or even death, the parent(s) should be directly responsible. A guardian refusing to vaccinate their medically eligible child should be treated like what it is: child endangerment. Take for example the recent case of a six-year-old in Oregon that nearly died of tetanus after sustaining a cut while playing outdoors. The child’s parents had refused to vaccinate the child with DTaP, a safe vaccine intended to protect against tetanus. The boy was held in an intensive care unit for 47 days, undergoing multiple intravenous infusions to alleviate the high fever, hypertension, and tachycardia caused by the infection. All at the cost of over $800,000 for a disease that could have been easily prevented with vaccination. Despite the episode, the boy’s parents continue to refuse the vaccine.

Although bipartisan support exists for vaccination at the federal level, it is unlikely federal law eliminating philosophical and/or religious exemptions would come to pass as public health policy is traditionally left to the states. State legislatures are beginning to introduce laws that will help limit the increase in numbers of preventable disease cases due to lack of vaccination. New York state recently passed legislation forbidding religious and non-medical exceptions to vaccines. After signing the bill, Governor Cuomo (D-NY) said, “While I understand and respect freedom of religion, our first job is to protect the public health.” Washington state, plagued by surging number of measles cases, also recently banned personal and philosophical exemptions to the MMR vaccine, which protects against measles, mumps, and rubella. Merely going to a public park or a grocery store can place unvaccinated children or immunocompromised individuals at risk of contracting a preventable disease. Such was the case of a six-year old boy with leukemia that died of measles after being exposed by his intentionally unvaccinated siblings. Senator Bill Cassidy (R-LA), a former physician, stressed: “If you are such a believer in liberty that you do not wish to be vaccinated, there should be a consequence and that should be that you cannot infect other people.” While I agree that autonomy over one’s body is important, the government has the right to require a reasonable level of vaccination for all citizens as a matter of public health. 

In the U.S. where freedom and personal liberty are valued above all else, mandatory vaccination would have a lengthy and challenging uphill battle. Additionally, data suggests that mandatory vaccination does not necessarily increase vaccination coverage. Instead, the U.S. could increase vaccinations via financial incentives similar to the system in place in Australia whereby parents receive monetary compensation when their children meet vaccination requirements. However, the most successful approach might be akin to the one the CDC implemented over sixty years ago to encourage stricter vaccination requirements by the states. By providing educational support, the CDC engaged parents, policymakers, and state and local health officials at every level to increase vaccination coverage. Education is one of the most effective ways to counter vaccination noncompliance. Specifically, educating people on the alternatives to vaccines – the morbidity and the mortality associated with lack of vaccination – was shown to be the most effective strategy. Educating why vaccines are so crucial is the most powerful weapon to combat vaccine non-compliance. 

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Written by sciencepolicyforall

August 14, 2019 at 10:00 am

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Disparity in the Global Supply and Demand for Vaccines Against Rotavirus

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By: Lawrence Wang

Image by Arek Socha from Pixabay 

Vaccines are extremely important for individual and global health. These life-saving biologics are especially important for children in developing countries, who suffer disproportionately from vaccine-preventable infectious diseases. One of these infectious diseases is rotavirus, which causes severe diarrhea and kills around 200,000 young children and babies per year1. Effective vaccines against rotavirus are responsible for saving countless lives and reducing suffering around the world.

In November 2018, the major pharmaceutical company Merck canceled a long-term commitment it made with GAVI (The Global Alliance for Vaccines and Immunization) to provide its rotavirus vaccine, RotaTeq, to four countries in West Africa (Burkina Faso, Cote d’Ivoire, Mali, and Sao Tome) for $3.50 a dose. Simultaneously, Merck increased RotaTeq shipments to China where a course sells for $40, nearly 12 times more than in West Africa2. Merck reported that the reason for this termination was “supply constraints” and an “unprecedented increase in global demand” for Rotateq3. Vaccines that were earmarked for West Africa were instead diverted to China, where they would protect millions of Chinese children while leaving millions of West African children vulnerable.

This situation exemplifies the disparity in the global supply of, and demand for, vaccines. Many vaccines are produced by large pharmaceutical companies like Merck that are based in wealthy nations (e.g., Merck’s headquarters are in New Jersey, USA). In general, developed countries have more agency in purchasing and providing vaccines for their citizens at higher prices. Developing countries, on the other hand, usually lack the money to pay for vaccines and are consequently reliant on free or subsidized vaccines. Profit-driven companies such as Merck are thus incentivized to sell their limited supply of vaccines to countries that can afford to pay more.

GAVI and UNICEF (United Nations Children’s Fund) are organizations that work to address disparities in vaccine access between industrialized and developing countries by buying and delivering vaccines to poor countries around the world4,5. However, they still rely on pharmaceutical companies to produce the vaccines that they distribute. When Merck notified GAVI and UNICEF that it would stop supplying discounted RotaTeq doses to the four West African nations, their only recourse to address the unexpected vaccine supply shortage was to help the affected countries switch to anot­­her rotavirus vaccine produced by a different company2.

This potentially problematic situation was avoided by a multilateral collaboration between aid organizations, governments, and manufacturers. Specifically, other pharmaceutical companies like GlaxoSmithKline (GSK), Serum Institute of India, and Bharat Biotech stepped in to fill the dearth left by Merck by pledging to supply their rotavirus vaccines (Rotarix, Rotavac, and Rotasiil) to the four West African countries. These countries are expected to switch to these alternative vaccines (which are actually cheaper than Merck’s) in 2020 after their supplies of RotaTeq run out6.

While this story ostensibly has a happy ending, it also highlights inherent problems in the way vaccines are supplied to the world, specifically poorer nations. These nations are reliant on aid organizations like GAVI and UNICEF to provide them with free or discounted vaccines, which are in turn dependent on profit-driven pharmaceutical companies to produce and supply the vaccines. Why can’t these multinational pharmaceutical companies, which have vast resources at their disposal, just produce more vaccines when there is a shortage?

The answer to this question is multifactorial. Firstly, vaccine production is complicated and only multinational pharmaceutical companies have the sufficient expertise, infrastructure, and manpower to produce high-quality vaccines that are safe and effective at scale. Thus, even these companies need advanced warning to produce millions of vaccine doses. Secondly, the prices for vaccines have been increasing in recent years, mostly due to high fixed overhead costs and exclusive licensing practices that preclude competition7. Thirdly, vaccines represent only about 2-3% of big pharma’s trillion-dollar production portfolio and are not the most profitable part of their portfolios8. Thus, pharmaceutical companies have little incentive to pick up the slack. How, then, can the costs of vaccines be reduced and who is supposed to step up to make vaccines when big pharmaceutical companies fall short of their obligations?

One potential solution to reduce the cost of vaccine production is for smaller pharmaceutical companies to produce generic vaccines. Generics are alternative versions of patented drugs and vaccines that are supposed to work just as well as the original formulation. In fact, India has become one of the world’s leading producers of generics and is a major source of vaccines and drugs for Africa. The issue with this solution is that the generics manufacturing industry is fraught with regulatory issues such as poor quality control and lack of oversight9. Africa is most starkly affected by these issues because manufacturers ship their lowest-quality drugs to the continent. Some of these products are completely counterfeit, with no active ingredients, while others have only a fraction of the active ingredients listed10. Without fixing quality control and oversight of generics manufacturing, this is not a viable long-term solution to provide vaccines to poor countries.

Another potential solution to increase vaccine coverage in Africa specifically would be to empower the continent to manufacture its own vaccines. Though Africa is home to nearly 17% of the world’s population, it produces less than 1% of the world’s vaccines and spends millions purchasing vaccines from foreign entities. For instance, African governments imported $900 million worth of basic vaccines for children in 201411. GAVI and UNICEF could partner with pharmaceutical companies to spearhead capacity building in specific African countries so they could produce their own vaccines, instead of making them dependent on vaccines from third parties. Apart from providing vaccines, this strategy would potentially build local biomedical capacity, provide jobs, and incentivize highly educated African expatriates to return to their home countries12.

Unfortunately, global vaccine stakeholders are hesitant to invest in building vaccine production capacity in Africa. For instance, profit-driven pharmaceutical companies tend to invest in healthy markets that will yield stable returns on their investments. Before investing in building a manufacturing facility, these companies must first ensure that the vaccines they produce will be bought for a certain price at a certain time12. Besides, It will be an uphill battle if Africa cannot produce vaccines more cheaply than other countries like India, which has already optimized infrastructure for producing vast quantities of vaccines cheaply13. Overall, there are many economic barriers that prevent Africa from developing its own vaccine manufacturing infrastructure.

In conclusion, the recent story revolving around providing rotavirus vaccine for West African countries exemplifies the complex challenges in supplying vaccines for the world, especially developing countries that contain some of the world’s most vulnerable populations. Despite the relatively vast resources that global organizations and companies like GAVI, Merck, GSK, and UNICEF have at their disposal, the demand for life-saving vaccines continues to outstrip the supply of vaccines. The bottom line is that vaccines are a vital component to the health of people and nations, and access to these medicines ought to be a universal human right.

  1. https://www.who.int/immunization/diseases/rotavirus/en/
  2. https://www.npr.org/sections/goatsandsoda/2018/11/01/655844287
  3. https://www.fiercepharma.com/pharma/amid-china-launch-merck-cites-supply-limits-plan-to-scale-down-rotateq-shipments-africa
  4. https://www.gavi.org/
  5. https://www.unicef.org/
  6. https://www.npr.org/sections/goatsandsoda/2019/05/31/726863111/it-looked-as-though-millions-of-babies-would-miss-out-on-a-lifesaving-vaccine
  7. https://www.who.int/immunization/programmes_systems/procurement/market/en/
  8. https://www.theatlantic.com/business/archive/2015/02/vaccines-are-profitable-so-what/385214/
  9. https://www.statnews.com/2019/07/22/indian-pharmaceutical-industry-drug-quality-charges/
  10. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4105729/
  11. https://www.dw.com/en/africa-wants-to-manufacture-its-own-vaccines/a-46151389
  12. https://www.frontiersin.org/articles/10.3389/fpubh.2019.00056/full
  13. https://www.thehindu.com/sci-tech/health/trusting-the-science/article25861183.ece

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Written by sciencepolicyforall

August 7, 2019 at 2:45 pm

Science Policy Around the Web – April 26, 2019

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By: Mary Weston, Ph.D.

Source: Pixabay

World’s first malaria vaccine to go to 360,000 African children

On Tuesday, the World Health Organization (WHO) announced the launch of a large-scale pilot of the first malaria vaccine ever developed. 360,000 children under 2 years old will be vaccinated per year across three African countries (Malawi started vaccinating this week and Ghana and Kenya will began in the next couple weeks). The combined effort could immunize up to one million children by 2023. Children under five years old are at the most risk for life-threatening complications from malaria and more than 250,000 children in Africa die from the disease every year. 

The vaccine was developed by GlaxoSmithKline (GSK) and the PATH Malaria Vaccine Initiative (MVI) with support from the Gates Foundation. Data from clinical trials indicates it only provides partial protection, preventing around 40% of malaria cases. Thus, the vaccine is meant to complement existing solutions to preventing malaria ( e.g.bed nets, insecticide, and rapid diagnosis and treatment of the disease).  

Malaria is a parasitic infection that is transmitted via a bite from the female Anopheles mosquito. While the disease is preventable and treatable, an estimated 435,000 people die from it each year. The newly developed vaccine protects against P. falciparum, the most prevalent malaria strain found in sub-Saharan Africa.

The vaccine, known as RTS,S or Mosquirix, has taken decades to develop. It is given in four doses: 3 doses provided between the first five and nine months of age and the last delivered around the 2ndbirthday. While this is a big step, some malaria researchers are questioning the implementation of this vaccine when other, more effective vaccines are currently in clinical trials. However, even 40% efficacy will be very helpful in combating this devastating disease.

(Katie Hunt, CNN)

Drug Distributor And Former Execs Face First Criminal Charges In Opioid Crisis

For the first time, federal criminal charges were brought against a pharmaceutical distributer for its role in perpetuating the US’s deadly opioid crisis. Rochester Drug Co-Operative (RDC), the 6th largest distributor in the US, was charged with conspiring to distribute controlled narcotics (fentanyl and oxycodone), defrauding the United States government, and willingly failing to file suspicious order reports. Separate individual charges were also brought against two of their former executives.

Distributors connect drug makers to pharmacies and they are charged with monitoring drug distribution to ensure there is no abuse. However, this monitoring seems ineffectual at best. In one extreme example, an investigation by the Charleston Gazette Mail reported that a single pharmacy in the small town of Kermit, West Virginia (population 392) received 9 million hydrocodone pills over a two year period from out of state drug companies. 

In the RDC case, the US attorney in Manhattan, Geoffrey S. Berman, argues that greed has been the primary motivator for this abuse. Prosecutors said that RDC’s executives ignored warning signs and distributed tens of millions of fentanyl products and oxycodone pills to pharmacies they knew were distributing drugs illegally, resulting in massive profits. RDC has effectively admitted to violating federal narcotics laws and has agreed to pay a $20 million fine and will be supervised by an independent monitor over the next five years.

More than 700,000 people have died from drug overdoses over the last 20 years, the majority of which have been attributed to opioids, and some estimates predict hundreds of thousands more could die in the next decade due to opioid overdoses alone. 

Addiction treatment is underfunded in the US and the White House Council of Economic Advisers estimated that the crisis cost $500 billion in economic losses in 2015 alone. Hundreds of lawsuits across the country have been filed against opioid makers, producers, and distributors in hopes of holding them accountable, preventing misbehavior in the future, and receiving money to offset the costs of the crisis on the public. 

(Richard Gonzales, NPR)


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Written by sciencepolicyforall

April 26, 2019 at 9:30 am

Science Policy Around the Web – April 9, 2019

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By: Mohor Sengupta Ph.D.

Image by Sasin Tipchai from Pixabay

Culture of Secrecy Shields Hospitals With Outbreaks of Drug-Resistant Infections

Large hospital settings are thriving spots for drug-resistant infectious organisms. Two recent cases are glaring examples of the problem. A recent report detailed a mysterious and newly discovered germ that was detected in a Brooklyn hospital last year. Doctors identified the culprit to be a fungus, Candida auris, that infects people with compromised immune system. Sooner than a blink in medical timeline, the fungus spread to Venezuela, Spain, South Africa, India and Pakistan. 

The man with the original infection at the Brooklyn hospital died, but the strain ofCandida auris lived on. It was detected in everything he had used and on all items in his hospital room. Recently the fungus showed up in Illinois and New Jersey. 

In January this year, CDC sent out an alert about another disease involving a type of the bacteriumPseudomonasaeruginosa, which is resistant to every known antibiotic. It was discovered at a Tijuana hospital. Multiple patients who had received weight-loss surgery, an invasive procedure, became infected. Several Americans that had traveled to Mexico to get this surgery contracted the indomitable P.aeruginosa infection.

Although the CDC regularly alerts Americans about lapses in medical care elsewhere, it often keeps incidents relating to deadly infections in American hospitals under wraps from public knowledge. 

For example, Klebsiella pneumoniae carbapenemase (KPC)-producing isolates are bacteria of the family Enterobacteriaceae that are resistant to the chemical carbapenem. This strain was first isolated in 2016 from clinical cultures in a small community hospital in rural Kentucky. However, it was not until 2018 that CDC reported the discovery, and the name of the Kentucky hospital has still not been released.

The CDC has claimed in the past that confidentiality is necessary to encourage hospitals to disclose infectious outbreaks to the CDC. Health officials agree that alerting the public about contained infections affecting only a small subgroup of people will create unnecessary panic in the larger population that might not be suitable hosts for the infection in the first place.  

However, that argument fails to contest instances where people died because hospitals did not come clean about an ongoing superbug infection. 11 people died from a contaminated medical scopein Virginia Mason Medical Center in Seattle between 2012 and 2014. 

Measures to pass Federaland state legislaturesin favor of promoting public knowledge about hospital infections have stalled on more than one occasion. 

It is important that drug-resistant infections in the hospital setting are made known to the public. It should be left to their discretion whether they should sign up for the hospital’s services. This knowledge is a fundamental right of the people and denying this knowledge to avoid fear, confusion and panic must be reconsidered.  

(By Andrew Jacobs and Matt Richtel, New York Times)


‘Monkey, Rat and Pig DNA’: How Misinformation Is Driving the Measles Outbreak Among Ultra-Orthodox Jews

“It is our belief that there is no greater threat to public health than vaccines,” says a page tucked inside the “The Vaccine Safety Handbook”, a parenting magazine. 

Over the fall months last year, men visiting New York from the middle east and Europebrought back measles with them, which efficiently spread into communities of orthodox Jewish people, mostly in un-vaccinated children. 

Rockland county is an example of an area of recent intense measles outbreak. Only 72.9 percent of people in the county between the ages of 1 and 18 are vaccinated. This number is far lower than the vaccinated percentage in general population. 

“The Vaccine Safety Handbook” gives spurious information to readers about vaccine manufacture process. “Vaccines contain monkey, rat and pig DNA as well as cow-serum blood, all of which are forbidden for consumption according to kosher dietary law,” Moishe Kahan, a contributing editor for Peach magazine, said in an email.

Resistance from ultra-orthodox communities have led to massive spread of measles in these neighborhoods, prompting Mayor Bill de Blasio to declare the outbreak a public health emergency needing mandatory vaccination, earlier Tuesday. The vaccine is given in two doses in children, at ages 1 and 5. It is 97 percent effective. 

Officials at the CDC said it “continues to be seriously concerned about the accelerating numbers of measles cases being confirmed nationally.” 

The measles virus is an RNA virus of the genus Morbillivirus. It exists as body fluid droplets released into the air from an infected person and can survive for two hours outside a host. 90 percent of unvaccinated people in its proximity will contract the disease.

Health officials have been consistently urging orthodox families to get their children vaccinated, but thanks to magazines such as “The Vaccine Safety Handbook”, their efforts are somewhat thwarted. Added to that, orthodox families tend to have many children, and it becomes difficult to keep a track of everyone’s vaccination schedules. Participation of infected children in social gatherings and attendance in schools have led to the spread of the infection in children and adults. Being an insular community, the measles outbreak has been largely confined to districts inhabited by the community.

 (Tyler Pager, New York Times)


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Written by sciencepolicyforall

April 9, 2019 at 9:15 pm