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Posts Tagged ‘yellow fever

Science Policy Around the Web – March 18, 2017

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By: Joel Adu-Brimpong, BS

By James Tourtellotte, CBP Today [Public domain], via Wikimedia Commons

Public Health Policy

Missing the Brush Strokes while Gazing at the Bigger Picture

Last Wednesday, the House Committee on Education and the Workforce approved a little-advertised bill called HR 1313, or the genetic testing bill, with partisan-line voting (all 22 republicans in favor and all 17 democrats opposed). Overshadowed by the highly publicized, contentious debate over the Affordable Care Act repeal-and-replace efforts, this bill has remained largely undetected by the media as it traverses congress. This genetic testing bill would not only enable employers to require their employees to undergo genetic testing but also allow employers access to the genetic information, according to an article by STAT news. Employees refusing such requests could be at risk for thousands of dollars in penalties.

Current legislation, including the Americans with Disabilities Act (ADA) and the 2008 Genetic Information Nondiscrimination Act (GINA), prohibit such authority by employers, preventing requests by employers for “underwriting purposes”, which include “basing insurance deductibles, rebates, rewards, or other financial incentives on completing a health risk assessment or health screenings.” Additionally, genetic information provided to employers must be de-identified and aggregated to protect individual identities.

The HR 1313 bill would circumvent current legislation by nullifying these protections as long as the genetic test requests are part of “workplace wellness programs.” Employers purport that the ADA and GINA are “not consistent with the well-established and employee protective wellness program regulatory framework under HIPAA.” They argue that the House bill will aid in aligning the ADA and GINA with laws about workplace wellness programs. Conversely, experts including Jennifer Mathis, director of policy and legal advocacy at the Bazelon Center for Mental Health Law, and Nancy Cox, president of the American Society of Human Genetics, have come out against the bill. In an opposition letter to chairwoman Representative Virginia Foxx (R-N.C.), and ranking member, Robert Scott, of the U.S. House Committee on Education and the Workforce, critics of the bill state that “Workplace wellness programs are fully able to encourage healthy behaviors within the current legal framework: they need not collect and retain private genetic and medical information to be effective. Individuals ought not to be subject to steep financial pressures by their health plans or employers to disclose their own or their families’ genetic and medical information.” Nonetheless, with the possibility of such infringement, we remain lost in the bigger debate surrounding Affordable Care Act repeal-and-replace efforts with little regard for subtle components like HR 1313. (Sharon Begley, STAT news)

Infectious Diseases

Here We Go Again? The Re-emergence of Yet Again, Another Arbovirus

The recent resurgence of arboviruses, or ARthropod-BOrne viruses, in the Americas is concerning. While the 1990’s saw the reemergence of Dengue and the West Nile, Chikungunya resurfaced in 2013 and, recently, Zika in 2015. With South and Central America and the Caribbean still reeling from the reemergence of these viruses, another arbovirus appears to be making a comeback. Over the past weeks, a fifth arbovirus has been detected. Per a perspective piece co-authored by Dr. Anthony Fauci, infectious disease expert and director of the National Institute of Allergy and Infectious Diseases, there are on-going outbreaks of yellow fever in Brazil.

As of February 2017, there have been 234 reported cases and 80 confirmed deaths, with many other infections pending investigation. In context, the number of reported cases currently exceeds previously observed rates of infection for this time of the year. Regionally, the reported cases appear localized to rural areas in southeastern Brazil, chiefly Sao Paulo, Espirito Santo and Minas Gerais. According to the article, current cases appear to be “sylvatic” or jungle cases, with transmission occurring primarily between forest mosquitoes and non-human primates. Thus far, there is no evidence to suggest human-to-human transmission via the infamous Aedes aeqypti mosquito. Humans currently serve as “incidental hosts.” However, the propinquity of the affected areas to major urban centers in Brazil, where routine coverage of yellow fever vaccination is low, is alarming.

Experts posit that the likelihood of spread to the continental United States is low. However, they caution, “In an era of frequent international travel, any marked increase in domestic cases in Brazil raises the possibility of travel-related cases [anywhere].” A particularly poignant example in the article is the December 2015 large urban yellow fever outbreak in Angola and subsequent spread to the Congo. This led to an exhaustion of the world’s emergency supply of vaccines for epidemic response, “prompting health authorities to immunize inhabitants in some areas using one fifth of the standard does in order to extend vaccine supply.” Amidst these critical times of global health crises, threatened cuts to U.S. global health support will likely be catastrophic for developing nations. (Madison Park, CNN)

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Written by sciencepolicyforall

March 18, 2017 at 9:31 pm

Science Policy Around the Web – April 12, 2016

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By: Amy Kullas, Ph.D.

A representation of the surface of the Zika virus is shown. A team led by Purdue University researchers is the first to determine the structure of the Zika virus, which reveals insights critical to the development of effective antiviral treatments and vaccines. (Purdue University image/courtesy of Kuhn and Rossmann research groups)

Funding the ongoing Zika pandemic

Shifting funds for Zika is a good start, but more money is still needed

Last week, the White House made the decision to redirect $589 million in unspent federal funds, previously allocated for an Ebola response, to cover costs associated with fighting and researching Zika. The White House is still advocating for additional funding for both the ongoing Zika pandemic and to replenish the money that was moved away from Ebola. Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases (NIAID) at the National Institutes of Health (NIH), informed ScienceInsider that ~$50 million of the reallocated funds will go to NIAID to fund Zika research. None of the redirected funds will come out of the money that NIAID had previously received for research on Ebola, as the vast majority of those funds have already been spent. Further, Fauci warns “That’s not enough to last me very long. We can start the work, but we can’t finish what we need to do.”

Dr. Anne Schuchat, principal deputy director of the Centers for Disease Control and Prevention revealed in a press conference on April 12, “Everything we know about this virus seems to be scarier than we initially thought.”

In February, the Obama administration had requested almost $2 billion to help thwart the Zika virus and its transmission. Unfortunately, the Republican-controlled Congress failed to act on this emergency funding request. White house officials are nevertheless still trying to persuade Congress to pass the emergency Zika funding. Fauci bleakly predicts, “If we don’t get all of the Zika money, that is when things start getting hurt,” alluding to the possibility of having to further shift critical NIAID funds away from ongoing malaria, influenza, and tuberculosis research. (Puneet Kollipara, ScienceInsider)

Mental Health

Solutions to mental health impairments require global collaboration

Globally, almost 1/3 of people will suffer from a mood, anxiety, or substance-use issue during their lifetime. In fact, these disorders are one of the leading causes of disability. The resources to assist people facing these problems are not only inadequate in the United States, but around the world as well. There are some countries in Africa, where people are extremely underserved leaving them particularly vulnerable because these countries have the fewest resources for mental-health care as they only one psychiatrist for the entire country. In fact, there are only 9 mental health providers per 100,000 people worldwide.

Importantly, support for mental health does not lack political backing. Both the World Health Organization and the World Bank will coorperate to broaden global efforts in mental health. This past September, mental health was included in the United Nations’ Sustainable Development Goals. Since 2011, new investments (estimated at ~$80 million US) have been made by the three largest funders of mental-health research in low- and middle-income countries: the US National Institute of Mental Health, Grand Challenges Canada, and the UK Department for International Development. Recently, research has focused on efficacy, effectiveness and implementation in the low- and middle-income countries. These local research teams often work or consult with colleagues in rich countries. Researchers, clinicians, and caregivers must unite to all work together because “when it comes to mental health, all countries are developing.” (Pamela Y. Collins & Shekhar Saxena, Nature Comment)

Vaccine shortage and Global Health

Dangerous shortage of yellow fever vaccine

Four. There are only four facilities worldwide that produce yellow fever vaccines: the Pasteur Institute, two government facilities in Russia and Brazil, and a French vaccine company Sanofi Pasteur. Unfortunately, their combined efforts have been failing the world’s demands and the ongoing outbreak in Angola only further emphasizes the escalating shortage. Jack Woodall, formerly of the Centers of Disease Control and Prevention and the World Health Organization, warns “another major outbreak…could be impossible to control.” He admits that this potential is something that he’s deeply concerned about.

Yellow fever is an acute viral hemorrhagic disease transmitted by infected mosquitoes. The ‘yellow’ in the name refers to the jaundice that affects some patients. Without treatment, up to half of severely affected people will die. Annually, there are an estimated 60,000-80,000 deaths attributed to yellow fever globally. There is no specific treatment for yellow fever, leaving vaccination the most important preventative measure.

When a yellow fever outbreak occurs in an urban setting, like the one in Angola, it is often relentless as the mosquitoes can easily transmit the virus person to person. William Perea, of the World Health Organization’s (WHO’s) Control of Epidemic Diseases department, stated that Angola has confirmed 490 cases and almost 200 deaths, the actual numbers could be 10 fold higher. Since February, a large vaccine initiative has been underway, reaching 6 million of Luanda’s estimated 7.5 million residents. Currently, yellow fever has stretched into 6 of the 18 provinces in the country. The global emergency yellow fever vaccine stockpile has been left empty, unlikely to be replenished anytime soon. (Kai Kupferschmidt, ScienceInsider)

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Written by sciencepolicyforall

April 12, 2016 at 12:00 pm