Wednesday, September 7, 2016

The next great pandemic: What will it look like and where will it come from?

This was originally published on Global Health TV on August 23, 2016.
A few years ago, in a survey by epidemiologist Larry Brilliant, 90 percent of epidemiologists said that a pandemic that will sicken 1 billion, kill up to 165 million and trigger a global recession that could cost up to $3 billion would come in the next two generations. Currently, we’re living through three pandemics  HIV, Zika and cholera. What will the next pandemic look like and where will it come from?
Those are some of the questions science journalist Sonia Shah attempted to answer in an event marking the centennial of the Johns Hopkins University’s Bloomberg School of Public Health and in her book “Pandemic: Tracking Contagions from Cholera to Ebola and Beyond,” published earlier this year. The book should be required reading for anyone interested in the future of global health.
Shah spent six years trying to figure out how microbes turn into pandemic-causing pathogens. She looked at the history of pandemics, particularly cholera because it’s one of our most efficient pandemic-causing pathogens. She went to places where new pathogens are emerging to try to figure out what are the political and social drivers that push these microbes into human populations.

Tuesday, September 6, 2016

UN needs to look beyond patents for improving access to medicines

This was originally published on Devex on August 4, 2016.
The lack of access to medicine has become a regular feature of the health landscape in many developing countries. In the West African country where I’ve been spending time lately, stockouts of essential medicines happen regularly, not only in the public sector (where you might expect it) but also in projects well-funded by donors (where you might not).
The World Health Organization estimates that availability of selected generic medicines was only 38 percent and 46 percent in the public sector in low- and middle-income countries, respectively, and a full three-quarters of the world’s population (around 5.5 billion) have no access to proper pain relief.
Earlier this year, U.N. Secretary-General Ban Ki-moon appointed a High-Level Panel on Access to Medicines to assess this problem and come up with some solutions. Specifically, the purpose of the panel was “to review and assess proposals and recommended solutions for remedying the policy incoherence between the justifiable rights of inventors, international human rights law, trade rules and public health in the context of health technologies.”
But leaks from the panel’s highly secretive proceedings suggest that the secretary-general told the panel to focus on intellectual property and patents to the exclusion of other issues that hamper access to medicine — weak health systems, questionable government policies, a lack of health workers and a lack of resources.

Friday, September 2, 2016

Controversy brewing over the greatest barriers to access to medicine

A worker selects medicine from the MEDS (Mission for Essential Drugs and Supplies) warehouse in Nairobi. MEDS is jointly owned by the Kenya Conference of Catholic Bishops and the Christian Health Association of Kenya. Photo: Bedad Mwengi

This was originally published on Global Health TV on July 16, 2016.

In comments last week at the International AIDS Conference in Durban, South Africa, UN Secretary General Ban Ki-moon said four things deserved credit for getting the AIDS pandemic under control — people living with HIV, biomedical companies, generic medicines and international finance.

But despite his gratitude to biomedical companies and generic medicines, the secretary-general is overseeing a process that threatens to undermine those companies' ability to improve access to medicine in developing countries.

The World Health Organization says an estimated 2 billion people (27% of the world’s population of 7.5 billion) lack access to essential medicine, most of them in Africa and Asia, but a full three-quarters of the world’s population (around 5.5 billion) have no access to proper pain relief treatment.

To address this staggering problem, the Secretary-General set up a High-Level Panel on Access to Medicines earlier this year. The purpose of the panel was “to review and assess proposals and recommended solutions for remedying the policy incoherence between the justifiable rights of inventors, international human rights law, trade rules and public health in the context of health technologies.”

Sounds like a great and noble idea, right? But some expert commentators say the panel is on track to do more harm than good because of its terms of reference.

Thursday, September 1, 2016

Kenya starts to shift focus to chronic diseases while not relenting in HIV fight

A patient at a rural health camp in Mwae County, Kenya has his blood pressure checked as part of a full physical exam. If he needs hypertension treatment, he will get it as part of the cost of the camp. Photo: Bedad Mwangi

This was originally published on Global Health TV on June 28, 2016.

For some time, huge disparities between global health spending and the global disease burden have raised concerns that this funding was not being allocated based on the evidence. That is, money was not always going where the disease burden was greatest.

The Institute for Health Metrics and Evaluation (IHME) has pointed out that the disparities are most extreme in HIV/AIDS on the high end and non-communicable diseases (NCDs) on the low end.

As the toll from communicable diseases like AIDS and malaria decline and people live long enough to get NCDs, we need to invest more in fighting NCDs (also called “chronic diseases”) and reduce these glaring disparities between global health spending and disease burden. Countries like Botswana, Eritrea, Kenya Malawi, Mozambique, Rwanda, South Africa, Swaziland, Tanzania, Uganda, Zambia and Zambia — all countries that increased their treatment coverage by more than 25% between 2010 and 2015, according to UNAIDS — now have to pivot to NCDs without taking their eyes off of HIV.

Kenya is an excellent case in point.