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Showing posts with label sickness. Show all posts
Showing posts with label sickness. Show all posts

Wednesday, April 11, 2012

BIRDS’ FLU RETHOUGHT WITH SCIENTIFIC OPENNESS

BIRDS’ FLU RETHOUGHT WITH SCIENTIFIC OPENNESS

Erle Frayne D. Argonza

Birds flu struck the world as a pandemic just a few years back, creating fright night panic in some key cities over incoming overseas visitors that are afflicted with the ailment. Indonesia is among those countries hit hard in terms of transmission of the birds flu, and so the Indonesian case could be examined to rethink the health problem at hand.

What makes the birds flu hazard truly alarming is that over 80% of those afflicted die of the disease. It now seems that, on hindsight, the lack of scientific openness had inflated the destructive reach and impact of the bird flu pandemic.

There is over-consciousness about intellectual property piracy of course, which accounts for the behavior of self-constraint among research scientists. How far can that wall of secrecy be loosened up to effect a cross-border clamp down of the bird flu virus?

Below is an interesting reportage about the subject.

[Philippines, 03 April 2012]

Source: http://www.scidev.net/en/health/bird-flu/editorials/tackling-bird-flu-effectively-needs-scientific-openness-1.html

Tackling bird flu effectively needs scientific openness

David Dickson

2 March 2012

Efforts to limit publication of controversial bird flu research could end up doing more harm than good.

Last week, a 12-year-old boy in Indonesia died after becoming infected with the H5N1 bird flu virus. His death brought the global death toll to 347 since the disease was first reported among humans in 2005.

At first sight the figure does not look too alarming compared to the many millions that die from other infectious diseases. And although the virus is usually fatal — up to 80 per cent of those infected die from it — the overall incidence of human infection remains relatively low.

This is because most people only get infected through contact with infected poultry. But what if the virus could spread between humans?

This spectre has now been raised by two teams of scientists, working at a medical centre in the Netherlands and the University of Wisconsin in the United States, respectively. Each team genetically altered the virus into a form that can pass between ferrets through the air — implying that a similar strain could evolve (or be created) that could spread between humans.

The consequences could be so disastrous that last year, a US body set up in 2005 to look at the potential biosecurity risks of laboratory-created organisms recommended that papers on the work submitted to the world's two leading scientific journals, Science and Nature, should not be published in full.

The argument of the National Science Advisory Board for Biosecurity (NSABB) was that the information could be used by terrorist groups or individuals to produce a powerful biological weapon that could spark a deadly epidemic if released into the human population.

Risks of restriction

There is a strong logic to this argument. Withholding the technical details of the steps required to produce a deadly virus would certainly make it considerably more difficult for anyone to copy the process.

And some have advocated going even further to curtail access to such information with calls for a ban on all research that could lead to new, potentially lethal viruses. Their argument is that the threat such viruses would pose if they escaped from the laboratory is so great that nothing justifies the risk of even carrying out research for them.

But both arguments have flaws. Those seeking publication of the information in heavily edited form risk denying scientists access to data that could play an essential role in preparing defences against the virus, such as developing vaccines.

A complete ban on the research could have similar repercussions. Scientific understanding of the bird flu virus, how it spreads and how it mutates, is essential to minimise the chances of another flu pandemic. The flu virus that swept across the world in 1918 killed up to 20 per cent of those infected, causing an estimated 50 million deaths.

An alternative strategy

The scientific community has had intense discussions over what to do with the papers over the past few months.

Initially the NSABB suggested a solution could lie in publishing redacted (edited) versions of the papers with some of the key scientific and technical data omitted.

Both journals to which the research was submitted have been exploring how they might do this while making full versions of the papers available to scientists who have been vetted to ensure they would use the data responsibly.

But on close examination, this option has presented difficulties. For example, much of the technical data in one of the papers has already been presented at a scientific conference so attempts to prevent its further dissemination may be ineffective.

Another significant objection raised at a meeting organised by the WHO in Geneva two weeks ago (16 February) was the difficulty of reaching an international consensus on the criteria for vetting scientists who request the full data.

Concerns in perspective

Following the WHO meeting Nature said in an editorial that the benefits of open publication outweighed the risks identified so far, and that in principle "the papers should ultimately be published in full". [1]

Similarly the editor of Science said in a recent interview with the BBC that "our default position is that we have to publish in complete form". [2]

A final decision is awaiting further discussion at the WHO. But this position is brave, and correct.

There are substantial public health benefits in as many scientists as possible having access to the data if they are to understand potential changes to the virus.

These outweigh the advantages — likely to be short-lived — of restricting access to prevent the data from falling into the wrong hands. And at present, the biosecurity concerns are "too general and hypothetical", says Nature.

Furthermore, the political sensitivities of deciding who the 'wrong hands' are, and who should make this decision, risk heightening the international tensions that already exist over attempts to limit the proliferation of weapons of mass destruction, most recently over Iran's nuclear programme.

But two things are essential if the data are to be made more widely available. First, open publication must be accompanied by an effective monitoring system. This would look out for potential misuse of the data.

Second, the issue needs as wide a public debate as possible, actively promoted by both health officials and journalists to ensure it is adequately informed.

Developing countries such as Indonesia, which has the highest bird flu transmission rates and the most fatalities, have a particular interest in the outcome of this debate. They have more to gain from new techniques to prevent virus transmission, such as effective vaccines, than from restrictions on the publication of these data.

Concerns about biosecurity must be kept in perspective. They are certainly important, but should not cloud our judgement on the urgency of developing adequate protection against an evolved form of the virus, whether natural or man-made.

David Dickson
Editor, SciDev.Net

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Friday, September 23, 2011

INSECTICIDE RESISTANCE RESURGES MALARIA, GO BIOTECH!

INSECTICIDE RESISTANCE RESURGES MALARIA, GO BIOTECH!

Erle Frayne D. Argonza

The use of good old chemistry to annihilate malarial and related mosquitoes seems to be running its course down by the day. Reason: after decades of insecticide-based health campaigns, malaria keeps on re-surging back with a vengeance.

Let me add the case of dengue, where the aedes aegpyti mosquito kept on resurging back year after year amid the fogging by insecticide. Akin to the use of insecticide-immersed bednets in Africa, bednets are now being widely disseminated purportedly to stem the attacks of the aedes mosquito. But to no avail! Dengue is back, and it had killed hundreds of patients as of this writing, with tens of thousands of patients recorded.

I am of the opinion that biotech holds the greater salvation value for eradicating malaria, dengue and related mosquitoes that serve as vessels to disease-inducing parasites. Malaysia has already shown the way to breeding genetically modified mosquitoes that can catalyze the sterilization and death of breeder mosquitoes in the field, so it’s really just a matter of emulating the biotech way of Malaysia across nations.

Below is an update report about the insecticide resistance in Africa.

[Philippines, 23 September 2011]

Source: http://www.scidev.net/en/health/malaria/news/insecticide-resistance-linked-to-malaria-resurgence.html

Insecticide resistance linked to malaria resurgence

Emeka Johnkingsley

24 August 2011

[ABUJA] Scientists have linked growing insecticide resistance with a resurgence of malaria in Senegal.

Researchers working in the village of Dielmo warned that new approaches may be needed to fight the malaria scourge on the continent.

They found that in the two years (August 2008–2010) following the distribution of bednets treated with deltamethrin, a long-lasting insecticide recommended by the WHO, malaria cases significantly decreased.

But, in the following four months, cases increased to higher levels than those before the bednets were introduced. This increase in morbidity was therefore likely to be due to increased resistance by malaria-carrying mosquitoes to pyrethroid insecticides, said the authors, whose findings were published online in The Lancet Infectious Diseases last week (18 August).

Thirty-seven per cent of Anopheles gambiae mosquitoes were resistant to deltamethrin in 2010, and the proportion of mosquitoes with the kdr mutation that confers resistance to pyrethroids insecticides in general increased from 8 per cent in 2007 to 48 per cent in 2010.

The authors said that the scale-up of bednet distribution programmes and indoor spraying campaigns has "led to a very rapid spread of pyrethroid resistance in the major malaria vectors".

The study found that malaria resurged, in particular, in older children and adults, who are increasingly susceptible to the disease.

This susceptibility cannot be explained by increasing pyrethroid resistance, the authors said. They suggest that "either a recent increase in exposure to malaria vectors in older age groups or a decrease in protective immunity" could be responsible.

Pierre Druilhe, an author of the research and a researcher at the Malaria Vaccine Development Laboratory at the Pasteur Institute in France, said that the resurgence in malaria morbidity had been foreseen for a long time and goes beyond the problem of insecticide resistance.

He said that in areas that have a high incidence of the disease, exposure to malaria-carrying mosquitoes induces a strong immune response that protects individuals. While insecticide bednets do cut the number of bites from vectors, this in turn reduces acquired immunity — leading to a new equilibrium where the chance of an infectious bite causing malaria increases.

In an accompanying commentary, Joseph Keating and Thomas Eisele warned of the danger of generalising the research to the rest of the continent, particularly because of the short period of the study.

But Druilhe said: "This type of situation [pyrethroid resistance] can happen in all high transmission areas, which corresponds to the vast majority of malaria endemic areas in Africa".

Link to full paper in The Lancet Infectious Diseases

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Saturday, September 10, 2011

NO FIXED PATH TO HIV PREVENTION

NO FIXED PATH TO HIV PREVENTION

Erle Frayne D. Argonza

Could there be a single, most acceptable path to HIV prevention? This is the guide question posed upon those biomedical specialists and experts who are into HIV research & development as well as to the practitioners.

Long before the biomedical disciplines found the pharmacologic panacea to HIV, alternative health practitioners in Asia already found the cure to ailment which they tried on many patients in the 70s and 80s. Whether the biomedical fields will come to accept these non-conventional solution remains to be seen.

One thing is clear though at this juncture: that biomedical experts are now of the consensus that there is not a single megalithic path to HIV prevention. This is a welcome departure from the extremely positivist premise of biomedical paradigm which sought to reduce disease treatment to a single active ingredient from drug-based medication.

Below is an update report on relevant developments from the International AIDS Society or IAS.

[Philippines, 09 September 2011]

Source: http://www.scidev.net/en/opinions/biomed-analysis-no-single-path-to-hiv-prevention-1.html

Biomed Analysis: No single path to HIV prevention

Priya Shetty

22 July 2011

Excitement about new drug treatment for HIV prevention does not mean we should lose sight of other methods, cautions Priya Shetty.

Scientists trying to prevent people from becoming infected with HIV are on a roll. After a huge leap forward last year in AIDS vaccine research, when powerful sequencing uncovered potent anti-HIV antibodies, new research shows convincingly that treatment with antiretroviral drugs can also be used to prevent infection.

The latest results on the effectiveness of drugs for pre-exposure prophylaxis (PrEP), presented at the International AIDS Society conference (IAS 2011) in Rome this week, were released just a couple of weeks before. The finding that PrEP could reduce new HIV infections by up to 73 per cent was so compelling that the trial was halted early.

With such excitement over a preventive approach that we have available right here, right now, suddenly a vaccine might not seem like the holy grail of HIV prevention after all.

But the early days of HIV vaccine research are a cautionary tale. The assumption that a vaccine was just around the corner seemed to lead, initially, to complacency that might explain why it is only relatively recently that other approaches to prevention have been high on the agenda.

And at IAS 2011, there was a broad consensus that pursuing one approach does not render the others redundant — and indeed that it would be impossible to tackle a disease such as HIV/AIDS without several approaches.

Vaccine research gets a boost…

For years, HIV prevention has relied on non-biomedical, behavioural interventions such as condom use and safe-sex counselling. Since behaviour is difficult to change, such tactics are notoriously difficult to implement. Yet, for several years, they were the only weapons in the fight to prevent the spread of HIV.

Once scientists knew that HIV was the cause of AIDS, they were confident that a vaccine would soon be developed for the virus. But they had not bargained for its complexity — and AIDS vaccine research has been problematic from the beginning.

Most disease-causing viruses come in a few different strains; HIV has hundreds of them. Not only that, the virus is capable of changing its surface proteins to evade antibodies. Devising a vaccine against HIV is a huge challenge.

Speaking at IAS 2011, Gary Nabel, head of the US National Institutes of Health's Vaccine Research Center, which was set up in 1999 to find an HIV vaccine, described most of the time spent hunting for it as "the dark ages".

But last year, everything changed, said Nabel. The discovery of antibodies that worked against 90 per cent of HIV strains (compared with 40 per cent for previously found antibodies) has made the prospect of an HIV vaccine real again.

…but existing tools show promise

Even before the resurgence in vaccine research, male circumcision and microbiocide (disinfecting) gels had shown great promise in preventing infection. The WHO now says "there is compelling evidence that male circumcision reduces the risk of heterosexually acquired HIV infection in men by approximately 60 per cent".

Early clinical trials had hinted at the promise of treatment for prevention. And in the past few months, studies have shown that combination antiretroviral treatment (tenofovir/emtricitabine) reduced the risk of HIV-negative people becoming infected by 44 per cent in men who have sex with men, and by up to 73 per cent in heterosexual couples.

A key randomised clinical trial that was also presented at IAS 2011, called HPTN 052, showed conclusively for the first time that putting infected people on antiretroviral therapy early can reduce their chance of passing on the infection by 96 per cent.

Many paths to prevention

As thrilled as HIV researchers have been with the results of preventive drug trials, the implementation of treatment programmes will be far from simple. Developing countries have too few healthcare workers, and rolling out antiretroviral treatment can be logistically difficult — so adding treatment for prevention will add to already heavy burdens.

Deciding which groups are eligible for drug treatment, which means putting otherwise healthy people on powerful drugs, also raises ethical questions that are not easily solved.

Given these complexities, it would be short sighted not to pursue aggressively a vaccine that would confer lifetime immunity in one shot. Nor should the public health community abandon non-biomedical strategies such as condom use and reducing risky behaviour.

Safe sex is not just about HIV, after all — prevalence rates of other sexually transmitted diseases are on the rise in many developing countries, and rates of unwanted pregnancy remain high.

The take-home message from IAS 2011 is crystal clear. After years of struggle, we can now contemplate moving towards ending the epidemic. But we should not threaten the chances of success by playing off one approach against another.

Journalist Priya Shetty specialises in developing world issues including health, climate change and human rights. She writes a blog, Science Safari, on these issues. She has worked as an editor at New Scientist, The Lancet and SciDev.Net.

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