“An antibiotic used to treat severe bacterial infections showed promise at treating a highly drug-resistant and deadly form of tuberculosis [TB],” according to a study conducted by U.S. government and South Korean researchers and published in the New England Journal of Medicine on Wednesday, Reuters reports (Steenhuysen, 10/17). The “small study offers a bit of cautious optimism about the prospects for treatment of tuberculosis, … showing that adding a 12-year-old antibiotic called linezolid, brand name Zyvox, to existing treatments cured nearly 90 percent of patients with a form of tuberculosis resistant to both first- and second-line antibiotics,” NPR’s “Shots” blog writes (Knox, 10/18). “However, most of the patients [in the study] — 82 percent — experienced side effects while on the treatment, which tempered the findings, the team reported,” Reuters notes. “Researchers are desperately looking for new treatments for drug-resistant forms of TB, which threatens to derail progress in the global fight to eradicate the disease,” according to the news agency (10/17).
“Drug-resistant malaria is spreading in Asia, experts warned as a high-level conference opened Wednesday with the aim of hammering out an action plan to strengthen the region’s response,” Agence France-Presse reports. “Resistance to the drug used everywhere to cure the life-threatening disease has emerged in Cambodia, Thailand and Myanmar,” Richard Feachem, director of global health at the University of California, San Francisco and former head of the Global Fund to Fight AIDS, Tuberculosis and Malaria, said, according to the news service. “The danger is that at some time this resistance may break out of Southeast Asia and crop up in Africa,” he added, AFP writes. Feachem spoke ahead of the “Malaria 2012: Saving Lives in the Asia-Pacific” conference in Sydney, which “will seek consensus on the actions needed to strengthen the region’s response to malaria,” according to AFP (Coorey, 10/31).
In a BMJ Group Blogs post, Caroline Robinson, global health advocacy manager for Results U.K., discusses the prevalence and treatment of tuberculosis (TB) and drug-resistant TB in Europe and provides the example of Romania. She writes, “[E]vidence brought to light in a new report [.pdf] released recently outlining the effect funding shortages will have on HIV and TB, including drug-resistant TB, in the European region suggests that Romania does not have the institutional capacity to ensure its citizens have the basic right to health. The country relies on grants from the Global Fund to Fight AIDS, Tuberculosis, and Malaria, which look set to end in 2013.” She continues, “[Global Fund] Board members should ensure that middle-income countries with epidemics among key populations can access critical Global Fund contributions and the E.U. and its member states must continue to provide the resources the fund requires to meet demand. Unless such support is given, countries like Romania will continue to fall further down the league tables in terms of treatment for this curable disease” (10/10).
A new pilot project in Cambodia is allowing more than 3,000 volunteer health workers to use a special mobile phone text messaging service to report new cases of malaria, in addition to providing no-cost testing and treatment “in remote parts of the impoverished nation, where access to health services can be difficult,” Agence France-Presse reports. When a person tests positive for malaria, health workers begin them on treatment immediately and send a text message with the patient’s age, gender, type of malaria, and location “to the district health center, provincial health officials and a national malaria database in the capital Phnom Penh — a process that used to take a month,” AFP notes. “The information is also fed into Google Earth to create a map of reported cases and of potential hotspots of [malaria drug] resistance,” a problem in western Cambodia, according to the news service. “Together, the data helps officials track each case and make sure the right treatment is available or that more medication is supplied when stocks are running low,” AFP writes, adding, “Some 230 volunteers have used the mobile phone service so far and there are plans to eventually include all volunteers in the project,” which is being implemented by the Malaria Consortium (Se, 9/17).
Global Health Funding Cuts Threatening Fight Against HIV, TB In Eastern Europe, Central Asia, NGO Report Says
The fight against HIV and tuberculosis (TB) in Eastern Europe and Central Asia is being threatened by cuts in global health funding, according to “a report [.pdf] by leading European non-governmental health organizations,” Reuters reports. In the report, “experts called on the European Union to step in to fill the gaps left by global donors to countries within and neighboring its borders,” the news service notes. According to Reuters, “[c]ountries in Eastern Europe and Central Asia have some of the world’s fastest growing HIV epidemics,” and “Europe is also home to the world’s highest documented rates of drug-resistant TB” (Kelland, 9/18).
Nature examines efforts to combat antibiotic resistance in India, writing, “Antibiotic resistance is a problem worldwide, but is particularly worrying in India, where hospital standards are inconsistent and antibiotics are readily available over the counter at pharmacies.” The magazine highlights “India’s first joint medical-society meeting on antibiotic resistance, held on 24 August in Chennai,” noting, “The symposium is part of an ongoing campaign by Indian clinicians for a national policy to curb misuse of these vital drugs.” It continues, “Last week, physicians moved a step closer to their goal when India’s drug regulators announced a plan that would put tight restrictions on the sale of antibiotics.”
After testing about 5,600 existing medications for their effectiveness against drug-resistant strains of tuberculosis (TB), researchers from Weill Cornell Medical College reported this week in the Proceedings of the National Academy of Sciences that oxyphenbutazone, “an anti-inflammatory medication marketed in the 1950s as Tandearil and still used in veterinary medicine,” killed both latent and active TB bacteria in test-tube experiments, the Los Angeles Times’ “Booster Shots” blog reports. The medication is inexpensive, estimated to cost two cents per day in developing countries, according to the researchers, but it needs to go through “a series of clinical trials in which researchers would flesh out, in a human population, the medication’s safety and effectiveness record at various doses, in different patient populations and at different stages of the disease,” the blog writes.
The Washington Post examines how the “discovery of an almost untreatable form of tuberculosis [TB] in India has set off alarm bells around the world and helped spur a dramatic expansion of government efforts to battle the killer lung disease.” The newspaper writes, “For the past decade, a nationwide tuberculosis program involving millions of health workers and volunteers has made slow but significant progress in battling the disease in India and has been hailed as a public health success story,” but “any sense of complacency was dispelled in December when a doctor in Mumbai, Zarir Udwadia, discovered a strain of the disease that did not respond to any of the 12 frontline drugs.”
In a 200th anniversary article for the New England Journal of Medicine, Salmaan Keshavjee of the Department of Global Health and Social Medicine at Harvard Medical School and Paul Farmer of Partners in Health “seek to elucidate the reasons for the anemic response to drug-resistant tuberculosis [TB] by examining the recent history of tuberculosis policy,” they write. The authors outline the history of TB drug development and how the disease became resistant to myriad drugs, and write that by the 1970s, “[t]uberculosis, whether caused by drug-susceptible or drug-resistant strains, rarely made even medical headlines, in part because its importance as a cause of death continued to decline in areas in which headlines are written. They continue, “In the United States, federal funding for tuberculosis research was cut; consequently, drug discovery, development of diagnostics, and vaccine research ground almost to a halt.”
“The World Health Organization said Thursday that governments in the Mekong region must act ‘urgently’ to stop the spread of drug-resistant malaria which has emerged in parts of Vietnam and Myanmar,” Agence France-Presse reports. “There is growing evidence that the malaria parasite is becoming resistant to a frontline treatment, the anti-malarial drug artemisinin, in southern and central Vietnam and in southeastern Myanmar, the WHO said in a statement,” AFP writes, noting, “WHO regional director, Shin Young-soo, said countries must ‘urgently address this issue before we put at risk not only the fragile gains we have made in malaria control but also our goal of a malaria-free Western Pacific Region.'” The news service adds, “Countries in the Mekong region must “intensify and expand” operations to contain and eliminate artemisinin-resistant malaria, Shin said at a WHO regional meeting in Hanoi” (9/28).