The WHO and FDA approve drugs to treat malaria, tuberculosis and other diseases in low- and middle-income countries, but “some of the manufacturers, predominantly Chinese and Indian firms, may be knowingly producing” poor quality medicines, according to “the conclusion of my research teams’ studies, published this week in the journal Research and Reports in Tropical Medicine,” Roger Bate, resident scholar with the American Enterprise Institute and lead author of the studies, writes in a Washington Post opinion piece. “With little or no oversight, these companies may be cutting corners in the manufacturing process — or worse, watering down the active ingredient in their drugs, perhaps when the price of the raw material spikes and supply becomes harder to obtain,” he states, adding, “By exposing people to insufficient doses of the active ingredient, the drugs may also accelerate drug resistance and cause tremendous harm to whole populations in the long run.”
“[A] surge in money for [insecticide-treated] nets and other interventions” to fight malaria over the past decade has reduced the malaria-related death rate by 26 percent since 2000, and a “new push” to fight the disease, which killed 655,000 people in 2010, would have beneficial results, according to a report set to be released by Ray Chambers, the U.N. special envoy for malaria, an Economist editorial notes. “But raising the cash will be tricky and getting the promised result harder still,” the editorial states. The African Leaders Malaria Alliance estimates that “[u]niversal deployment of good treatment, diagnostics and preventive measures, including bed nets, would — in theory — prevent 640 million malaria cases and three million deaths by 2015, the paper explains,” and notes “[t]his would cost at least $6.7 billion between 2012 and 2015,” the Economist writes.
GlobalPost’s “Global Pulse” blog interviews Mario Raviglione, the director of the WHO’s Stop TB Department since 2003, “about the progress and frustrations with detection and treatment of tuberculosis [TB].” Among other topics, Raviglione discusses “progress in addressing HIV-TB co-infection,” the emergence of extensively drug-resistant TB (XDR-TB), and research in diagnostics, such as the GeneXpert machine, which gives a “very quick” diagnosis of MDR-TB, according to the blog (Donnelly, 7/12).
The widespread incidence of drug-resistant tuberculosis (TB) “calls for a new approach to TB in the developing world,” a Bloomberg editorial states. A “breakthrough test,” called Xpert MTB/RIF, “makes mass screening [for drug-resistant TB] feasible,” according to the editorial, which notes the test, developed by “California-based Cephied Inc. in collaboration with the non-profit Foundation for Innovative Diagnostics with funding from the Bill & Melinda Gates Foundation,” detects resistance to the TB drug rifampicin, provides results in two hours, and can be used without advanced laboratory facilities.
IRIN examines a global increase in resistance to antibiotics, writing, “Almost one in every five deaths worldwide occurs as a result of infection, but many bacterial illnesses will become incurable as the efficacy of current antibiotic drugs wanes, according to the World Health Organization (WHO).” The news service continues, “With increasing resistance to antibiotics, the need to find replacements is becoming more urgent.”
The Institute of Medicine (IOM) on Friday released a summary of a joint workshop by the Institute of Medicine, the Indian National Science Academy, and the Indian Council of Medical Research, titled, “Facing the Reality of Drug-Resistant Tuberculosis: Challenges and Potential Solutions in India.” According to the report’s webpage, “The aim of the workshop was to highlight key challenges to controlling the spread of drug-resistant strains of [tuberculosis (TB)] in India and to discuss strategies for advancing and integrating local and international efforts to prevent and treat drug-resistant TB” (4/27).
A strain of malaria that is resistant to artemether, the main ingredient in Coartem, a widely used drug to treat the disease, may be spreading in Africa, according to a study published Thursday in Malaria Journal, Bloomberg Businessweek reports. “Studies in Cambodia and Thailand have shown that drugs based on artemisinin, the class of remedies to which artemether belongs, are becoming less effective there,” the news service writes, adding that study author Sanjeev Krishna of the University of London said, “Drug resistance could eventually become a devastating problem in Africa, and not just in southeast Asia where most of the world is watching for resistance.” According to the authors, “[t]he effectiveness of other artemisinin-based drugs, such as artesunate, wasn’t significantly affected by the mutations,” the news service states (Bennett, 4/26).
“The World Health Organization heralded major gains Tuesday in the fight against malaria, one of the developing world’s biggest killers, but warned universal access to treatment remains elusive,” Agence France-Presse reports, noting, “The assessment came on the eve of World Malaria Day,” observed Wednesday and “designed to shine the light on the mosquito-borne parasite that killed 655,000 people in 2010, including 560,000 children under five” (4/24). “A massive acceleration in the global distribution of mosquito nets, the expansion of programs to spray the insides of buildings with insecticides, and an increase in access to prompt antimalarial treatment has brought down malaria mortality rates by more than a quarter worldwide, and by one-third in Africa since 2000,” but “simply maintaining current rates of progress will not be enough to meet global targets for malaria control,” the agency writes in a news release (4/24).
“In recent weeks, the emergence on the Thai-Myanmar border of malaria strains resistant to artemisinin, a plant-derived drug, have led to pessimistic headlines and reminders of the setback caused by resistance to the drug chloroquine, which began in the 1950s,” columnist and author Matt Ridley writes in the Wall Street Journal’s “Mind & Matter,” noting, “April 25 is World Malaria Day, designed to draw attention to the planet’s biggest infectious killer.” He continues, “For this reason, prevention generally works better than cure in eradicating infectious diseases: Vaccination beat smallpox, clean water beats cholera, less crowded living beats tuberculosis and protection from mosquitoes beats malaria.”
A strain of malaria that is resistant to artemisinin combination therapy (ACT) is spreading along the Thai-Myanmar border and has the potential to spread to Africa if efforts to effectively treat and prevent the disease are not undertaken, according to a study published in the Lancet on Friday, Reuters reports (Lyn, 4/5). Since 2008, patients treated with ACT have been slower to clear the parasite than previously, “[a]nd this precursor to resistance seems to be spreading, despite efforts to carefully use artemisinin (by giving it in combination with other drugs) to avoid the emergence of resistance,” Scientific American writes.