Though the FDA’s Monday approval of the antiretroviral drug Truvada for pre-exposure prophylaxis (PrEP) to reduce the risk of HIV infection among people at risk of contracting the virus “was hailed by many as an important step in the fight against AIDS, concerns that people will incorrectly use the drug — potentially spurring drug resistance — led others to blast the agency for not laying down tougher rules,” the Wall Street Journal’s “Health Blog” writes. “Instead of requiring that people prove they are HIV-negative before getting a prescription filled, the FDA slapped a boxed warning on the drug, saying it must only be used by people who have a confirmed HIV-negative test prior to getting a prescription, and then get tested at least every three months while they are using it,” the blog notes (Marcus, 7/16).
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).
“Many of Africa’s anti-malaria drugs are fake or of poor quality, weakening a crucial battle against the world’s deadliest disease, a new investigation has found,” GlobalPost reports, adding, “Many of the drugs — even those approved by the World Health Organization — are Chinese fakes or low-quality variants that failed quality tests, according to two new studies released today” (Conway-Smith, 7/10). “Two studies published in Research and Reports in Tropical Medicine suggested manufacturing problems, rather than counterfeiting, may be to blame for these substandard drugs in low- and middle-income countries around the world,” Agence France-Presse writes (7/10). Writing in a Business Day opinion piece published on Tuesday, “Roger Bate, lead author of the studies and a scholar at the conservative American Enterprise Institute, warned of ‘unthinkable’ public health consequences from drug resistance,” GlobalPost notes.
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.
Health Ministers From Southeast Asia Asked To Support U.N. In Stemming Spread Of Drug-Resistant Malaria In Region
“Health ministers from the Association of Southeast Asian Nations (ASEAN) are being asked to support United Nations efforts to stem the spread of drug-resistant strains of malaria, especially along the borders of Cambodia and Burma,” VOA News reports. “Scientists fear resistant strains of malaria may spread beyond Southeast Asia, reaching continents such as Africa, a region with many victims of the mosquito-borne parasite,” according to the news service. “Thomas Teuscher, executive director of the United Nations-backed Roll Back Malaria Partnership (RBM), says more effort is needed to ensure that drug-resistant malaria at least remains localized in Southeast Asia,” VOA notes.
Cuban Company's Sales Of Larvicides To Fight Malaria-Carrying Mosquitoes In Africa Continue Despite U.N. Concern, Miami Herald Reports
The Cuban state-owned company Labiofam “is increasing sales of its mosquito larvicides to fight malaria in Africa, despite cautions by U.N. experts that such products have limited use and are not the most cost-effective method of attacking the disease,” the Miami Herald reports. The company’s website “says its larvicide Griselesf is used in anti-malaria programs in Ghana, Angola, Gambia, Tanzania, Nigeria, Burkina Faso, Equatorial Guinea, and Zambia,” according to the newspaper.
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 Wall Street Journal reports on a rise of multi-drug resistant tuberculosis (TB) in India, writing, “India’s slow response to years of medical warnings now threatens to turn the country into an incubator for a mutant strain of tuberculosis that is proving resistant to all known treatments, raising alarms of a new global health hazard.” The newspaper continues, “Spread of the strain could return tuberculosis to the fatal plague that killed two-thirds of people afflicted, before modern treatments were developed in the 1940s, said Dr. Mario Raviglione, director of the Stop TB Department of the World Health Organization.” The newspaper notes, “The WHO is now assisting India to combat the strain” (Anand, 6/19).