global_aid
New technology and modern innovations have played an ever-increasing role in the fight against global poverty in the 21st century, but where do these new tools and practices come from? Most come from established technology and manufacturing firms like GE, IBM and Apple. Major universities are also hotbeds for invention. However, in the last five years there has been a surge in innovation coming from grassroots and non-traditional organizations with the help of social media and other sites, such as Kickstarter. Keeping with the changing tides, the University of California at Irvine launched a contest in May of this year encouraging students to propose original solutions for poverty relief.

The contest took development out of its traditional setting and encouraged all to participate. Undergraduates, graduate students, faculty and UCI alumni were all invited to come together and take part. The Blum Center for Global Engagement hosted the challenge. The goal of the challenge, as Blum Center Director Richard Mathew states, was “to bring the vast stock of ingenuity, creativity, knowledge and passion that exists across the campus to bear on alleviating poverty at home and abroad.” The Solutions Challenge presented an unorthodox approach to relief development as it aimed to bring minds of all backgrounds together in the hopes of producing greater results.

Participants were only required to submit a “feasible idea.” That is to say that the participants did not need to be engineers. All submissions had to meet three criteria, however. First, the proposals had to elaborate on the specific impact on poverty that the device or technology would address. Second, the proposal had to be reasonably realistic and achievable given limited time and resources. Finally, participants had to enumerate the scope their proposal would cover as long as their long-term goals. Three finalists were chosen and met with potential investors in a private venue.

First place was given to PhD student Katya Cherukumilli. Her proposal was to use certain minerals to remove toxic fluoride from drinking water in rural India. Erik Peterson, a resident of Irvine, won second place with his proposal for Lifesign, which would be a device given to homeless citizens as a register that would include data such as health information, hometown and needed services. Replacing handwritten signs, the device would show a code to be entered on the Lifesign website to donate to certain causes and services. Irene Beltran, an undergrad at UCI, took home third place with her “Lab on a Chip” proposal. The chip is tiny and only requires a drop of blood to test for tuberculosis. All three finalists are now consulting with industry leaders and investors.

UC Irvine’s challenge was inspired in part by another school in the University of California system. UC Berkeley’s Development Impact Lab runs a similar contest every year, encouraging engineers, computer scientists and IT specialists to develop technology-based ideas for global aid. UC Irvine’s contest encourages a more theoretical approach, prioritizing creativity in ideas ahead of a physical prototype.

Joe Kitaj

Sources: Govtech, Blumcenter, Berkeley
Photo: UCI

fight_against_tb
The Indian government has increasingly used technology to aid its fight against tuberculosis (TB). By using biometric and mobile technology, it has been able to better ensure that patients take their proper treatment. This mitigates the risk of spreading the disease and developing into multi-drug resistant TB.

For a disease that kills more than 270,000 people in India and a few million worldwide in other countries, developments in the fight against TB have been slow to come. The vaccine that is currently being used to prevent TB is more than 85 years old and is only effective against certain strains of the disease in children. The most widely used diagnostic test was created 125 years ago and misses half the cases. It also cannot detect strains of TB that are resistant to drugs.

India passed a law in 2012 that made TB a notifiable disease, which means that doctors are required to report an infected person to the government. To make the process easier, the government has rolled out a program called Nikshay in private and public hospitals. Nikshay is an electronic reporting unit that uploads case files and treatment processes onto a single database across the country. This makes it easier to track people who have contracted the disease and ensure that they are taking the proper treatment.

In some places, Nikshay has been compounded with Aadhar, a biometric identification system that was rolled out a few years earlier. Aadhar gives every Indian citizen a unique number that is linked to a biometric card. Coupling the data in Nikshay and Aadhar improves monitoring and evaluation, and makes payments easier as Aadhar can also be linked to a bank account.

Treating TB is a long and complicated process. Estimates show that fighting TB can amount to 39% of a household’s annual expenditure. An infected person needs to take 13-17 pills daily for six months. If he stops his treatment before the proper time, he runs the risk of developing multi-drug resistant TB, a more virulent and difficult-to-treat form of the disease.

Some state governments in India have begun to use the SIMpill, which was originally implemented in South Africa a decade earlier, to ensure that the treatment process is completed correctly. It gives patients pre-programmed medicine bottles that are able to monitor whether pills are taken at the right time in the right amount. Each time the bottle’s cap is opened the central server is notified. If there is a discrepancy or a missed dosage, the patient and caregiver receives a reminder text message on their phone.

In another innovative use of mobile technology, some states have rolled out the Mobile Technology for Community Health program, which sends patients SMS reminders about appointments, treatments and health tips. The central government has also initiated the Missed Call Campaign, in which a person can give a toll-free number a missed call and have someone call them back to answer their questions.

– Radhika Singh

Sources: Gates Foundation, Gizmodo, MOTECH, Global Health Strategies
Photo: The Hindu

Tuberculosis (TB) is often forgotten as a global health threat, but recent advances in molecular technology have health officials optimistic about the future.

It is estimated that one-sixth of all annual deaths caused by infectious diseases result from TB. The second-largest killer behind HIV/AIDS, the disease kills an estimated 4,000 people a day. Sub-Saharan Africa experiences the worst of it, as the infectious disease is the most common cause of death among HIV-positive people. Estimates say that over 1,000 people with HIV die from TB every day.

One of the biggest problems when it comes to TB is detection. Currently, HIV-associated TB is being detected in only half of the estimated number of people who have it. Another issue that arises is weak healthcare coverage, which places an economic burden on poor people. Additionally, a lack of healthcare coverage has an effect on people’s vulnerability to TB and health outcomes from the disease.

However, progress in the fight against TB has been seen over the past two decades. The TB mortality rate fell between 1990 and 2013 by an estimated 45%. In that time, over 60 million people were cured from the disease and 37 million lives were saved. Most of the success has been attributed to a rise in new technology. In fact, such interventions are said to not only save lives, but to be cost-effective, because for every dollar spent there is an estimated $30-$43 return.

Cepheid Inc., a diagnostics company based in California, created one such revolutionary piece of technology. Dubbed GeneXpert, the automated molecular technology has been said to be one of the most significant achievements in decades in regards to TB research.

The device is more accurate and faster than traditional diagnosis methods, such as the out-of-date smear microscopy, which was created a century ago. GeneXpert works by allowing health workers to place gathered sputum samples in cartridges, which in turn are connected to a computer. As a result, the DNA of TB bacteria can be detected within two hours. The device can also identify multidrug-resistant forms of TB.

In addition to being endorsed by the World Health Organization, it attracted the attention of global donors. Many poured in donations to help distribute it around the world.

In May, a study conducted in India showed that by using GeneXpert, the number of bacteriologically confirmed cases increased by 39%.

The problem with the technology, however, is its expense.

Poor people in the developing world, those who are most likely to need GeneXpert, have trouble getting necessary access to the technology. While donors across the world are taking care of the $17,000 price tag associated with each machine, countries are struggling to pay for the cartridges. Each cartridge costs $10, meaning some countries cannot purchase them on a large scale because of a lack of funds. Additionally, GeneXpert requires access to electricity, computers and refrigeration, a difficulty for many TB-prevalent areas.

Even with some of these issues, health officials are still excited with the recent activity. The creation of GeneXpert, as well as rather large investments in the device, have led to more companies starting to develop diagnostic technologies. The hope is that some of these technologies will eliminate the downsides of GeneXpert. According to a report by UNITAID, a global health initiative, there are currently 81 manufacturers running tests with almost 200 potential new products having to do with TB diagnostics.

One such company is Alere Inc. The diagnostics company, based in Massachusetts, is working on a transportable test that would be powered by batteries, giving it the capability of being used portably for an entire day. With the test being portable, the company says that health workers would then have the ability to decide about treatments on the spot, the same place where the diagnosis was made.

The company, which received a $21.6 million grant from the Bill and Melinda Gates Foundation, is also working to make the costs of its machine and cartridges less expensive than GeneXpert.

While questions still remain, as Alere has yet to run any type of trials on its technology, those devoted to the fight against TB are still hopeful about the future. Through boosted investments and partnerships between public and private sectors, revolutionary technology has, and will continue to, aid the fight against tuberculosis.

– Matt Wotus

Sources: The Hill, New York Times
Photo: Dr. Dang’s Lab

drug resistant bacteria

The White House has said President Barack Obama will call for $1.2 billion in funding for research on drug-resistant bacteria in his upcoming budget proposal. If the funding is approved, the total would double last year’s funding for the same research, marking it as an administration priority in healthcare.

The rise of bacteria that is resistant to normal antibiotic treatments has been of concern for some time. The Centers for Disease Control and Prevention say that drug-resistant bacteria, sometimes called “superbugs,” account for a probable two million illnesses and 23,000 deaths in the United States alone each year.

The funding would pay for research in government agencies on drug resistance and how bacteria becomes immune to antibiotics. Additionally, it would fund researchers looking for new treatments for drug-resistant bacterial illnesses.

Drug resistance has become a problem because of the over-prescription and misuse of antibiotics. This is a naturally occurring phenomenon that has been accelerated by human intervention. Drug-resistance threatens both prevention and treatment of a wide array of illnesses including malaria, pneumonia, gonorrhea and bloodstream infections.

Particularly pressing are multi-drug resistant, or MDR, and extremely drug-resistant, or XDR, tuberculosis. In 2012, there were approximately 450,000 new cases of MDR tuberculosis around the world. MDR TB cases now make up about six percent of new TB cases. XDR TB cases have been identified in 92 countries, in all regions. Because XDR TB cases are underreported, research and treatment are difficult.

The interconnectedness of today’s world makes drug-resistant bacteria even more threatening. While the root causes of drug-resistance may be local, that bacteria can easily move through trade and travel, spreading far quicker than previously possible.

Some of the riskiest drug-resistant bacteria are methicillin-resistant Staphylococcus aureus; hospital borne bacteria like Enterococcus, Staphylococcus, Klebsiella, Acinetobacter, Pseudomonas and Enterobacter; foodborne bacteria like escherichia Coli and salmonella; sexually transmitted infections like gonorrhea and chlamydia; and tuberculosis.

– Caitlin Huber

Sources: Washington Post, CNN, World Health Organization

Photo: Rawstory

tuberculosis
Tuberculosis has ravaged the world throughout history—from ancient Egypt, Greece and Rome to today, where it has adapted into drug-resistant forms. The Centers for Disease Control and Prevention has classified tuberculosis as “one of the world’s deadliest diseases,” infecting millions per year. Nine million cases of TB were recorded in 2012, and of that number, 1.3 million deaths resulted.

Tuberculosis is most prevalent in South-East Asia, Africa and the Eastern Mediterranean, according to a report by the American Lung Association. These regions also have high incidences of TB and HIV co-infection. The CDC states that TB is the “leading killer” of people with HIV.

Tuberculosis, which attacks the body in the form of bacteria, usually affects the lungs, but can also threaten the kidneys, spine and brain. It is transmitted through the air. The disease has the capacity to affect many in the form of “latent TB infection” and “TB Disease.”

Those with latent TB do not get sick, as their body has fought off the infection. They also cannot pass the infection to others. However, the bacteria can “become active in the body and multiply,” causing the person to “go from having latent TB infection to being sick with TB disease.” TB disease typically occurs when one’s immune system cannot stop bacteria from growing. Those with TB disease can spread the bacteria to others.

On July 3, 2014, the World Health Organization (WHO) released its plan to eradicate tuberculosis in countries with fewer than 100 cases per million people. There are 33 such countries, all located within Europe and North America. While these are not regions where the disease is endemic, eradicating TB in these areas would help develop strategies for treating TB in high incidence areas in the future, says Medical News Today.

The WHO has broken down their plan into different stages. First, they would have “an initial pre-elimination phase,” which purposes to reduce the number of cases to 10 per million people by 2035. “Full elimination” is to be achieved by 2050, which would result in one case per million people. Tuberculosis would no longer cause a public health threat at this point.

In order to reach full elimination, the WHO has specified “eight key interventions” that they will implement in the 33 countries. Funding, TB screening, investment in research and tools and monitoring of the program are all key aspects of the package. Additionally, addressing more indirect issues related to TB are included. For example, monitoring migrant and “cross-border issues” would help identify TB in at-risk populations. Additionally, this would extend the program into regions with high rates of TB and help these areas develop strategies for TB reduction.

Why did the WHO choose these 33 countries to implement their plan? According to Dr. Hiroki Nakatani, the World Health Organization Assistant Director-General, areas with low-TB prevalence “already have the means to drive down TB cases dramatically by 2035.” Additionally, efforts will not only take place in the 33 countries, but also in endemic regions. Medical News Today says that efforts in areas with high TB prevalence will have to increase in order to prevent the spread of TB from these areas to low-risk regions.

— Bridget Tobin 

Sources: Medical News Today, WHO 1, WHO 2, CDC 1, CDC 2, NIH, American Lung Association
Photo: World Focus

tb_in_children

New findings in tuberculosis among children could mean that diagnosing the disease could be faster, cheaper and more effective for the millions of people infected by the disease each year.

Tuberculosis (TB) is the second largest killer due to a single infectious agent worldwide, only following HIV/AIDS, and is the leading killer of people with HIV. The ones most affected by the disease are low to middle-income countries, where upwards of 95 percent of TB deaths occur.

Developing countries where malnutrition and compromised immune systems affect the overwhelming majority see the most cases of TB. Even though all groups are at risk, children and young adults are at a greater risk of contracting the disease.

The disease is very difficult to diagnose in children — the early symptoms of TB are also present in dozens of other illnesses — and by the time a positive diagnosis is reached, the disease has already spread throughout the lungs, brain and other organs.

In 2012 alone, there were 530,000 cases of TB in children, and out of the children who were HIV-negative, 74,000 died of the disease because of late and improper diagnosis.

A better diagnosis is needed so that doctors can start treating TB earlier (in its early stages) for better chances of overcoming the disease and so children who show false positives for TB do not need to go through unnecessary treatment.

Health staff in several poor countries have been using a standard test for TB which has failed 93 percent of the time, showing false negatives, leaving thousands of infected children untreated.

Recently, after seven years of study and examining the blood of 2,800 children, an international team of researchers discovered that TB can be positively identified by examining 51 genes.

Over 80 percent of cases were discovered positive for TB by examining this specific gene signature. Researchers examined the blood samples to see which genes were activated or suppressed in samples testing positive.

It was found that TB could be distinguished from other diseases in 51 of the 30,000 genes that make up the human genome. A “risk score” was developed from the examination of this gene signature, and when tested, over 80 percent of the samples were accurately diagnosed positive for TB. Tests that were found negative ruled out TB as a diagnosis with just as much accuracy.

“Childhood TB is a major problem in African hospitals. An accurate test for childhood TB would be an enormous breakthrough, enabling earlier diagnosis, reducing long hospital admissions for investigation of TB suspects, and limiting the number of children treated inappropriately,” said head researcher Brian Eley. Eley is part of the University of Cape Town and lead the clinical study in South Africa.

Early, accurate diagnosis of TB would lead to reducing deaths related to TB in children. The discovery of what these 51 key genes demonstrate in relation to TB will help lead the way to a significant global decrease in the disease that currently affects millions.

 — Jerilynn Haddow

Sources: WHO, IRIN Africa, Wellcome
Photo: Blogspot

North_korea_tuberculosis_crisis_usa_stanford
Despite the Democratic People’s Republic of North Korea’s penchant for holding Americans hostage and despising the United States on principle, the country has nonetheless reached out to a Stanford University-led research team to help solve its mounting tuberculosis (TB) crisis.

North Korean doctors first approached Stanford Medical School and California-based tuberculosis experts in 2008. Since that time, the North Korean government has invited members from the Stanford Medical School to address the state of TB in the country, the worst in the world outside of sub-Saharan Africa.

Tuberculosis affected 8.6 million people in 2012 and claimed 1.3 million lives. While it is largely eradicated in industrialized societies, the respiratory disease still affects developing countries located in Southeast Asia, Africa and the Western Pacific.

North Korea’s problems with TB arose in the 1990’s, when the country was wracked with floods, droughts and ultimately wide-spread famine after the Soviet Union’s collapse in 1990. Without aid from their former Communist ally, widespread malnutrition overwhelmed the country’s inhabitants, resulting in upwards of 2.5 million starvation related deaths.

Improper nutrition coupled with few medical supplies led to a resurgence of TB in the country. In 1998, the Ministry of Public Health began implementing Directly Observed Treatment Short (DOTS) course, a repetitive and now defunct method of TB treatment.

Unlike other regions that evolved their treatment methods (like sub-Saharan Africa,) North Korea continued use of DOTS resulted in Multi-Drug Resistant Tuberculosis (MDR TB,) particularly virulent strains of the disease that do not respond to basic antibiotic therapy.

Although North Korea does not keep drug-resistance records, a report by Eugene Bell, an NGO specializing in patient relapse, revealed large numbers of TB relapse in North Korea, signifying particularly high levels of MDR TB.

“We had anecdotal information from North Korean doctors, who were right on this one. They weren’t able to diagnose drug resistance, but they could see what happens when they treated people with drugs and they came back,” says K.J. Seung, a Eugene Bell doctor and author of the MDR TB report in the Public Library of Science. “Now we have original scientific data that clearly documents drug resistance.”

The notoriously xenophobic regime’s plea for help has resulted in the 2013 installation of North Korea’s first diagnostic laboratory to test drug-resistant MDR TB. In collaboration with the TB Consortium and the Nuclear Threat Initiative, a nonprofit working to strengthen global security, the team is dedicated to improving North Korea’s treatment facilities and teaching North Korean doctors modern methods of controlling the disease.

The invitees must remain apolitical and are constantly monitored by minders, government-appointed tour guides that ‘mind’ what one sees and does in the hosting country. Despite these constrictions, researchers have continued their efforts to bolster MDR TB resistance efforts, noting the health of North Korea and the world depends on their efforts.

Emily Bajet

Sources: Global Post DDN News, Stanford, Stanford, Stanford Medical School, North Korea Now, Mother Board, World Health Organization
Photo: Vice

Tuberculosis_symptoms_treatments
Tuberculosis (TB) is an infectious disease caused by the bacterium Mycobacterium tuberculosis. It is transmitted through droplets of saliva and other fluids from the throat or lungs in people with active forms of the disease. TB is the second deadliest infectious disease next to HIV/AIDS.  Not everyone who catches the infection develops symptoms, but if they do and do not receive treatment, TB can be fatal.

In 2012, 8.6 million people became ill with TB and 1.3 million died.

How Do You Get TB?

TB is spread when particles of the bacterium from an infected person’s lungs or throat come out into the air when they are coughing or talking and someone else breathes them in. TB is not spread easily however and people who catch TB are normally close friends or family members of an infected person. Not everyone who gets infected with TB will get the disease, many people’s immune systems are able to fight off the disease. Often people who get TB were infected with in a long time ago but become symptomatic when their immune system is weaken.

Who Gets TB?

TB often attacks those with suppressed immune systems including people with HIV/AIDS, people undergoing chemotherapy and the elderly. TB is the top killer of people with HIV/AIDS. While TB was once endemic in North America, Europe now 95 percent of TB deaths occur in low and middle-income countries.

TB is more common in men, but TB is still the third-largest killer of women worldwide.  Many of the women who die from TB are HIV infected. According to the World Health Organization (WHO,) the majority of TB cases in 2012 were in South-east Asian (29 percent,) Africa (27 percent) and the Western Pacific region (19 percent.)  TB largely affects young adults, although children also contract the disease. Tobacco smoking also puts people at a much greater risk for TB; 20 percent of those who become ill with TB are smokers.

What are the Symptoms of TB?

Symptoms of active TB include coughing, fever, fatigue, night sweats, chest pain and coughing up blood.  If untreated, TB can lead to death; however, in developed countries, TB is very rarely fatal as the disease is treatable and curable.

How is TB Treated?

TB is treated with a combination of drugs administered over six months to 12 months. The most common treatment is a combination of isoniazid plus two to three other drugs including rifampin, pyrazinamide and ethambutol. Isoniazid is also prescribed in non-active TB as a preventative measure.

Thankfully, TB has been steadily declining; since 1995, there has been a 45 percent reduction in TB deaths. The WHO has treated 56 million cases of TB and has saved 22 million lives through prevention strategies.

Elizabeth Brown

Sources: World Health Organization, Center for Disease Control and Prevention, American Lung Association
Photo: Drug Discovery

tuberculosis_vaccine
Today, scientists have new hope of controlling and ending tuberculosis. McAster University Researchers have recently come across a vaccine against tuberculosis. According to Dr. Fiona Smalil, professor and chair of the Department of Pathology and Molecular Medicine at McAster University, the research team is “the first to develop such a vaccine for tuberculosis.”

The McAster University researchers have also explained that the new tuberculosis vaccine would “stop the spread of this highly contagious illness.”

Moreover, the vaccine would provide a more positive response in developing nations. The vaccine could save millions of lives. According to pubmed.gov, tuberculosis is out of control in developing countries. It is killing millions of people every year.

Researchers have emphasized that “In these areas, the present vaccine–Mycobacterium bovis bacillus Calmette-Guérin (BCG)–is failing.” As a result, the McAster University team hopes to create a better quality vaccine in order to reduce the number of deaths caused by tuberculosis each year.

The new vaccine was developed to act as a booster to BCG. BCG is the only TB vaccine available. Developed in the 1920s BCG has been used worldwide. Currently, the BCG vaccine is part of the World Health Organization’s immunization program in Asia, Africa, Eastern Europe, South America, and Nunavut. In order to create a better vaccine, McAster researchers decided to hold a 10 year test program.

According to Dr. Smalil, McMaster researchers began the first human clinical trial in 2009, which included 24 healthy human volunteers and 12 who were previously BCG-immunized. Researchers have found that the trials have been widely successful.

By 2012 they established that the vaccine was safe, and observed a strong immune response in most trial participants. As a result, Tuberculosis could be controlled and eliminated by 2020.

– Stephanie Olaya

Sources: Science Daily, Inquisitr
Photo: The Guardian

 tuberculosis

Over 600 million people in Bangladesh, Pakistan, and India are infected with the tuberculosis bacterium Mycobacterium tuberculosis. Each year, at least three million people reach the potentially deadly staged called active TB. The disease is still treatable at this stage with antibiotics, but traditional tests miss more than one out of three active cases. An average of 400,000 people die from the disease in South Asia every year.

For the first time, thanks to a new strategy developed at University of California, Davis (UC Davis) Health System, the disease can be effectively detected in children. Over 20,000 people in Pakistan will now be tested for the dangerous stage using the scientific breakthrough.

In traditional screening, a laboratory worker must identify the bacterium in a sputum sample observed under a microscope. Unfortunately, this test rarely picks up more than 50 percent of active cases of lung TB. The new TB screening looks for antibodies in the blood that are found only when a person is fighting off active TB. This new test is expected to detect 80 percent of active cases.

Another advantage to the new strategy is the speed of the screening. While the sputum microscopy test requires three sputum samples collected over a three-day period, the new test requires only a few drops of a blood sample and results are provided in two hours. According to researchers, because it takes such little time, millions more people can be screened worldwide per year.

An additional limitation of conventional screening comes from the very use of sputum samples. Children often have trouble providing a sputum sample, and are often missed in TB screening. TB can also be inactive in the lungs but active in other organs and tissues, cases that are missed by sputum screening. These two undetectable groups account for over 20 percent of all active TB cases.

The new strategy is based on an FDA-approved diagnostic instrument and was developed by UC Davis Medical Center scientists along with colleagues in Pakistan. Preliminary trials were funded by the U.S. Agency for International Development (USAID), and were reported in the journal Clinical and Vaccine Immunology. USAID and the World Health Organization (WHO) fund today’s large-scale research. An additional grant was awarded in July 2013 from the U.S. State Department and USAID, which will focus on developing and commercializing the TB test in partnership with the Forman Christian College in Pakistan.

“The fast turn-around time of the new antibody diagnostic test, in combination with high number of patients who can be tested, should enable millions of more TB patients to be screened,” said Imran Khan, assistant professor in the Department of Pathology and Laboratory Medicine, and Center for Comparative Medicine at the UC David Medical Center. “As a result, effective treatment can be provided in a more timely fashion to reduce the spread of this deadly disease.”

– Ali Warlich

Sources: UC Davis Health System, WHO
Photo: News Medical