vaccination_programsVaccinations are often dreaded here in the “developed” world. But they are such a basic part of life that almost everyone gets them without a second thought. However, for thousands upon thousands, vaccinations are not second thought but a luxury.

While immunizations are widely available in America and Europe, it is a different story in the developing world. But is it possible to tell who actually needs their vaccinations? Shot records are a struggle to get even here in America at times, but in the developing world it can be a nightmare to tell who needs what.

Back in 1974, the World Health Organization (WHO) began the Extended Program on Immunization (EPI). The plan was to set up the managerial and technical functions needed to vaccinate children from diphtheria, measles, tuberculosis, poliomyelitis, tetanus and whooping cough. The end goal was to get children the vaccines they needed on schedule through health visits.

At the time, coverage levels for vaccines was at five percent, but by 1991, the 80 percent benchmark target was met, saving millions of lives. Recently, the WHO has recommended vaccines against type B of haemophilus influenza, hepatitis B, streptococcus pneumoniae, rotavirus, rubella and human papillomavirus for girls.

These extra vaccines are necessary, but the effects of them have not yet been realized. Part of the problem is that with more vaccines come more logistical issues. More vaccines mean that more and improved communication between caregivers and health workers is needed. Add to this the fact that health systems are becoming more complicated and there appears a huge logistical problem.

This is where new diagnostic technology comes in to play. Coupled with spread of mobile technology throughout the developing world, detection paired with cloud technology could redefine the way vaccines are administered around the globe. One organization, Diagnostics for All, is doing just this.

Regular measuring of vaccine administration is extremely important in determining the progress in vaccination goals, such as the ones set out by the EPI. However, in the developing world, common modes of measurement such as household surveys lack accuracy in detecting diseases preventable by vaccines. This is because of low participation, the cost of a clinical examination and reporting inflation.

To fix this, Diagnostics for All has developed an easy solution. Using patterned paper technology, they have developed a test that can be used in resource-stricken areas of the world. It is lightweight, less expensive than other forms of diagnostic tests, reliable and easy to use. No trained doctor is required to run the test and minimal training is needed to perform it: “a sample from a finger prick is sufficient to yield results. No syringes are involved and neither clean water nor sample preparation is needed.”

The test can display results in minutes and has the possibility to interface to Smartphone technology. This idea has the potential to fix the logistical problems that have developed since the WHO began recommending more vaccinations in 2014. By administering a test that can be cheaply done on a broad scale it will be possible to see who needs what and who has already been vaccinated, all from one Smartphone. Will this possibility become a reality? Only time will tell.

Gregory Baker

Sources: Embedded-Computing, DFA, GHSPJournal, WHO
Photo: Humanosphere

While medication treats an ailment, it is the rapid diagnosis of the ailment that is critical to saving many lives. With the rising rate of antibiotic-resistant infections, the need to diagnose quickly and correctly to facilitate accurate choice of medication has grown exponentially. The rapid diagnosis issue is compounded in resource-poor settings that are mired with lack of easy access to affordable healthcare and infrastructure.

Consider the example of tuberculosis (TB), a deadly infectious disease that can take up to six months or more to treat completely. In 2013, there were more than nine million new cases of TB. Most of these occurred in Africa and Asia. The standard-of-care diagnostic, a sputum smear, is slow and can take multiple health visits, which many people can ill afford. Additionally, the sensitivity of the test is variable and is worse when the patient is HIV positive, which almost 13 percent of TB patients are.

Now multiple-drug resistant TB (MDR-TB) infections, where most of the available antibiotics are no longer effective, are a huge concern. MDR-TB develops because of the incorrect use of antibiotics. The more rapidly TB is diagnosed and the more often correct treatment is prescribed, the less the incidence of MDR-TB and the less the chance of it spreading. As the ceiling of new antibiotic development is being pushed, drug-resistant infections urgently need to be controlled.

Rapid and accurate diagnosis is a necessity not just for TB but for everything ranging from malaria to diabetes. Both academics and the industry are hard at work to develop techniques that can provide results in a matter of hours. Some, especially those related to telemedicine like new iPhone blood glucose testing, can do this from the convenience of one’s home. However, the real conundrum has been how to make this cheap to manufacture, affordable to buy for resource-poor populations who need it and easy to use when there is no infrastructure in place.

Diagnostics For All is a nonprofit organization that aims to produce technology particularly for the 60 percent of the developing world that lack easy access to healthcare. Its projects range from a simple, easy-to-use liver function test to monitor the efficacy of HIV anti-retroviral therapy, to detecting micronutrient levels in children so that appropriate nutritional supplements can be provided. Its systems are based on a patterned paper technology developed at Harvard University. Since the paper takes up the test sample easily and micro channels made on the paper allow the sample to flow into tiny wells of chemical indicators, there is no need for any external power. The indicator changes color based on a component in the sample, allowing an easy read out. The patterned paper can be manufactured cheaply on large scale. Diagnostics For All supports its work with philanthropic grants and partnerships with the for-profit sector.

Foundation for Innovative New Diagnostics (FIND) is another international nonprofit organization that builds partnerships with enterprises and assists in developing novel diagnostic techniques through expertise and capacity building. It supports the discovery and scale-up of diagnostic tools bridging the gap between development and delivery, and ensures that these technologies are made available to high-burden countries at preferential pricing. It has developed several techniques among which are an HIV viral load detection system co-developed with California based, Cepheid and malaria and sleeping sickness diagnosis methods with Massachusetts based, Alere.

There are several other organizations out there, including those making strides in telemedicine, that are working to make diagnosis faster, cheaper and more accurate. As science makes progresses towards developing these new techniques, markets, nonprofit and for-profit business models, and governments all have to play their part in keeping up with strides being made and ensuring that these new methods are realized in practice.

– Mithila Rajagopal

Sources: Alere, NCBI, Sanofi, San Francisco Business Times, WHO 1, WHO 2
Photo: Fashion For A Cause