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J&J Paves the Way for Affordable Tuberculosis Treatment

Affordable Tuberculosis Treatment
On September 29, 2023, Johnson & Johnson (J&J) announced that it would not enforce patents in 134 low- and middle-income countries for Sirturo — its brand name for bedaquiline tuberculosis treatment. This change is an exciting step toward providing generic, affordable tuberculosis treatment to people who desperately need it. 

Patents and Medication Prices

Patents can keep the cost of life-saving medications out of reach for many – especially those in poverty. So why do medications have patents? Pharmaceutical companies must undergo a rigorous testing process through the FDA to ensure the drugs are safe enough to go on the market. They obtain a patent to protect their research, which the FDA requires before approval. Once this patent is obtained, pharmaceutical companies must undergo a five-step process: 

  1. Discovery. 
  2. Preclinical research.
  3. Clinical research.
  4. FDA review.
  5. Post-market safety monitoring. 

More than 90% of drugs do not make the cut — most fail because they either do not adequately treat the condition or because they cause side effects that are too debilitating.

It takes about 10 years for a new drug to complete the five-step process toward FDA approval, costing an estimated $2.6 billion. Considering that 90% of medications are not approved, pharmaceutical companies try to recoup their investment by passing that cost onto consumers. Innovation of new medications used to be the goal of pharmaceutical companies, but with the increased costs of research and development, they shifted their focus from innovating new medications to capitalizing on existing medications. Over the past five years alone, the average cost of medications has increased by more than 71%.

Rising Costs of Medications

Patents prevent the development of generic alternatives to medications. When pharmaceutical companies shifted their focus toward capitalizing on existing medications, they started proactively renewing drug patents to ensure generic alternatives could not be developed. Without competition on patented medications and no federal oversight on drug prices, pharmaceutical companies can set the price of life-saving medications as they see fit.

This decision is particularly devastating for developing countries. Even when generic alternatives are available, research has found that developing and poverty-stricken countries often pay more than others.

“Developing countries are often paying far more for everyday drugs than they should be. Why do some poor countries pay 20 to 30 times as much as others for common medicines to relieve pain or treat hypertension? In large part, because of flawed drug buying practices and broken generic medicines markets,” said Amanda Glassman, the executive vice president at the Center for Global Development.

Without generic medications, affordable health care is out of reach for developing countries, and people are paying the price for their health. Even when generic medications are available, there is little regulation of prices. 

Tuberculosis and Poverty

Poverty is a huge determinant of tuberculosis. Tuberculosis risk factors are rampant in the poorest communities: overcrowding, malnutrition, inadequate ventilation and limited general health and disease prevention knowledge.

Given the prevalence of tuberculosis risk factors in poverty-stricken communities, the need for generic tuberculosis medications is a lifeline most vulnerable communities need now more than ever. This need is why Johnson and Johnson’s announcement that they will not enforce patents on their patented TB medication is a step in the right direction. The hope is that this will pave the way for affordable tuberculosis treatment by allowing the development of generic, more affordable alternative drugs.

“The decision is intended to assure current and future generic manufacturers that they may manufacture and sell high-quality generic versions of Sirturo without a concern that the company will enforce its bedaquiline patents, provided the generic versions of Sirturo produced or supplied by generic manufacturers are of good quality, medically acceptable and are used only in the 134 low- and middle-income countries,” J&J said.

– Ann-Jinette Hess
Photo: Flickr

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Greece’s Refugee COVID-19 Vaccination Campaign

Greece's Refugee COVID-19 VaccinationAfter much delay, the Greek government has finally rolled out a concrete plan for vaccinating an estimated 60,000 migrants and refugees within its borders. Announced on June 3, 2021, Greece’s refugee COVID-19 vaccination campaign will use Johnson & Johnson’s single-dose vaccine to begin inoculating more than 11,000 asylum seekers on the Greek islands of Lesbos, Chios and Samos.

Greece’s Refugee COVID-19 Vaccination Rollout

Human rights groups have repeatedly criticized the center-right government of Prime Minister Kyriakos Mitsotakis for failing to make refugees a priority during the country’s vaccine rollout. Mitsotakis’s administration pledged to make refugees eligible for vaccines, but until this recent announcement, the national vaccination campaign had largely sidestepped Greece’s large migrant population.

The Euro-Mediterranean Human Rights Monitor and others have called the country’s “Greeks-first” policy discriminatory and misguided. Organizations argue that inhabitants of refugee camps are far more vulnerable to COVID-19 than the general population due to overcrowding, limited space and lack of access to proper sanitation facilities. Another point of argument is that stopping the spread of COVID-19 within these vulnerable populations can limit transmission in the rest of society, ultimately benefiting the whole country.

Refugees in Greece

The tension between refugee advocates and the Greek government began long before the COVID-19 pandemic. Greece is one of the most popular routes for migration into Europe from Asia, Africa and the Middle East. After crossing from Turkey, migrants often end up in Greece waiting for their asylum claims to process.

Resentment between Greek citizens and migrants has been steadily rising over the years and the Mitsotakis government has adopted an increasingly tough stance on illegal migration that has come under fire from human rights organizations.

Multiple groups have accused the government of illegally returning asylum seekers to Turkey or leaving them adrift at sea rather than processing them through official asylum channels. One particularly startling accusation claimed that “13 men, women and children currently residing in a refugee camp on the island of Lesbos were beaten, robbed and forced onto a life raft” by uniformed officials who claimed the group required COVID-19 testing. The Greek government has denied these allegations but humanitarian groups still stand strong in protecting the human rights of migrants and refugees.

Vaccination Challenges for Refugees

Mistrust could hamper Greece’s refugee vaccination campaign. According to officials, only about 15% of asylum seekers in Greece have expressed interest in receiving a vaccine, although the number may increase as the campaign gets underway. Across the globe, many refugees fear that registering with a government vaccination platform could lead to arrest, detention or even deportation. Others fall prey to misinformation or encounter language and digital access barriers.

However, the main reason for limited global refugee vaccinations so far is the dramatic difference in vaccine supply between wealthy and low-income nations. Wealthier countries account for 85% of the world’s administered vaccines yet “85% of the 26 million refugees in the world are hosted in developing countries.” A recent contributing factor to limited vaccine access relates to COVAX, the vaccine initiative providing COVID-19 vaccines to low-income nations. Due to supply issues, expectations determined that COVAX would distribute 190 million fewer doses than originally anticipated by the end of June 2021.

Reasons for Hope

Although the road to refugee vaccination in Greece has been bumpy, the newly announced campaign is still a positive first step toward providing the country’s vulnerable migrant population with access to COVID-19 vaccines. There are also signs from around the globe that refugees will soon be able to receive vaccines in far greater numbers.

As of May 2021, 54 countries have started vaccinating refugees and 150 countries have said either publicly or privately that they will include refugees in their vaccine campaigns. Jordan’s campaign, in particular, has had a strong start. The country was the first in the world to include refugees in its COVID-19 vaccination drive. By the end of May 2021, 30% of Jordan’s refugees had received at least one vaccine dose.

International health officials are optimistic that the vaccine inequality between upper and lower-income nations will soon decrease. In June 2021, the United States announced that it would be donating 500 million doses of Pfizer vaccines to “92 low- and lower-middle-income countries and the African Union” through COVAX. Recent positive efficacy results from the Novavax vaccine should boost global supply even further. Overall, hope is on the horizon as the world comes together in a collaborative effort toward combating the COVID-19 pandemic.

– Jackson Fitzsimmons
Photo: Flickr

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COVID-19 Vaccinations in Malta

COVID-19 vaccinations in Malta
As of late May 2021, the rollout of the COVID-19 vaccinations in Malta has allowed 70% of Malta’s adult population to receive at least one dose. The country’s decreasing COVID-19 cases and the success of the vaccine rollout offer hope to Maltese officials as they plan to reopen the country.

The Rollout of COVID-19 Vaccinations in Malta

Thanks to Malta’s increase in vaccinated citizens, hospitalizations have decreased by 95%. The country’s health minister, Chris Fearne, reported that 42% of adults are fully vaccinated. The country has administered Johnson & Johnson, Moderna, Pfizer-BioNTech and AstraZeneca vaccines. On June 8, 2021, the country’s active COVID-19 cases dropped to just 70, with a report of only one new case. Malta is among the growing number of nations, such as Israel and Bhutan, that are reporting successful vaccine rollouts.

Malta’s Declaration of Herd Immunity

With the successful vaccine rollout, the Maltese government has declared herd immunity. However, the World Health Organization (WHO) has voiced uncertainty about such declarations. Due to new COVID-19 variants, the proportion of the population requiring vaccination to achieve herd immunity is unknown. The new variants reduce the effectiveness of the COVID-19 vaccine, meaning vaccinated people may still be at risk.

According to the Bloomberg vaccination tracker, the 42% of the Maltese population that is fully vaccinated does not include children 16 and younger. As a result, the total percentage of the population that is fully vaccinated is only 36.5%. Despite its small population of only about 500,000 people, the country has reported more than 30,000 COVID-19 cases and more than 400 COVID-related deaths.

Looking Ahead

Though COVID-19 cases are falling in Malta, the U.K. has announced that it will not lift its Malta travel ban. When the U.K. revised its “green list” of countries whose citizens will not have to follow quarantine requirements upon entry, Malta was still not part of the list. However, other countries such as Portugal and the Netherlands have eased restrictions on traveling to Malta.

Although the majority of Malta’s adult population has received vaccinations, the mask mandate will remain in place until July 1, 2021. After July 1, fully vaccinated people will no longer have to wear masks outdoors as long as COVID-19 cases stay relatively low.

As the country reopens and allows travelers to visit again, the Maltese government has set a new requirement for people entering the country: a vaccination certificate or a negative PCR test. The government will also provide incentives to visitors, such as hotel and scuba diving vouchers, to promote tourism and boost the economy.

Maltese citizens will also need vaccine certificates in order to attend certain public gatherings. The certificates will act as proof for citizens who have received COVID-19 vaccinations in Malta. Fearne reports that as of June 10, 2021, Maltese people have downloaded more than 60,000 vaccine certificates.

The success of Malta’s COVID-19 vaccination rollout inspires hope for other countries. With more vaccine diplomacy and less vaccine nationalism, more countries can progress toward achieving herd immunity.

– Jordyn Gilliard
Photo: Unsplash

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Strides to Improve Mental Health in Rwanda 

Mental Health in Rwanda
In 1994, Rwanda experienced a genocide that resulted in the death of approximately 1 million people and the displacement of millions more. Many are still feeling the results of this genocide to this day, just 27 years later. Studies have shown that 94% of the population witnessed at least one traumatic event during the genocide, including the death of a loved one, the destruction of their home or a threat to their lives. As a result, approximately 25% of the population meets the criteria for Post-Traumatic Stress Disorder (PTSD). Every April, during the annual commemoration of the events, there is a spike in people experiencing symptoms of PTSD and anxiety. The burden of mental health in Rwanda is a pressing concern for the country and it has made great strides to tackle this challenge.

The State of Mental Health Care Globally

Mental health services are often the last health service that undergoes establishment or receives funding. Globally, mental health professionals account for just 1% of the workforce worldwide. Meanwhile, 45% of the world’s population has access to just one psychiatrist per 100,000 people, even though over 10% of the global population has a mental health disorder. These numbers are even higher in sub-Saharan Africa, where the average rate of mental illness is about 12%. There are only 0.06 psychiatrists per 100,000 people in Rwanda.

What the Rwandan Government is Doing

Despite these grim statistics, the Rwandan government recognized the need for large-scale mental health services in the wake of the genocide. In 1995, it established a national mental health service with the goal of providing services within the context of the community.

Since then, mental healthcare has featured in many of Rwanda’s health goals, including Rwanda’s Fourth Sector Strategic Plan, which the country passed in 2018. This plan set goals and strategies for the nation’s health care for six years since its implementation (until 2024). It sets up several strategies for the future of care for mental health in Rwanda. These include having mental health intervention in all health centers and community units, defining the mental health package for each level, scaling up the surveillance and reporting system for following up with patients and expanding services for the prevention and treatment of drug and alcohol abuse and addiction.

Another strategy is the construction of a National Mental Health Care Center. The plan considers mental health alongside physical health issues such as malaria. It even includes a section ensuring people with disabilities, who are often cannot access mental health plans, have access to care.

The Rwanda Ministry of Health also teamed up with Johnson & Johnson in 2018 to establish a five-year three-pronged approach to understand the burden of mental disorders, decentralize care and increase access to affordable, quality medicine. These two plans, if implemented successfully, will provide access to mental health services for much of the country and ensure a healthier, happier population.

The Future of Mental Health Care

These plans are especially vital right now, as, due to the inherent trauma of living through a global pandemic, the burden of mental health in Rwanda and throughout the world is sure to rise. Governments need to be willing and able to commit to ensuring the continued mental health of their people. Rwanda has become an example in sub-Saharan Africa and much of the world for how to integrate mental healthcare into a national health plan. Hopefully, these plans will continue to improve the state of mental health care in the country through the COVID-19 pandemic and beyond.

– Harriet Sinclair
Photo: Pixabay

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Johnson & Johnson’s Africa Innovation Challenge Celebrates Public Health Initiatives

africa innovation challenge“What’s New?” This is the question engraved on a medallion for the Dr. Paul Janssen Award for Biomedical Research. Johnson & Johnson (J&J) created the award in 2014 to honor Janssen, a prominent pharmaceutical researcher who passed away in 2003. Janssen would pose this two-word question daily to his research and development lab. Now, every year, the award is given to an innovative and passionate scientist or team of scientists alongside a $200,000 prize as part of J&J’s Africa Innovation Challenge.

The Africa Innovation Challenge

The challenge is part of J&J’s Champions of Science initiative. Seema Kumar, J&J’s vice president of innovation, global health and policy communication, explains that the initiative is designed to “champion science” because “science needs champions.” The 2016 launch of J&J’s Africa Innovation Challenge 1.0 was part of a geo-specific initiative to support scientific advancements in Africa. Such developments are key to improving healthcare in impoverished areas.

J&J sought applications from Africa-based entrepreneurs who were creating new healthcare services and products in “early childhood development and maternal health,” “empowering young girls” and “overall family well-being.” Winners received mentorship from J&J’s team of researchers, engineers and scientists as well as up to $100,000 in funding.

The Need for Innovation

Access to healthcare is often a hurdle throughout Africa. Twenty-seven of the world’s 28 poorest countries are located in Sub-Saharan Africa. As of 2015, the majority of the world’s poor reside in Sub-Saharan Africa, where the average poverty rate is 41%. In comparison, data from 2018 suggests that approximately 8.6% of the world’s population lives in extreme poverty.

With such high rates of poverty, it is estimated that less than 50% of Africans have access to modern healthcare facilities. In 2009, sub-Saharan Africa spent only 6.1% of its GDP on healthcare. For the majority of African countries, less than 10% of their GDP goes toward health expenditures. The continent consequently has the highest mortality rates in the world and is the sole continent in which deaths from chronic diseases are outnumbered by deaths from infectious diseases.

J&J’s Africa Innovation Challenge aims to alter these statistics and improve healthcare in Africa through science-based initiatives. After naming three Africa Innovation Challenge winners in 2017, J&J launched the Africa Innovation Challenge 2.0 in 2018. This time, the six challenge categories were “botanical solutions,” “packaging innovations,” “mental health,” “health worker support,” “digital health tools” and “essential surgical care.” J&J announced six winners, who each received up to $50,000 in funding. These are the nine companies that have won the Africa Innovation Challenge since its launch in 2016.

Winners of the Africa Innovation Challenge

  1. 2017 winner SaCoDé makes washable and re-wearable pads that tie around the waist for girls and women in Burundi. The pads prevent infection among the many Burundian women who cannot afford disposable pads. Since winning the Africa Innovation Challenge, SaCoDé has opened two new manufacturing locations and created jobs for 20 women in Burundi.
  2. 2017 winner Innov Asepsis makes hands-free faucets. There is an approximately 60% chance of contracting an infection from unclean faucet handles in Uganda, but these hands-free faucets reduce the risk of infection by eliminating contact. PedalTaps fit onto existing sinks to reduce the spread of diseases related to faucet handles.
  3. 2017 winner J-Palm is a makeup and skincare brand made from cold-pressed palm oil. Makeup products imported into Liberia are affordable and popular but are often made with chemicals that may be toxic. J-Palm addresses this issue by providing customers with affordable, safe makeup products. The company supports local farmers and has created 330 new jobs in Liberia.
  4. 2019 winner LifeBank is a digital platform with the goal of increasing safety, efficiency and efficacy in Nigeria’s blood supply chain. Approximately 8% to 14% of HIV cases in Nigeria are a consequence of poor safety and regulatory measures in the blood donation system. LifeBank works to deliver the necessary blood for transfusions to Nigerian hospitals in less than 45 minutes to improve the quality of the blood supply chain.
  5. 2019 winner The Hope Initiative uses a validated metric to measure “hope among nurses and mothers” in Rwanda and to “understand how hope intersects with healthcare worker burnout and perinatal health outcomes,” according to the J&J website. An estimated 50% of healthcare workers are classified as “high risk” for experiencing burnout. Based on demonstrated research that hope decreases burnout, The Hope Initiative’s goal is to diminish burnout among emergency care workers by identifying the “interventions that positively influence hope.”
  6. 2019 winner Dreet is a Botswanan phone application that uses hearing device tests and remotely connects children in rural Africa to healthcare professionals. Approximately 67% of the world’s hearing-impaired population resides in developing countries. The Dreet application helps families navigate life with a hearing-impaired child while working to mitigate high or unnecessary healthcare expenses.
  7. 2019 winner Crib A’ Glow is a “solar-powered, foldable phototherapy crib provided to hospitals, health centers and parents” in communities across Nigeria to treat infant jaundice, according to the J&J website. Infant jaundice most commonly occurs when babies’ livers have not matured sufficiently in order to remove a chemical compound called bilirubin from the bloodstream. An estimated 6 million babies worldwide do not receive treatment for jaundice. Left untreated, jaundice can cause hearing loss, developmental issues, cerebral palsy and, in some cases, death. Crib A’ Glow helps to give poor infants a chance.
  8. 2019 winner Uganics manufactures mosquito-repelling soap that is both affordable and organic. Africa has the world’s highest rates of malaria transmission. In 2018, the continent was home to 93% of the world’s malaria cases and 94% of malaria-related deaths. Sixty-seven percent of those deaths were children. Uganics’s soap helps prevent malaria from spreading in Uganda.
  9. 2019 winner M-SCAN aims to help pregnant women in rural Ugandan communities who do not have access to ultrasounds. The company’s device uses a portable probe and smartphone, laptop or tablet to perform ultrasounds. This device helps healthcare professionals and/or midwives prepare for any risks that may arise during delivery.

The winning companies, or “Champions of Science,” have helped increase healthcare access among Africa’s poor while also improving healthcare safety. Through J&J’s Africa Innovation Challenge, these sustainable solutions to public health problems have also created jobs, providing workers with stable incomes and helping boost countries’ economies. By expanding support and funding for public health innovations, companies, organizations and governments can continue to “champion” change.

– Zoe Engels
Photo: Flickr

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DREAMS Fights Against AIDS

DREAMS Fights Against AIDS
Today, approximately 36.9 million people are living with HIV globally and 25 percent of that number do not even know their status. Of those millions, HIV infects about 1,000 young girls and women each day and accounts for 74 percent of new HIV infections among adolescents in sub-Saharan Africa. HIV/AIDS continues to be at the forefront of global public health issues in the world today and appears to be most prevalent in low and middle-income countries. However, the organization DREAMS fights against AIDS and initiatives like the United States President’s Emergency Plan for AIDS Relief (PEPFAR) is helping it accomplish its goals.

What is PEPFAR?

PEPFAR emerged in 2003 and has received strong support ever since, resulting in the United States becoming a global leader in the response to the HIV/AIDS epidemic and PEPFAR being a model for development programs around the world. PEPFAR has helped transform the response to HIV/AIDS by working with over 50 countries, as well as causing a significant decline in new HIV diagnoses among young girls and women through the DREAMS partnership.

The DREAMS Partnership

DREAMS is a public-private partnership between PEPFAR, the Bill and Melinda Gates Foundation, Girl Effect, Johnson & Johnson, Gilead Sciences and ViiV Healthcare to implement an ambitious HIV/AIDS reduction program. This initiative launched in 2014 on World AIDS Day and targets 10 African countries in which 65 percent have extremely high HIV rates, especially among young girls and women. This movement aims to support affected women, as well as prevent any further spreading of HIV/AIDS. It has resulted in the integration of DREAMS activities into the plans of the involved countries.

The DREAMS Impact

The DREAMS organization fights against AIDS in 10 countries including Kenya, Lesotho, Malawi, Mozambique, South Africa, Swaziland, Tanzania, Uganda, Zambia and Zimbabwe. These countries’ populations account for more than half of all new HIV infections that occurred in young girls and women globally in 2015.

DREAMS’ plan consists of multiple solutions surrounding the main problem of the HIV/AIDS epidemic in the world. It delivers a package that combines evidence-based approaches addressing structural drivers that directly and indirectly increase the risk of HIV in girls, such as poverty, gender inequality, sexual violence and a lack of education. More specifically, this comprehensive package of interventions has four focus groups including educating girls and young women through a range of activities to prevent their risk of HIV and violence, targeting men and boys within the community for treatments, strengthening families through social protection programs and the implementation of parenting programs related to adolescent HIV risk and shifting norms to mobilize communities and change to prevent violence and the further spread of HIV/AIDS.

Currently, 80 percent of young girls and women ranging from 15 to 24 years old and living with HIV are in sub-Saharan Africa. By the end of 2016, new HIV incident recordings in young girls and women decreased by 25 percent in the hardest-hit countries and further reduced by 40 percent by the end of 2017.

The DREAMS Innovation Challenge

While DREAMS has made significant progress since its formation, HIV/AIDS is still infecting an alarming number of young girls and women every day. Fifty-five organizations won the DREAMS Innovation Challenge and are now implementing solutions in six main focus areas such as strengthening leadership and capacity of community-based organizations (such as nonprofit or grassroots organizations) to support the expansion of intervention, ensuring girls’ access and smooth transition into secondary school, creating new methods to engage men in HIV testing and counseling and treatments, supporting pre-exposure interventions, providing employment opportunities to young women to decrease their risk of exposure to HIV and increasing the availability and use of data to inform, increasing impact and further producing innovative solutions.

Selected solutions resulting from this challenge were those that introduced new innovations in the 10 countries where DREAMS fights against AIDS. It also offers sustainable, long-lasting solutions and countries can implement them rapidly within two years. More than 60 percent of the challenge winners are small, community-based organizations that not only received funding but also became new PEPFAR partners.

Continuing on its innovative path to preventing and reducing the spread of HIV/AIDS, PEPFAR recently announced its investment of nearly $2 billion to empower and support women and girls, with it channeling nearly $200 million through the DREAMS partnership. This will allow more girls to avoid contracting HIV at birth, keep more adolescents HIV free and support vulnerable women and children while treating HIV positive women. Additionally, the partnership has recently grown to provide more than $800 million to 15 African and Caribbean countries since its founding in 2015. PEPFAR has helped 2.4 million babies to be born HIV free from HIV-positive mothers and has saved about 17 million lives through its efforts as DREAMS fights against AIDS. Thankfully, this organization shows no sign of slowing down in the fight against HIV/AIDS for young girls and women around the world.

– Adya Khosla
Photo: Flickr