Posts

tools to prevent cervical cancerCervical cancer continues to be a big problem for developing countries. More than eight out of ten cervical cancer deaths will happen in developing countries, in spite of the fact that the tools to prevent cervical cancer are available now.

How Countries are Addressing the Issue

In May 2018 in Geneva, Gavi the Vaccine Alliance “welcomed the call” issued by the World Health Organization Director-General, Dr. Tedros Adhanom Ghebreyesus, for coordinated action against cervical cancer. The first steps on the path to eliminating cervical cancer are sustainable disease control through significant investments and holistic health systems.

Currently, cervical cancer is projected to overtake childbirth as the leading cause of death among women, especially in low- and middle-income countries. Around the world, 266,000 women and girls die each year as a result of cervical cancer. By 2030, that number could increase to more than 380,000.

Eight Gavi-supported countries have launched the vaccine nationally with 30 countries implementing a demonstration program. Ethiopia and Senegal begin nationwide vaccination in 2018. These countries understand that the tools to prevent cervical cancer are available now.

Battling Cervical Cancer in Developing Countries

Cervical cancer is the third most common cancer worldwide, with 80 percent of cases happening in the developing world. It is the leading cause of death among women in developing countries, where it causes about 190,000 deaths each year. Cervical cancer risk is highest in Central America, sub-Saharan Africa and Melanesia.

A lack of effective screening programs used to detect and lead to treatment of pre-cancerous conditions is the major reason for the much higher cervical cancer occurrence in developing countries. Roughly about five percent of women in developing countries have been screened for cervical dysplasia, compared to 40 to 50 percent of women in developed countries.

Of the total number of cases of cervical cancer worldwide, 99 percent were estimated to contain HPV DNA. HPV virus infects the cells of the cervix and slowly causes pre-cancerous cellular changes (dysplasia) that progress. Women are generally at the highest risk of HPV infection in their teens, 20s or 30s. It can take as long as 20 years after the initial HPV infection for cancer to develop.

Using the Proper Tools to Prevent Cervical Cancer

In many developing countries, treatment options are limited. Cervical lesions are often treated with aggressive approaches like cone biopsies or hysterectomies (removal of the uterus) rather than with appropriate outpatient approaches.

Simple outpatient procedures should be used instead to destroy or remove pre-cancerous tissue. A common outpatient method is cryotherapy; another is a loop electrosurgical excision procedure (LEEP). LEEP does involve more equipment and supplies, but it removes diseased tissue while at the same time providing a specimen for analysis, reducing the possibility of overlooking invasive cancer.

The keys to curing cervical cancer and reducing HPV infections are education, screening and access to vaccines. What is required is the removal of barriers preventing women and girls from accessing the necessary healthcare. From vaccination campaigns to self-administered screenings, many countries are already on the right path to helping stop unnecessary deaths from cervical cancer. The tools to prevent cervical cancer are available now, and women in developing nations have a right to access those tools.

– Gustavo Lomas
Photo: Flickr

Delivering Vaccines to Developing CountriesIn the developed world, vaccines are readily available: they are kept refrigerated until they are needed in a doctor’s office or in a hospital. Unfortunately, delivering vaccines to developing countries is a big issue that needs to be addressed. Nanoly, a bioscience company, hopes to address the issue of vaccine transportation without refrigeration, through the use of its revolutionary polymer called NanoShield.

The proteins within a vaccine need to have a controlled environment to survive, thus, controlling storage temperature is the most important factor. The polio, measles and tetanus vaccines all need to be kept within a 35-45 degrees Fahrenheit temperature. These are also some of the most important vaccines that developing countries need.

If the vaccines are not stored in that temperature range, the proteins in the vaccine cease to function, rendering the vaccine useless.

The current “cold chain” method of delivering vaccines to developing countries requires the use of a chain of cold storage units that maintain the optimal temperature for vaccines during transport. However, the cold chain becomes difficult to maintain when it gets closer to rural areas due to the lack of electricity.

Nanoly’s creation is a new way to keep the vaccines temperature regulated and is more reliable than the cold chain. By blending the proteins with NanoShield, the polymer protects the proteins in the vaccines from outside temperatures.

During tests with high temperatures over a two week period, vaccines with NanoShield had an 88 percent efficacy rate while vaccines without it had only an 18 percent efficacy rate. The NanoShield protected the proteins and a large number of the vaccines were still usable. NanoShield can be applied to anti-viral vaccines, antibody drugs and therapeutics to help keep the temperature regulated.

It seems that there are also no adverse reactions to the polymer as well. Not only does the polymer protect the proteins from deteriorating due to high temperatures, it also does not need to be removed to administer the vaccine.

Delivering vaccines to developing countries can be difficult due to the lack of electricity. Thanks to Nanoly and their NanoShield polymer, delivering the vaccines becomes much more viable.

Developing countries need these vaccines to help protect their citizens from diseases like polio and measles. Nanoly can potentially save millions of lives thanks to the polymer they have developed.

Daniel Borjas

Photo: Flickr

Vaccines in UgandaUganda is an African country that has made huge strides in recent years in terms of vaccination and immunization coverage. Vaccines in Uganda have become more available to children in the last two decades and new vaccines have been developed and implemented into the country’s routine programs. Despite this, coverage for certain diseases still lags behind other African countries. Here are eight facts about vaccines in Uganda:

  1. In 2012, Uganda launched a nationwide HPV vaccine to help fight the country’s most common form of cancer. Cervical cancer is three times more common in Uganda than the global average. Uganda’s Ministry of Health helped roll out the new vaccine program, launching in several different school districts to raise awareness about the disease.
  2. Uganda achieved 90 percent child immunization coverage for certain diseases in 2014, and since then, coverage has risen to as high as 98 percent.
  3. The last polio case was seen in Uganda in 2010. Uganda plans to fully eradicate the disease by 2018, and will replace the oral polio vaccine with a more effective injectable one using a $1.5 million grant from the Ministry of Health.
  4. Uganda experienced a Yellow Fever outbreak in April of 2016, with 30 confirmed cases and seven deaths. The country’s rapid response team collected samples, confirmed cases and collected and referred samples to the Uganda Virus Research Institute to help quell the spread of the disease. Uganda is located on the “Yellow Fever belt” of Africa and is a high-risk country for transmission of the Yellow Fever virus.
  5. In 2014, Uganda introduced a pneumococcal conjugate vaccine to stave off pneumonia in both childhood and adulthood. Despite increased introduction of vaccines in Uganda, diseases like pneumonia and tuberculosis remain a threat due to under-immunization.
  6. DTP3 coverage in Uganda has increased by 14 percent in the last 11 years, from 64 percent to 78 percent. Uganda aims to achieve 80 percent DTP3 coverage, though they have struggled to increase coverage in recent years and lag behind other African countries such as Kenya.
  7. Over 90 percent of Uganda’s immunization programs are funded by donors and nonprofit organizations. One of the organizations with the strongest impact has been the Global Alliance for Vaccines and Immunization (GAVI). They have contributed more than $300 million since 2000.
  8. Thanks to a new rotavirus vaccine, Uganda estimates 70,000 lives will be saved and over 300,000 hospital admissions may be avoided between 2016 and 2035.

After revamping its vaccination program in the early 2000s, Uganda has made significant progress in curbing the spread of disease. While there are still areas to be improved, vaccines in Uganda have saved thousands of lives thus far and have improved the health of the country.

Nicholas Dugan

Photo: Flickr

Mother_Newborn_Poverty
Maternal and neonatal tetanus or MNT is responsible for the deaths of 50,000 babies a year in developing countries. So, Kiwanis International joined the United Nations Children’s Fund (UNICEF) to eliminate this disease with the Eliminate Project. In June 2010, Kiwanis announced the Eliminate Project at the 95th Annual Kiwanis International Convention and pledged to eliminate MNT from mothers and newborns in poverty by 2015.

The Eliminate Project’s goal is to raise money for vaccinating pregnant women whose babies might be at risk of MNT. MNT is caused by bacteria found in the soil of developing countries. The disease spreads through unhygienic birthing practices and causes intense pain to the newborn, killing the baby within five to six days.

However, MNT is easily preventable if the mother takes three doses of the Tetanus Toxoid-Containing Vaccines (TTCV). The solution is cost-effective too; the total cost of these doses is only $1.80.

UNICEF has made excellent progress to combat this disease with 90 percent of its funds going directly to the cause. Kiwanis has also made progress by raising $110 million for the Eliminate Project with many fundraising projects. According to the World Health Organization, the number of newborns in poverty dying of neonatal tetanus went from 787,000 in the late 1980s to only 34,019 in 2015.

Kiwanis and UNICEF have been successful in decreasing the prevalence of the disease in a number of countries, but there is still more work to be done. There are mothers and babies in 19 countries in Africa, Asia, Europe and North America who are contracting the disease with little to no healthcare. On a positive note, there are 13 countries that scheduled immunization campaigns in 2016, and Kiwanis clubs around the world are relentlessly raising money to eliminate MNT once and for all.

Emma Majewski

Photo: Flickr

Health
Discussions on global health often focus on the challenges still faced. Undeniably, there is still a lot of work to do to fight diseases and to ensure that everyone has the chance to lead a healthy life, but the progress made is often overlooked. The last few decades have seen many advances in medicine and technology, along with greater commitment to address global health issues. Is this paying off?

These are the improvements in global health made in the last 25 years:

  • Global life expectancy has increased by six years – from 66 to 72 years. In 1991, only 57 percent of newborns lived in countries where they could expect to reach their 60th birthdays. In 2015, 84 percent of newborns could expect to reach their 60th birthday and five percent could even reach their 80th birthday.
  • There has been a huge decline in childhood deaths. In 1991, more than 12 million children under the age of five died; in 2015 this is down to just under six million.
  • Several medical breakthroughs were made, including rapid diagnostic tests for malaria, antiretroviral drugs to manage HIV, the MenAfriVac that protects against meningitis A in sub-Saharan Africa and the Ebola vaccine.
  • Vaccines have played a big part in controlling infectious diseases such as measles, rubella, whooping cough, tetanus, diphtheria and polio. One example of the impact of vaccines is the progress that has been made in eradicating polio. In 1991, there were more than 13,000 cases of polio; in 2015 this was down to only 74 cases.
  • Even the diseases we are still struggling with, like malaria, are causing fewer deaths due to better prevention and control measures. Malaria mortality rates have fallen by 29 percent globally since 2010.

If you are interested to see what improvements in global health have happened in your lifetime, visit Mosaic Science.

Helena Jacobs

Photo: Flickr

DroneDeploying unmanned drones in low and middle-income countries could save money and increase vaccination rates, according to new research conducted by the Johns Hopkins Bloomberg School of Public Health and the Pittsburgh Supercomputing Center.

Many low- and middle-income countries struggle to deliver lifesaving vaccines to sick people who are fighting preventable diseases.

Bruce Y. Lee, director of operations at the International Vaccine Access Center at the Bloomberg School says “[We] make all these vaccines but they’re of no value if we don’t get them to the people who need them. So there is an urgent need to find new, cost-effective ways to do this.”

Currently, vaccines such as hepatitis B, tetanus, measles and rotavirus are typically transported by road through two to four storing sites before they reach clinics where the doses are finally administered to patients. The majority of vaccines require refrigeration until they are used or else they will spoil.

In addition, non-vaccine costs of routine immunization are expected to rise between 2010 and 2020, mostly derived from supply chain logistics.

In the meantime, unmanned drones have proliferated. They can traverse all land and topography, decrease labor costs and substitute the need for vehicle transportation. They have been heavily used for surveillance and in humanitarian aid delivery.

A study conducted at Johns Hopkins University found that utilizing drones to transport vaccines to their final destination could slightly increase the rate of immunization, immunizing 96 percent of the target population as compared to 94 percent using land-based transport. This simultaneously produced significant savings, eight cents for every dose administered (roughly 20 percent savings).

“Assuming the drones are reliable, are capable of making the necessary trips and have properly trained operators, they could be a less expensive means of transporting vaccines, especially in remote areas,” says Lee. He adds, “They could particularly be valuable for urgent orders.”

An initiative led by the United Parcel Service Foundation and Gavi, the Vaccine Alliance, has raised $800,000 grant to support the launch of a zip line drone project in Rwanda that will commence later this year. The government of Rwanda will use zip line drones to make 150 life-saving blood deliveries per day to 21 transfusing facilities in western part of the country.

According to Dr. Seth Berkley, CEO of Gavi, the Vaccine Alliance, “It is a totally different way to deliver vaccines to remote communities and we are extremely interested to learn if UAVs can provide a safe, effective way to make vaccines available for some of the hardest-to-reach children.”

The Rwanda drone network has been initially focused on delivering blood supplies, but plans to expand to include vaccines and treatments for HIV/AIDS, malaria and tuberculosis.

In rural Virginia, Bhutan and Papua New Guinea, drones are currently being tested for medical supply deliveries. UNICEF is also testing their viability of use in Malawi and in Tanzania.

Sarah Poff

Photo: Pixabay

Vaccines_are_an_Economic_Investment
In addition to preventing serious illnesses, vaccines are an economic investment as they have the added bonus of saving money. As fewer people get sick, this reduces the need for complex and often long-term medical treatment which allows communities to save greatly.

Research from the Johns Hopkins Bloomberg School of Public Health, in addition to other studies, has shown that the returns on vaccines are 16 times the investment; that is to say, every dollar spent on vaccines, on average, saves sixteen dollars in future medical spending.

The journal Health Affairs, which published the Johns Hopkins study, noted that when other factors are considered beyond direct medical costs, such as time not taken off from work due to illness, the return rises to as high as $44 for every dollar spent.

While the economic benefits of vaccinations are great for every country, they especially matter in poor or developing countries, where funds are often stretched thin and accessing affordable health care can be difficult if not impossible.

The World Health Organization estimates that malaria costs Sub-Saharan Africa $100 billion every year. In a region plagued by poverty, that is too much money for countries to be spending on preventable diseases.

Vaccines show that when we invest in prevention, we can make huge savings on treatment. In turn, the money that would be spent treating preventable diseases can go to other places, such as to education, poverty reduction schemes or energy programs.

Vaccines are an economic investment that not only saves lives, they save money in so many ways, not just treatment costs.

When people are sick with a debilitating illness, not only do they spend money for treatment, they lose money when they cannot work resulting in a vicious cycle of economic hardship. Continued increased access to vaccines can help millions around the world.

Emily Milakovic

Photo: U.N. Multimedia

MenAfriVacOn Feb. 22, 2016, vaccine experts from all over the world convened in Ethiopia with leaders from the 26 African “meningitis belt” countries to celebrate the success achieved by MenAfriVac, a vaccine created for use in Africa.

The vaccine was developed specifically for Africa and targets meningococcal A meningitis, a bacterial infection of the thin lining surrounding the brain and spinal cord. Meningitis is a highly-feared disease due to its capacity to kill its host within hours. Survivors often experience permanent hearing loss, paralysis or even mental retardation.

“We have achieved something truly historic with MenAfriVac®—creating an affordable, effective, tailor-made vaccine for Africa,” said Steve Davis, president and CEO of PATH, a nonprofit global health organization.

According to PATH, more than 90 percent of meningitis epidemics in Africa attacked mostly infants, children and young adults. To zero in on this specific cause of meningitis, PATH partnered with the Meningitis Vaccine Project and the World Health Organization (WHO).

In the five years that MenAfriVac has been in effect, 235 million children and adults have been vaccinated. From 250,000 cases during an epidemic from 1996 to 1997, to only 80 confirmed cases in 2015, the vaccine has effectively protected millions of people.

However, a resurgence is possible within 15 years if an immunization program is not implemented permanently. Several countries applied for funding to begin implementing MenAfriVac into their national childhood immunization programs. Gavi, a global health partnership that focuses on vaccines, has spent $367 million campaigning and stockpiling the vaccine since 2008 to support these countries.

“Meningitis A was a scourge across Africa’s meningitis belt for generations but today we can be proud that a safe, effective meningitis vaccine is protecting hundreds of millions of people from death and disability,” said Dr. Seth Berkley, Gavi CEO. “But we must not be complacent. It is critical that at-risk countries begin introducing this vaccine into their routine schedules and ensuring every child is reached and protected.”

This achievement could not have been possible without the vital partnerships that contributed to the development of the vaccine. U.S. agencies financially supported MenAfriVac, provided technical expertise and participated in clinical studies of the vaccine.

Continued partnerships could lead to solutions for other diseases around the world and have a positive impact on global health.

Emily Ednoff

Sources: Gavi, PATH
Photo: Flickr

 

Polio_Eradication
On March 27, 2014, the World Health Organization (WHO) certified that the South-East Asia region, home to a quarter of the world’s population, was polio-free.

The beginning of the WHO Global Polio Eradication Initiative (GPEI) in 1988 was faced with 350,000 cases of poliovirus infections, in 125 countries worldwide. This 2014 achievement now means 80 percent of the world’s population is polio-free.

Mass immunization efforts are the most effective when dealing with the spread of the poliovirus. In the Horn of Africa, it has been over one year since the last reported case of Polio due to the synchronized efforts to vaccinate every child with the oral polio vaccine (OPV).

The June 2015 Horn of Africa outbreak assessment deduced that poliovirus transmission has been interrupted.

Nigeria is currently the last country in Africa with the poliovirus, however they are making progress. In 2013 there were 49 reported cases of polio, however this year Nigeria has reported only six cases.

This dramatic drop in poliovirus infection is due to the OPV for type 1, 2 and 3 polioviruses. Vaccines are also administered to children of all ages and even at birth.

In February 2015 the Inactive Polio Vaccine (IPV) was introduced into the immunization program. It is predicted that by September 2015, Nigeria could be removed from WHO’s list of polio-endemic countries.

Poliovirus lives in an infected person’s throat and intestines and is spread through feces especially in unsanitary environments. Even though some persons infected with the poliovirus do not show any symptoms they can still pass on the virus. Moreover, there is no cure for polio which is why immunization is the most effect method to stop the spread of polio.

Marie Helene Ngom

Sources: World Health Organization South-East Asia, Scientific American, The Atlantic, World Health Organization Africa, Center for Disease Control and Prevention
Photo: Polio Eradication

New Ebola Vaccine Kills Virus in Monkeys

A recent study published by the Journal of Clinical Investigation has reported that a new prototype aerosol Ebola vaccine was found to successfully neutralize the deadly virus within monkeys during clinical test trials.

The study, led by Dr. Michelle Myer and conducted collaboratively by the National Institutes of Health and the University of Texas Medical Branch in Galveston, determined that the experimental vaccine activated immune cells within the respiratory system that subsequently provided full protection against the virus. The study also notes that this is the first time researchers have attempted to use an aerosol vaccine within monkeys to fight a hemorrhagic viral fever such as Ebola.

Co-author of the study Dr. Alexander Bukreyev, a medical virologist from the University of Texas Medical Branch in Galveston, recently stated, “This is one of the few vaccines that works. The initial several decades of attempts to develop a vaccine against the Ebola virus were unsuccessful.”

Vaccination researchers within the medical community have become familiar with the notion of failure, as an experimental drug designed to treat Ebola patients proved ineffective in fighting the virus. The experimental drug, known as TKM-Ebola-Guinea, was designed by Tekmira Pharmaceuticals and reportedly was, “Not likely to demonstrate an overall therapeutic benefit,” for patients infected wit Ebola.

The drug was designed to utilize RNA interference, a process in which the functions of certain genes within the Ebola virus are disrupted and subsequently renders the virus incapable of attacking human cells. Prior to the failure of the trials within human subjects, many researchers considered the experiment the single most promising lead in the race to stop Ebola, as the drug had proved effective in stopping the virus in monkeys during clinical test trials

Since the unprecedented outbreak of the disease in West Africa last year, the virus is estimated to have killed over 11,000 people and infected an additional 27,000 people in the nations of Sierra Leone, Liberia and Guinea, according to the World Health Organization .

As the aerosol vaccine does not require the assistance of trained medical professionals, the distribution of the vaccine within developing regions that lack adequate health infrastructures and large personnel staffing will prove to be notably less challenging. Dr. Igor Lukashevich, a medical virologist from the University of Louisville, recently argued that, “This aerosolized form of the vaccine is really what the field needs right now. The discussion […] right now is if this Ebola outbreak will be some kind of game changer for vaccine development, or will it only be one more scare that will be forgotten.”

Dr. Meyer explained in a recent interview that human cells “in the lungs are acting as the first barrier for protection. That’s ideal to combat the virus at the site of the infection.”

Four of the monkeys used for the study were given a single dose of the vaccine, while an additional four were given two doses of the vaccine. Two other monkeys were given a liquid form of the vaccine, while two more monkeys were not vaccinated in order to serve as controlled variables for the study. Four weeks after the administration of the vaccines, all 12 of the monkeys were administered 1,000 times the fatal dose of the Ebola virus.

Two weeks after the injection of the Ebola virus into the test monkeys, all of the vaccinated monkeys had remained healthy while the two unvaccinated monkeys became infected with the disease and were euthanized.

Dr. Daniel Bausch, a medical virologist of Tulane University, noted that the study was “a positive step forward,” but cautioned that “it’s not a breakthrough or ‘Eureka!’”

The success of the aerosol vaccine during the clinical trials on the monkeys indicates the next step will now be for testing to begin on humans in the coming months.

James Thornton

Sources: New York Times 1, New York Times 2, MB
Photo: Red Orbit