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EU to crack down on inequality of MS treatment
Newsdesk Gates Foundation gives $27 million to fight Japanese encephalitis vaccine in which the virus’ structural proteins are inserted into the yellowfever-vaccine backbone. Jacobson says the programme will look at some of
Rights were not granted to include this image in electronic media. Please refer to the printed journal. Bill and Melinda Gates award $27 million grant
these second-generation vaccines to see if they can be made available throughout Asia. “This is good news”, Solomon told The Lancet Neurology. “It gives us an opportunity to ensure that vaccines currently available are better utilised, and also to try and ensure that newer vaccines reach the people that really need them—children in poor rural areas of Asia.” The other two goals are the introduction of the vaccine into the routines of various nations’ healthcare systems, and advocacy because the disease “is so poorly recognised”.
AP Photo/ED Bailey
A 5 year, $27 million grant from the Gates Foundation will be used to tackle Japanese encephalitis—a mosquito-borne disease that has been spreading throughout Asia, including areas of Nepal, that had not been affected for decades. Four goals are outlined in the programme, according to director Julie Jacobson (Program for Appropriate Technology in Health, Seattle, Washington, USA). The first goal is surveillance, which Jacobson says is “terrible”. Only 40% of countries report figures, which total 50 000 cases per year. But, Jacobson says, “we know they’re not even the tip of the iceberg”. There is no commercially available diagnostic test, and the programme plans to develop one for use where the virus is endemic. The programme will also improve the vaccines, Jacobson says. The original vaccine, developed in 1941, is derived from mouse brain, is very expensive (requiring three doses at $3–5 per dose) and has a questionable side-effect profile. Tom Solomon (University of Liverpool, UK) notes that there is also a live attenuated vaccine, developed in China, and newer vaccines, including a chimeric
The virus—a cousin of other flaviviruses such as yellow fever, dengue fever, and West Nile virus— was first isolated in 1871. The illness begins with fever, malaise, and headache, which last 2–3 days. Children then develop seizures and specific neurological symptoms that can include fine-motor disability, behavioural problems, and blindness, depending on which areas of the brain are affected. Most children will be left with residual deficits. “It’s just a really severe disease”, says Jacobson. “70% of kids who get it either have a lifetime disability or die. That’s why something needs to be done.” In India, the disease is known as “brain fever” and has a seasonal peak in November and December. It has been spreading westwards from the eastern regions, according to Mandavilli Gourie-Devi (Sir GangaRam Hospital, New Delhi, India), who told The Lancet Neurology that any new vaccine should be low-cost, free from side-effects, available in large amounts, and “ideally should require as few injections as possible”. Ivan Oransky
EU to crack down on inequality of MS treatment On Dec 18, 2003, the European Parliament (EP) approved a report that urges European Union (EU) health authorities to guarantee equal access to treatments for people with multiple sclerosis (MS) across the union. In the report, Multiple sclerosis and its treatment in the different member states of the European Union, Uma Aaltonen, a member of the EP who herself has MS, reviews treatment and services for people with MS in Europe. Finland and Denmark are among the most advanced in their approach. Finland, which has 6000 people with MS out of a population of 5·2 million, has numerous multidisciplinary teams, as well as
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national guidelines and a “best practice” programme. By contrast, in Italy—where there are 52 000 patients with MS—only 8% of 200 neurological centres provide an interdisciplinary approach and no specialised long-term care is available. Aaltonen notes that the most common problem across the EU (which has around 400 000 people with MS) is the provision of suitable long-term accommodation and housing for younger patients. The report calls for a Europewide epidemiological study funded by the EU to be done in cooperation with WHO as a “matter of urgency” and stresses the need to foster advanced research through inter-
national, particularly transatlantic, cooperation, especially in the study of genetics. It also calls upon the European Commission to create a “Code of Best Practices” to be followed in all EU countries and urges them to promote the development of specialised clinics and nursing homes so that young people with MS are not simply institutionalised in centres housing geriatric patients. The report also recommends the essential professional training of neurologists and hospital staff and calls for a debate on the subject to be placed on the agenda of a forthcoming meeting of EU Health Ministers. Xavier Bosch
THE LANCET Neurology Vol 3 February 2004
http://neurology.thelancet.com
For personal use. Only reproduce with permission The Lancet Publishing Group.
Rights were not granted to include this image in electronic media. Please refer to the printed journal. Bill and Melinda Gates award $27 million grant
these second-generation vaccines to see if they can be made available throughout Asia. “This is good news”, Solomon told The Lancet Neurology. “It gives us an opportunity to ensure that vaccines currently available are better utilised, and also to try and ensure that newer vaccines reach the people that really need them—children in poor rural areas of Asia.” The other two goals are the introduction of the vaccine into the routines of various nations’ healthcare systems, and advocacy because the disease “is so poorly recognised”.
AP Photo/ED Bailey
A 5 year, $27 million grant from the Gates Foundation will be used to tackle Japanese encephalitis—a mosquito-borne disease that has been spreading throughout Asia, including areas of Nepal, that had not been affected for decades. Four goals are outlined in the programme, according to director Julie Jacobson (Program for Appropriate Technology in Health, Seattle, Washington, USA). The first goal is surveillance, which Jacobson says is “terrible”. Only 40% of countries report figures, which total 50 000 cases per year. But, Jacobson says, “we know they’re not even the tip of the iceberg”. There is no commercially available diagnostic test, and the programme plans to develop one for use where the virus is endemic. The programme will also improve the vaccines, Jacobson says. The original vaccine, developed in 1941, is derived from mouse brain, is very expensive (requiring three doses at $3–5 per dose) and has a questionable side-effect profile. Tom Solomon (University of Liverpool, UK) notes that there is also a live attenuated vaccine, developed in China, and newer vaccines, including a chimeric
The virus—a cousin of other flaviviruses such as yellow fever, dengue fever, and West Nile virus— was first isolated in 1871. The illness begins with fever, malaise, and headache, which last 2–3 days. Children then develop seizures and specific neurological symptoms that can include fine-motor disability, behavioural problems, and blindness, depending on which areas of the brain are affected. Most children will be left with residual deficits. “It’s just a really severe disease”, says Jacobson. “70% of kids who get it either have a lifetime disability or die. That’s why something needs to be done.” In India, the disease is known as “brain fever” and has a seasonal peak in November and December. It has been spreading westwards from the eastern regions, according to Mandavilli Gourie-Devi (Sir GangaRam Hospital, New Delhi, India), who told The Lancet Neurology that any new vaccine should be low-cost, free from side-effects, available in large amounts, and “ideally should require as few injections as possible”. Ivan Oransky
EU to crack down on inequality of MS treatment On Dec 18, 2003, the European Parliament (EP) approved a report that urges European Union (EU) health authorities to guarantee equal access to treatments for people with multiple sclerosis (MS) across the union. In the report, Multiple sclerosis and its treatment in the different member states of the European Union, Uma Aaltonen, a member of the EP who herself has MS, reviews treatment and services for people with MS in Europe. Finland and Denmark are among the most advanced in their approach. Finland, which has 6000 people with MS out of a population of 5·2 million, has numerous multidisciplinary teams, as well as
74
national guidelines and a “best practice” programme. By contrast, in Italy—where there are 52 000 patients with MS—only 8% of 200 neurological centres provide an interdisciplinary approach and no specialised long-term care is available. Aaltonen notes that the most common problem across the EU (which has around 400 000 people with MS) is the provision of suitable long-term accommodation and housing for younger patients. The report calls for a Europewide epidemiological study funded by the EU to be done in cooperation with WHO as a “matter of urgency” and stresses the need to foster advanced research through inter-
national, particularly transatlantic, cooperation, especially in the study of genetics. It also calls upon the European Commission to create a “Code of Best Practices” to be followed in all EU countries and urges them to promote the development of specialised clinics and nursing homes so that young people with MS are not simply institutionalised in centres housing geriatric patients. The report also recommends the essential professional training of neurologists and hospital staff and calls for a debate on the subject to be placed on the agenda of a forthcoming meeting of EU Health Ministers. Xavier Bosch
THE LANCET Neurology Vol 3 February 2004
http://neurology.thelancet.com
For personal use. Only reproduce with permission The Lancet Publishing Group.