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WHA takes on bioterrorism and poverty
Newsdesk WHA takes on bioterrorism and poverty This year’s World Health Assembly (WHA; May 13–18) agreed on the need for more concerted action against new threats such as bioterrorism as well as more traditional communicable diseases. As expected, the WHA endorsed a recommendation by WHO’s executive board to drop the 2002 deadline for destruction of remaining variola virus stocks to continue research into new smallpox vaccines. It called on the WHO Director-General, Gro Harlem Brundtland, to report annually on progress in research, but stopped short of setting a new target for the destruction of the virus, despite misgivings by China and several other countries about the risks of retention of the stocks at secure laboratories in the USA and Russia. “The recent terrorist attacks on the United States have confirmed that the intentional release of smallpox is not a remote possibility’’, said US Health Secretary Tommy Thompson. The assembly heard how WHO has stepped up its preparedness against the
deliberate use of biological and chemical agents, mainly by trying to improve channels to deal with naturally occurring infectious disease outbreaks and strengthening the diagnostic capabilities of laboratories around the world. In her address, Brundtland drew attention to public health progress through new global initiatives on AIDS, tuberculosis, malaria, and vaccinations. “These encouraging developments are just a start. We need continued reduction in prices of medicines and other commodities, and expansion of quality services to the millions in need. We must scale up our effort even if the struggle seems beset with political and institutional minefields”,Brundtland said. Non-governmental groups joined forces to demand that WHO take a higher profile in the debate on access to essential medicines and be more confrontational towards pharmaceutical companies over pricing. “WHO must help set the research agenda for diseases that have fallen off
the radar screen of private industry and received little attention from public research institutes’’, said Médicins Sans Frontières, calling for greater action into “neglected diseases’’ such as leishmaniasis, sleeping sickness, and Chagas disease (see p393). WHO officials dismissed criticism that it was falling short in its public health advocacy role. David Nabarro, director of Brundtland’s office, said that this year’s assembly bore no comparision with the “boring and irrelevant’’ events he first attended in the late 1980s. “At that time I was working as a medical officer in Nepal and it was like coming from the moon to earth, the issues we were dealing with there and what was discussed here. But as the assemblies have gone by, the focus has become much more on real issues faced by real people—eg, care for people with AIDS, completing the eradication of polio. The engagement, the content, and the results are completely different from the sort of assembly 10 years ago’’, he said. Clare Kapp
New goals set for filariasis elimination in India
Science Photo Library
The WHO-sponsored Global Alliance the alliance (New Delhi, May 2–3, to Eliminate Lymphatic Filariasis 2002) heard that 26 million people in (GAELF)—set up in May 2000—has 22 countries were covered by MDA devised a two-pronged in 2001—almost a strategy to eliminate LF ten-fold increase Rights were not through mass drug on 2000. Now, it granted to administration (MDA), has been decided include this and alleviating disabilities to scale up national in acute cases. By elimination proimage in interrupting disease grammes to cover electronic media. transmission it is possible 350 million people Please refer to to eliminate LF. MDA by 2005—a real involves administration of challenge since the printed a single, annual dose of some infected journal. two drugs—albendazole people show no and either diethylsymptoms. “The carbamazine (DEC) or crucial element is ivermectin, to popul- MDA covers symptom-free “at risk”. that the progations “at risk”. Glaxorammes should be SmithKline’s donation of 5 billion owned by national and community tablets of albendazole (worth authorities, otherwise they may not US$1 billion) over the next 20 years succeed”, says Nevio Zagaria (WHO). has reduced the cost of the However, India—with nearly onecombination. third of the global LF burden—is not Delegates at the second meeting of convinced of the MDA approach.
THE LANCET Infectious Diseases Vol 2 July 2002
http://infection.thelancet.com
SP Agarwal (Director-General of Health Services) told the meeting that India should await evaluation of the two-drug regimen before scaling up the MDA programme. According to Agarwal, there is insufficient evidence to show that the albendazole/DEC combination is superior to DEC alone. Citing a study done in Sri Lanka on the efficacy of the combination, Agarwal said that it did not have a “DEC alone” group for comparison. However, Mahroof Ismail (Department of Parasitology, University of Colombo)—principal investigator of the Sri Lankan trials—clarified that a “DEC alone” group was not included since previous studies had shown that DEC/ivermectin combination was superior to DEC alone. The objective of his study was to compare DEC/albendazole combination with DEC/ivermectin. Dinesh C Sharma
389
For personal use. Only reproduce with permission from The Lancet Publishing Group.
deliberate use of biological and chemical agents, mainly by trying to improve channels to deal with naturally occurring infectious disease outbreaks and strengthening the diagnostic capabilities of laboratories around the world. In her address, Brundtland drew attention to public health progress through new global initiatives on AIDS, tuberculosis, malaria, and vaccinations. “These encouraging developments are just a start. We need continued reduction in prices of medicines and other commodities, and expansion of quality services to the millions in need. We must scale up our effort even if the struggle seems beset with political and institutional minefields”,Brundtland said. Non-governmental groups joined forces to demand that WHO take a higher profile in the debate on access to essential medicines and be more confrontational towards pharmaceutical companies over pricing. “WHO must help set the research agenda for diseases that have fallen off
the radar screen of private industry and received little attention from public research institutes’’, said Médicins Sans Frontières, calling for greater action into “neglected diseases’’ such as leishmaniasis, sleeping sickness, and Chagas disease (see p393). WHO officials dismissed criticism that it was falling short in its public health advocacy role. David Nabarro, director of Brundtland’s office, said that this year’s assembly bore no comparision with the “boring and irrelevant’’ events he first attended in the late 1980s. “At that time I was working as a medical officer in Nepal and it was like coming from the moon to earth, the issues we were dealing with there and what was discussed here. But as the assemblies have gone by, the focus has become much more on real issues faced by real people—eg, care for people with AIDS, completing the eradication of polio. The engagement, the content, and the results are completely different from the sort of assembly 10 years ago’’, he said. Clare Kapp
New goals set for filariasis elimination in India
Science Photo Library
The WHO-sponsored Global Alliance the alliance (New Delhi, May 2–3, to Eliminate Lymphatic Filariasis 2002) heard that 26 million people in (GAELF)—set up in May 2000—has 22 countries were covered by MDA devised a two-pronged in 2001—almost a strategy to eliminate LF ten-fold increase Rights were not through mass drug on 2000. Now, it granted to administration (MDA), has been decided include this and alleviating disabilities to scale up national in acute cases. By elimination proimage in interrupting disease grammes to cover electronic media. transmission it is possible 350 million people Please refer to to eliminate LF. MDA by 2005—a real involves administration of challenge since the printed a single, annual dose of some infected journal. two drugs—albendazole people show no and either diethylsymptoms. “The carbamazine (DEC) or crucial element is ivermectin, to popul- MDA covers symptom-free “at risk”. that the progations “at risk”. Glaxorammes should be SmithKline’s donation of 5 billion owned by national and community tablets of albendazole (worth authorities, otherwise they may not US$1 billion) over the next 20 years succeed”, says Nevio Zagaria (WHO). has reduced the cost of the However, India—with nearly onecombination. third of the global LF burden—is not Delegates at the second meeting of convinced of the MDA approach.
THE LANCET Infectious Diseases Vol 2 July 2002
http://infection.thelancet.com
SP Agarwal (Director-General of Health Services) told the meeting that India should await evaluation of the two-drug regimen before scaling up the MDA programme. According to Agarwal, there is insufficient evidence to show that the albendazole/DEC combination is superior to DEC alone. Citing a study done in Sri Lanka on the efficacy of the combination, Agarwal said that it did not have a “DEC alone” group for comparison. However, Mahroof Ismail (Department of Parasitology, University of Colombo)—principal investigator of the Sri Lankan trials—clarified that a “DEC alone” group was not included since previous studies had shown that DEC/ivermectin combination was superior to DEC alone. The objective of his study was to compare DEC/albendazole combination with DEC/ivermectin. Dinesh C Sharma
389
For personal use. Only reproduce with permission from The Lancet Publishing Group.