Displaying 1-20 of 26 key documents
Source: World Health Organization (WHO) | June 2012
This report gives an overview of the last 40 years of work carried out by HRP, the Programme of Research, Development and Research Training in Human Reproduction, which was established in 1972, following a World Health Assembly resolution.
HRP aims to advance sexual and reproductive health. The organisation is the central mechanism within the United Nations system for research into human reproduction — bringing together policymakers, scientists, healthcare providers and community representatives to identify and address priorities for the sexual and reproductive health agenda.
The report highlights key achievements, including helping to prevent mother-to-child transmission of HIV; promoting human rights and gender equality in sexual and reproductive health; and widening access to family planning.
Source: Malaria Journal | April 2012
This review paper explores documented episodes of malaria resurgence worldwide, and assesses their association with malaria control programmes, a higher risk of disease transmission and drug resistance. It identifies 75 instances of resurgence in 61 countries over a period of 70 years, with the vast majority related to weakening control programmes, usually due to limited resources. This suggests that gains in malaria control can be lost rapidly if support is not sustained. The authors argue that finding ways to sustain funding for control programmes is crucial, and that there is an urgent need to develop practical solutions to operational and technical threats to their success.
Source: Working Group on Clinical Trials and Regulatory Pathways | November 2011
This report provides policy recommendations to help deliver safer and cheaper medical products to people suffering from neglected diseases in developing countries, where they are needed the most.
Although more drugs and vaccines are reaching late-stage clinical development, says the report, they are held back by a lack of funding to support clinical trials, as well as clinical research and regulatory capacity in settings where neglected diseases are endemic. This undermines safety and the validity of clinical data.
The report recommends a two-pronged approach to improving the quality and regulation of clinical trials in the developing world: establishing regional regulatory pathways for the oversight of clinical trials, and building quality and cost-efficiency into trial design and implementation. It also recommends practical steps that can be taken by donors, drug and vaccine developers, and regulatory authorities to begin implementing the changes.
Source: Trends in Pharmacological Sciences | March 2010
This paper, co-authored by Paul Newton of the Mahosot Hospital in Laos — who has collaborated closely with INTERPOL in its anti-counterfeiting operations — summarises evidence on the prevalence of counterfeit drugs, and details their medical and economic impact on poor countries. It outlines how the international community can tackle the problem, which the authors say needs to be taken more seriously. Although the trade in counterfeit drugs has obvious health impacts, its indirect effects are no less significant and include a loss of confidence in health systems and health workers.
Source: PLoS Medicine | June 2009
This study documents the chemical composition of drugs randomly sampled from pharmacies in Delhi and Chennai in India, and aims to offer the government guidance on improving drug regulation. India is a major producer and consumer of pharmaceuticals but, with quality control standards varying significantly between states, the country has high levels of counterfeit drugs. The study shows that 12 per cent of Delhi samples and 5 per cent of Chennai samples collected in 2008 and 2009 did not meet international quality standards. Although these numbers roughly match the government's estimates, there were differences between pharmacies in the types of drugs commonly counterfeited. And while some had no fake drugs, others had up to 30 per cent.
Source: Medicines Transparency Alliance (MeTA) | December 2010
This document from the Medicines Transparency Alliance — founded by the World Bank, the WHO and the UK Department for International Development (DFID) — gives an account of a pilot programme that investigated the medicines supply chain to identify problems that prevent vulnerable people from accessing essential medicines. It presents findings from Ghana, Jordan, Kyrgyzstan, Peru, the Philippines, Uganda and Zambia. The programme relied on different stakeholders from government, civil society and the private sector to collect, share and analyse data. The evidence gathered through the project was used to inform policy in these countries.
Source: WHO | December 2010
This report, published by the WHO, collates data obtained over 8 years by WHO assessment teams working in 26 African countries. The teams analysed different aspects of national regulatory systems such as management, funding and quality control procedures. Poor regulatory systems in impoverished nations are often blamed for allowing the spread of counterfeit drugs in the developing world. The report says that although mechanisms for drug regulation existed in every country, and there were guidelines for quality-control inspections, these were often not well executed because of a severe lack of resources and staff.
Source: PLoS ONE | April 2009
Ensuring that traditional medicines are safe and effective is a major challenge. This study uses mathematical models to show that the treatments that become popular through communities and get passed down through generations are not necessarily the most efficacious. Often, ineffective treatments that are based on superstition can spread because, the authors say, their very ineffectiveness means that patients use the treatment for longer than medicine that actually works.
Source: Medical Anthropology Quarterly | March 2010
This article argues that unless the modernisation of traditional medicine in Nepal is treated with care, it could create gender inequalities and the increased social marginalisation of women. Healthcare in Nepal is slowly being modernised to fit more with a model of Western medicine than with traditional Ayurveda. Ayurveda attracts many female practitioners since it is one of the few professions in this patriarchal society in which women are accorded high status.
Source: WHO | May 2005
This WHO report summarises the findings of a global survey on national policy and regulation of traditional medicine in 141 countries. It presents data on existing policies for traditional medicine and regulation of herbal medicines. The report highlights common hurdles to implementing these and provides a profile of each country surveyed.
Source: WHO | March 2005
This study assesses whether traditional medicine can contribute to more affordable global healthcare. It uses flowcharts to map out factors such as healthcare infrastructure and social mores that lead much of the developing world to use traditional medicine, and explains the different medicinal systems in use around the world. The author concludes that traditional medicine is a public health asset, provided it can be sufficiently standardised and verified.
Source: Evidence-based Complementary and Alternative Medicine | October 2005
This review article outlines the basic principles of traditional Chinese and Indian medicine, and the differences in how these are being integrated into national health systems. The authors discuss progress in drug discovery including traditional medicinal plants and the role of supporting industries — from breeders to manufacturers — in commercialising traditional medicine.
Source: Open AIDS Journal
This series of articles considers the questions and conflicts surrounding the use of patent pools for antiretroviral (ARV) treatments for HIV/AIDS.
It provides background to the debate, considers individual proposals including the UNITAID patent pool, and offers regional perspectives on the suitability of patent pools to Africa, China and India.
Source: The American Academy of Microbiology
This report summarises current understanding of antibiotic resistance, the scope of the problem, and the methods available for detecting and preventing it. It highlights unique challenges faced by developing countries including poor research infrastructure and counterfeit antibiotics.
The authors highlight the need to build laboratory capacity, improve diagnostic tools, establish surveillance programs and implement tighter controls on antibiotic use in these countries.
Source: WHO | 2005
This report from the WHO assesses the potential for creating early warning systems for vector-borne disease. It reviews the current state of research for several diseases such as dengue fever, leishmaniasis, malaria and West Nile virus.
The report includes an algorithmic framework for developing early warning systems, outlining data requirements and the different components of the system. It also contains two useful tables: one on the sensitivity of different infectious diseases to climate; and one summarising the existing research, identifying in which region the disease is most common, data availability and proposed actions.
A key problem in developing early warning systems, as highlighted by this report, is that non-climatic risk factors such as population immunity and food security strongly affect the potential for a disease outbreak. Equally challenging is the poor disease surveillance in many developing countries — the authors call on these countries to strengthen these systems, to help in the fight against climate change.
The report concludes that it will be important for researchers not to design these systems in isolation — health policymakers should be included at all stages of the design.
Source: Institute of Medicine | 2008
This extensive report from the Institute of Medicine of the US National Academies takes on the considerable challenge of understanding how, and to what extent, climate change will affect infectious diseases.
The report provides detailed summaries of current knowledge on diseases such as cholera and rift valley fever. Several pages are devoted to reviewing the latest climate science to contextualise the effect on infectious disease; it also includes several maps on climate anomalies to show how they are linked to disease.
One section highlights methods to assess climate change impacts on infectious diseases. These include analyses of historical records; monitoring programs, especially those that track disease in wild animals; and comparisons of satellite-derived environmental measurements with epidemiological data.
The report concludes with an analysis of the challenges facing policymakers. In many cases, it says, the best public health measures against climate change are those that strengthen health systems in general, such as better training for professionals and better disease surveillance. Policymakers will need to move away from the traditional thinking of individual policies for individual diseases, towards a joined-up approach aimed at tackling "systemic, long-term" stresses that cause a range of effects.
Source: The Lancet | October 2008
This series of commentaries and research articles — published by The Lancet, the Peking University Health Sciences Centre and the China Medical Board — addresses China's major health challenges, strategies and future. It has been produced by a group of 63 scientists from 10 countries with Chinese scientists making up two-thirds of the authors.
The research papers give scientific evidence on key health issues including the emergence and control of both infectious and chronic non-infectious diseases in China as well as the performance of China's healthcare system.
Authors of the series' commentaries further discuss a range of topical issues affecting China's health system, including the state of biomedical science and technology (see 'Progress in Chinese biomedicine a massive challenge'), medical research ethics, the lessons learnt from China's schistosomiasis control programme and the challenges the country faces in controlling HIV/AIDS.
Source: Nature Reviews | January, 2004
Vaccination for infectious diseases is a vital method of prophylaxis, and has transformed modern medicine. By contrast, research into vaccines against chronic diseases has been less successful, in part because of the increased complexity involved.
In this opinion piece, the authors outline the prospects for the development of chronic disease vaccines. These might not need to rely on the traditional method of inducing the body to produce antibodies, but rather on introducing monoclonal antibodies against specific proteins — this has so far worked well against Crohn's disease and rheumatoid arthritis.
The authors outline key hurdles in developing a successful therapeutic vaccine. Safety and efficacy are two obvious ones, but there is a third that is unique to vaccines for chronic diseases. Because these vaccines would block bodily chemicals — such as cytokines or hormones — it would not be acceptable for a vaccine to induce a life-long block (unlike a malaria vaccine, for example, where a lifelong block would be ideal).
These might be particularly useful in developing countries, say the authors. Because prophylaxis with vaccines is already a familiar concept, there should be no problem with patients' compliance, and judicious partnerships between public and private organisations could mean the vaccines are produced cheaply.
Source: PLoS Medicine | June 2007
Schizophrenia is relatively rare — affecting 1% of the world's population — but is arguably one of the most severe mental illnesses. Diagnosing and treating it can be hard enough in developed countries; the challenges are magnified in developing nations with inadequate health systems; few trained staff; and pervasive social stigma. So how best to treat it? In this debate, three psychiatrists offer their different viewpoints.
Vikram Patel, at the London School of Hygiene and Tropical Medicine, says the shortage of mental health specialists means that the most effective way of spreading the expertise around might be for non-specialist health workers or community representatives to be trained to bear the brunt of providing first-line mental health services. Saeed Farooq, at Pakistan's Lady Reading Hospital, argues that the principles of the WHO's DOTS TB programme, in which patients are given an uninterrupted supply of medication taken under close supervision, could be used to treat schizophrenia. The rationale is that missing medication for schizophrenia, which can be common given the cognitive impairment associated with the illness, has serious consequences and can lead to much higher risks of relapse. R. Thara, director of the Schizophrenia Research Foundation, Chennai, India, advocates tackling stigma by offering proper treatment. In India at least, he says, the mystification of mental illness is intensified by a lack of awareness about schizophrenia and also by "magico-religious" beliefs. Effective treatment that shows the symptoms to be an illness rather than a religious curse is the best antidote to stigma, he says.
Source: World Health Organization
In 2005, the World Health Assembly called on WHO member states to tackle their growing rates of cancer by developing rigorous cancer control programmes. To help guide the process, the WHO developed a series of six modules that provide practical advice for programme managers and policy-makers on how to advocate, plan and implement effective cancer control programmes, particularly in developing countries.
Individual modules focus on planning; prevention; early detection; diagnosis and treatment; palliative care; and policy and advocacy. As of May 2008, all but the one on policy and advocacy have been published.