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.

This special issue of the journal Philosophical Transactions of the Royal Society B: Biological Science explores how vaccines can fulfil their full potential for addressing global health challenges. It charts the progress to date, reviewing successes as well as challenges in the development and distribution of both human and veterinary vaccines.

The articles describe how vaccines can help mitigate and treat the world's major infectious diseases such as malaria, tuberculosis and HIV/AIDS, as well as chronic diseases, such as cancer. They explore vaccine policy and financing, ways to accelerate the development of new vaccines, issues surrounding public acceptance, and the logistics of getting vaccines to where they are needed. Also discussed is the use of vaccines to treat diseases in livestock — making an important link between health interventions, agricultural output and economic consequences.

The papers in this issue were presented at the meeting, 'New vaccines for global health', held at the Royal Society in London, United Kingdom, in November 2010.

This report, from medical aid organisation Médecins Sans Frontières, explores the impact of and lessons learned from the use of antiretroviral treatment (ART) for HIV/AIDS since 2000, when it began providing this to people in need of urgent treatment. It presents results of a survey conducted in 16 countries with different prevalence levels of the disease, which together account for 52.5 per cent of the global HIV/AIDS burden, and outlines the progress, strengths and weaknesses of the international response to the disease.

The report provides an overview of key treatment strategies to improve care and reduce its cost for patients and health systems; discusses the impact of decreased donor funding; and suggests policies that can help lower drug costs, for example, or foster innovations for more effective and affordable treatment. Most HIV-prevalent countries still lack the capacity to treat more than 50 per cent of their population in need of ART, or to provide ART in more than 50 per cent of existing facilities — underlining the need for more domestic and external resources.

This report makes a case for the importance of antimalarial drug monitoring as an integral part of disease surveillance programmes in developing countries. Antimalarials are some of the most commonly counterfeited drugs — the high prevalence of malaria translates to a large consumer market in the developing world. The problem is serious in South-East Asia but is expected to become significant in African countries too. The report suggests that scientists ensure drugs are genuine and of a good quality before conducting efficacy or resistance studies in areas where counterfeits circulate widely.

This report examines the impact of HIV/AIDS on people's livelihoods in rural areas of Africa, China, Central Asia, India and Russia.

The authors consider labour economising technologies, and set out the potential policy options. They conclude that providing anti-retroviral drugs would have an immediate, and a long-term effect on food security and is the only way of ensuring continued access to labour in the rural sector.

This article provides an overview of global efforts to develop turmeric — a curry spice that is also used in a variety of Indian traditional remedies — into a modern therapeutic drug. The author highlights some of the hurdles to developing turmeric, including intellectual property barriers, turmeric's insolubility in water and its poor bioavailability. He also describes current efforts including ongoing lab and clinical trials.

Too few effective antimalarials and poor use of bednets are two main reasons offered for why malaria still kills millions every year. This systematic review suggests that social and cultural factors in tackling malaria are often ignored. For example, many people in the developing world still use traditional medicine to treat malaria, which is often blamed on spiritual problems or curses, and can be a barrier to effective treatment.

This article from The Lancet provides useful background information on Chagas disease including its transmission, epidemiology, pathogenisis, diagnosis and treatment. The disease affects eight million people in Latin America and poses a growing health problem in non-endemic areas due to increased trade and travel.

This report gives an overview of progress in developing an HIV/AIDS vaccine, including new adjuvant strategies, novel vectors for antigen delivery and presentation, and alternative ways of eliciting antibody responses. The authors call for continued commitment to basic research to identify an effective and affordable HIV vaccine.

This Nanomedicine paper reviews a range of strategies based on nanotechnology that are currently being used or tested to improve HIV/AIDS treatment and prevention. The authors review nanomedical advances in antiretroviral therapy, gene therapy, immunotherapy, vaccines and microbicides.

They conclude that nanotechnology promises great improvements in all of these areas but they warn that the field still faces many challenges including the toxicity of nanomaterials, their stability in physiological settings and the question of how to mass-produce them.

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.

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.

This discussion paper describes the links between global climate change and ecosystem and animal health that researchers generally agree on and the impacts that, while less certain, are still likely. The author highlights gaps in current knowledge, emphasising the need for better disease surveillance and more localised climatological and ecological data.

This paper explains how interdisciplinary collaboration in health, nutrition, and agriculture has helped the Millennium Villages Project in 12 African villages meet the Millennium Development Goals.

Global science is increasingly under pressure to become more interdisciplinary. Econutrition is a good example of a cross-sector concept that joins environmental and human health, focusing on crosscutting areas such as agriculture and ecology.

Soil erosion and decreasing biodiversity causes environmental damage that lowers food production. A lack of food results in malnutrition and illness that, in turn, lead to poorer labour productivity and poorer agricultural management.

The Millennium Villages Project emphasises community engagement and leadership, and the case study from the Nyanza Province near Lake Victoria in Kenya illustrates that this can work well in improving nutrition.

One-fifth of adults in the area have HIV and many have malaria and TB. People in the region go hungry for up to seven months a year and are malnourished. The villagers constructed a health clinic and organised teams of community healthcare workers trained in nutrition.

Farmers receive fertilisers and plants if they donate ten per cent of their harvest towards a school lunch programme that concentrates on providing missing nutrients. For example, by adding local crops such as sweet potatoes common vitamin A deficiencies are eliminated. The key to success, say the authors, is to ensure that farmers are supported, especially in producing a variety of crops.

The author list for this collection of chapters, with names like Cesar Victora and Carine Ronsman, reads like a 'Who's Who' in nutrition and health for the developing world. The chapter topics are wide-ranging and include subjects such as the economics of nutrition programmes, the extent to which scientific data influences nutrition policies, and the challenge of providing food aid during humanitarian emergencies.

Each chapter is organised as a scientific paper. Most usefully perhaps, the authors of each chapter include both their conclusions, and a separate list of recommendations for researchers and policymakers.

This journal article, written by three researchers in Trinidad and Tobago, looks at malaria in the Caribbean. It asks why there are still outbreaks — including a big one in Jamaica in 2006/2007 — when the disease was allegedly eliminated in the late 1950s. The authors review malaria and vector data from across the Caribbean, summarising the pattern of imported cases as well as indigenous ones.

They identify three essential conditions for malaria transmission: presence of the vector, imported organisms and susceptible human hosts — all of which the authors show still exist across the Caribbean.

The authors suggest specific actions for regional policymakers to combat malaria. These include enhancing vector control skills, strengthening surveillance with new technologies, upgrading malaria therapy, increasing prevention strategies such as bed nets and raising public awareness of malaria. They emphasise that the role of climate change must be considered too, saying that rising temperatures could lead to new malaria vectors entering and colonising Caribbean islands and transmitting malaria on a major scale. But the authors are also careful to point out that the link to climate change is uncertain and remains contested in scientific circles.

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.

The third IPCC assessment report, Climate Change 2001, includes this section on the links between climate change and health. It offers a detailed look at how variations in climate, such as temperature or rainfall, could affect vector-borne disease. In particular, it evaluates computer models that predict climate impact on dengue fever and malaria. The assessment also looks at specific diseases such as leishmaniasis or schistosomiasis, explaining how the disease is spread and how changes in the environment might alter that spread.

The authors take a holistic look at the various factors involved. For example, in assessing schistosomiasis, they also consider the irrigation systems that will likely be needed to cope with expected water shortages resulting from climate change. The schistosomiasis parasite uses water snails as an intermediate host, so irrigation systems will need to be designed in such a way that they do not cause snail populations to multiply.

An update to the research on climate and vector-borne disease is also included in the fourth IPCC assessment report[796kB] although not in as much detail.

This journal article describes the first climate-based model used to predict outbreaks of dengue fever. Researchers from the University of Miami and the University of Costa Rica used climate data and vegetation indices from Costa Rica to predict disease outbreaks with 83 per cent accuracy.

Globally, there are up to 100 million cases of dengue fever, and its more dangerous form, dengue haemorrhagic fever, every year. The spread of dengue fever is set to rise as the world's climate changes. The importance of this model is that it could be used as the basis for an early warning system to prevent the spread of the disease by warning populations that are at risk.

The indices used in the model include variables such as El Niño Southern Oscillations and sea surface temperature, which affect populations of the Aedes aegypti mosquito that spreads the infection.

This Nature paper reviews evidence that a changing climate poses significant health risks and that global warming over the past few years has already increased illness and death worldwide.

Infectious diseases are strongly affected by climatic variations because the vectors that carry the bacteria or viruses do not have thermoregulatory mechanisms, say the authors. One of the most important existing sources of climatic variability is El Niño. This weather system has been shown to influence malaria in South America, rift valley fever in east Africa, cholera in Bangladesh and dengue fever in Thailand. If, as some scientists have suggested, climate change alters El Niño, the consequences will be significant.

The authors say there are some promising early warning systems for infectious disease. In Botswana, for example, two-thirds of the inter-annual variability of malaria can be predicted from sea surface temperatures and monthly rainfall.