This paper reviews the emerging fields of nutrigenetics and nutrigenomics to explain how new analytical tools can investigate the link between diet and genes. Nutrigenetics studies single gene interactions, whereas nutrigenomics studies how genes interact with each other or with proteins and nutrients.

In the post-genomic era, nutrition is more than just eating well and getting a balance of vitamins and minerals — our genes significantly influence our nutritional needs and the way we process nutrients. The authors argue that understanding these fields is vital to improving nutrition worldwide.

An introduction to the basics of genomics explains how it has been used by pharmaceutical companies to create the field of pharmacogenetics, which has the potential to produce personalised therapies based on an individual's genes.

Some dietary links with illness — food allergies, for example — are straightforward. Others, such as in heart disease or obesity are more complex. The authors offer a fairly comprehensive overview of known links in both cases.

The health implications of studying the link between genes and diet are great, say the authors. For example, cancer or heart disease management relies on dietary modifications but patients often respond differently. A greater understanding of nutrigenetics could lead to better-tailored treatment.

This review article, published in the African Journal of Food Agriculture Nutrition and Development, considers how policy interventions can protect vulnerable African nations from the increasing nutrition insecurity caused by the global economic crisis.

The author, Suresh Babu from the International Food Policy Research Institute, argues that the global recession has reduced foreign investment in, and demand for exports from, developing countries.

This has resulted in unstable commodity prices, lower earnings and reduced access to food, forcing people to adopt cheaper and less balanced diets that lead to higher levels of malnutrition.

Babu reviews past crises, including Indonesia in the aftermath of El Niño in 1997, to build a framework of potential policy interventions.

In the short-term, this includes subsidising fertilisers, distributing nutrition supplements and providing income support. In the medium to long-term, social safety net programmes, investment in research, and institution building are needed, says Babu.

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.

A population's immunity to disease can greatly affect outbreaks of vector-borne disease, and isolating the influence of climate variability has proven difficult. This research study sets out to evaluate the effect of climate by accounting for population immunity.

The authors collated data on cholera cases from a predominant strain in the rural area of Matlab, Bangladesh, from 1966–2002. They used a model to incorporate immunity from previous infections and also potential cross-immunity from previous infections by other strains. They found that both forms of immunity were long-lasting — over 10 years in some cases. Yet the variation in transmission did not always match variations in immunity; at several points, it coincided with severe weather change such as monsoon rains or river overflow.

The authors suggest that forecasting disease will require considering climate variability alongside population susceptibility.

This article, written by the WHO Rapid Pandemic Assessment Collaboration and published in the journal Science, examines the spread of A(H1N1) influenza, or 'swine flu', and assesses its potential to cause a pandemic.

Analysing surveillance data from Mexico, the authors suggest the geographical spread of swine flu will likely be comparable to other twentieth century pandemics, although the associated impact on human health is difficult to predict.

The authors suggest that the outbreak originated in mid-February 2009 in the village of La Gloria, Veracruz, where over half the population suffered acute respiratory illness. They calculate that the virus transmissibility — the number of cases that one case generates on average — is between 1.4 and 1.6, similar to the transmissibility of previous flu viruses including those that led to the 1918, 1957 and 1968 pandemics. The authors estimate that by 30 April 2009, 6,000–32,000 people will have been infected, with 0.4–1.4 per cent of cases being fatal.

This article, written by scientists from Canada, China, Egypt and India, examines the spread of alliances in health biotechnology and the extent of collaboration in this sector between the South and the North.

The authors surveyed 288 firms on South–North health biotech collaborations and use the results to map the extent and geography of partnerships. They analyse the international collaborations of firms in Brazil, China, Cuba, Egypt, India and South Africa and compare them to South–South collaborations.

The authors conclude that developing countries' firms are closely tied to northern health biotech networks and that South–North collaborations are common practice in health biotech. More than half the firms surveyed actively collaborate with countries in the North — compared to just a quarter working with other developing countries. Egypt is the only country where South–South collaborations outnumber South–North ones.

This series of commentaries and papers, published by The Lancet, examines the challenges to achieving a balance between trade and health.

It includes analyses of the WHO and World Trade Organisation (WTO), arguing that they facilitate trade before the health of poor people. Other authors explore issues such as global trade governance, intellectual property rights on life-saving drugs, and how trade practices adversely affect diet and exploit workers.

Richard Smith, from the London School of Hygiene and Tropical Medicine, and colleagues outline an agenda for action to strengthen the evidence on trade and health links, build capacity within health on trade issues and assert health goals in trade policy. They make specific recommendations for the WHO and WTO, donors, governments, nongovernment organisations and academics.

This article, published for The Rockefeller Foundation's conference series 'Making the eHealth Connection', assesses the barriers to quality health information in developing countries, which hamper the development of health systems and services. While the Internet has improved access to health information in developed countries, obstacles remain in developing nations — the most common being unreliable connectivity and expensive Internet access, especially in rural areas.

Other barriers include a lack of medical writing skills; language diversity; copyright issues; economic constraints; poor visibility of scientific outputs from developing countries; low levels of information technology literacy; cultural and lifestyle hurdles and a lack of appropriate public policies and funding.

The authors assess the current status of such barriers and explain how training, open access publishing and recent innovations in Internet access can help. They argue that the digital divide, and its consequent disparities, also exists in pockets within developed countries.

This paper proposes a model to provide better access to fairly priced antiretroviral (ARV) drugs for HIV-infected people in poor countries, while also safeguarding the interests of ARV manufacturers.

The authors explain what governments and brand and generic companies are doing to increase the availability of ARVs in developing countries, taking examples from Brazil, Canada, China, India, the United States and Thailand. They also discuss the implications of creating more South–South partnerships to produce and market ARVs; and the impact that the UNTAID–Clinton Foundation coalition has had on lowering ARV prices in developing countries.

The authors recommend an incentive-based strategy that includes international donors bulk-purchasing generic ARVs, individual governments providing financial relief packages for generic companies, and the WHO brokering negotiations between brand and generic companies.

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.

This series of five articles outlines new challenges and unsolved problems since the journal's last series in 2005. The first article ([189kB]) predicts the disease burden and economic losses that developing countries would face from chronic diseases such as cardiovascular disease, cancer, chronic respiratory disease, and diabetes. In the 23 countries that the authors incorporated into a model, chronic disease was responsible for 50% of the disease burden in 2005. If no action is taken, they say, about US$84 billion of economic production will be lost from heart disease, stroke, and diabetes alone in these 23 countries between 2006 and 2015. The second article ([105kB]) looks at how to scale-up strategies to fight chronic diseases in developing countries. The authors review evidence to identify which methods are cost-effective and financially feasible, and therefore ready to be scaled-up.

Tobacco control, salt reduction (both of which are detailed in the series' third paper ([177kB])), and a multidrug strategy to treat individuals with high-risk cardiovascular disease (see an in-depth look in paper four ([220kB])) are prime candidates for scaling-up. What effect improving health systems has on the level of chronic diseases should be properly evaluated, say the authors. For some health interventions, such as preventing or controlling diabetes, there is little cost-effectiveness data for low or middle-income countries, but their scientific effectiveness is so compelling that countries should consider how best to incorporate them. The final paper ([92kB]) is a call to action to incorporate existing interventions into healthcare programmes, which in 2005 was costed at US$5.8 billion.

1990 saw the first major effort to estimate the main causes of illness and the biggest killer diseases in different countries. The data are important for public-health officials to allocate their resources wisely but also for feeding into estimates to plan for the future. Importantly, these need to be regularly updated to ensure that health programmes are still going in the right direction. This paper updates the 1990 study and offer predictions up to 2030.

The most forceful change in disease trends is in developing countries, with the proportion of people affected by non-communicable diseases set to increase. Proportionally, the number of people with infectious diseases is set to fall, though not when it comes to HIV/AIDS.

Because the authors also rely on predicting socio-economic development trends, they created best-case and worst-case scenarios for economic growth. In the pessimistic scenario, by 2030, the three leading causes of illness will be HIV/AIDS, depression, and ischaemic heart disease; in the optimistic scenario, road-traffic accidents will replace heart disease as the third leading cause.

The WHO has provided its own estimates of how non-communicable diseases are set to rise in developing countries. These authors pool data from national registries and international databases to compare data on the differing burden from individual diseases. They outline the risk factors associated with the diseases.

The main three killers are cardiovascular disease, diabetes, and cancer. The paper ranks different types of cancer by how many people in developing countries they kill (lung and breast cancer are the deadliest) and also ranks diabetes prevalence by country (India, followed by China, has the highest prevalence).

To tackle these diseases, say the authors, people need to look closely at the risk factors in their life – eating healthily and exercising can do much to reduce the chances of getting one of these diseases.

Cardiovascular diseases are set to rise dramatically in developing countries, partly because of an increase in risk factors for the diseases, which include diet, physical activity, smoking. The authors looked at cardiovascular disease risks such as being overweight or obese, systolic blood pressure, and total cholesterol, and related them to national income, food purchase constraints, and urbanisation. Body mass index (BMI) and cholesterol increased as national income increased, then flattened, and eventually declined. BMI also rose with increasing urbanisation.

The authors suggest that cardiovascular disease risks will increasingly be concentrated in low-income and middle-income countries. Thus, preventing obesity should be considered a priority in these countries, along with measures to control blood pressure, cholesterol, and tobacco use.

Researchers looked at global patterns of antibiotic resistance to assess how best to tackle the problem. They looked at three geographically separated, and culturally and economically distinct countries — China, Kuwait and the US: the theory was that if these very different countries had different patterns of resistance, a country-specific approach could still work: if the patterns were similar, a coordinated international response would be needed.

China had the fastest growing rate of increasing resistance, followed by Kuwait and then the US. The authors note that surveillance data are urgently needed to clarify the scope of the problem. Despite the paucity of data, preliminary data show China is doing worst — resistance of SPN (Streptococcus pneumoniae) to erythromycin is 73 per cent, compared with 23 per cent in Kuwait, and its MRSA levels are at 90 per cent

The authors say that although these countries have different trends at the moment, increasing globalisation means this might not last long. Also needed are better methods of data aggregation and analysis of how resistance is transmitted across national boundaries.

The first of this two-part series looks in detail at how antibiotic resistance affects the treatment of different types of illnesses — those that attack the gut (such as salmonella or cholera) and respiratory system (such as the tuberculosis bacterium), and the bacterium that causes gonorrhoea.  Treating these diseases in developing countries is increasingly difficult because the cheap antibiotics that were once effective are growing to be useful against bacteria that have developed resistance. These changes are pushing up treatment costs in developing countries. Drug-resistant tuberculosis, for example, is more expensive to treat than the non-drug-resistant type.

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The second half of this series focuses on action needed to contain antimicrobial resistance. It outlines the risk factors that can lead to resistance emerging and spreading, particularly in developing countries: using poor-quality drugs or inadequate infection control in hospitals, for example. The article outlines strategies to stop the problem getting worse but points out that developing countries differ widely in the state of their healthcare systems and their resources, so a one-size-fits-all model is not useful.

The authors emphasise the importance of education of the public and of medical practitioners because otherwise the only information available to most healthcare professionals is from pharmaceutical companies that may not fit government or local priorities. In developing countries, unsanctioned providers are a particular problem because they might give people counterfeit or substandard antibiotics that can fuel resistance.

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Good prescribing practices are important in tackling antibiotic resistance, and diagnostics are key to ensuring good practice. Knowing who not to treat is as important as knowing who to treat. The article reports on analyses by the Global Health Diagnostic Forum of the Bill & Melinda Gates Foundation to assess how many lives could be saved by better diagnostics for six major illnesses, including malaria and tuberculosis. The researchers assessed the technical issues associated with implementing the diagnostic tests in developing countries for three classes of laboratory infrastructure — none, minimal, or moderate to advanced.

They found that for acute lower respiratory infections, syphilis, gonorrhoea, chlamydia and TB, outcomes could be much improved if tests were sent to sites with minimal or no laboratory infrastructure. In these types of settings, the practicality of obtaining a specimen is important. For example, obtaining a blood sample correctly to test HIV viral load is almost impossible where there are no laboratory facilities. Using sputum to test for TB has similar issues because of the impracticability of the sample medium. Thus, new biomarkers might be needed to test for diseases with specimens different from those currently used. Combination tests that look for a range of infectious organisms in one sample would be useful in resource-poor settings.

The researchers also highlight the importance of taking into account cultural and social sensitivities when designing interventions – blood sampling is not always accepted in some regions of the world, for example.

In this research article, Victor Konde of the University of Zambia argues that industrial biotechnologies can improve food security in Africa through improved livestock feeds and vaccines, as well as biotechnological pesticides, fertilisers and herbicides. He adds that biotechnology can also help farmers process crop and livestock products for new markets.

But Africa must first overcome a number of key challenges, says Konde — including restrictions on agricultural exports, weaknesses in scientific capacity and investment, and a lack of diplomatic strength to effectively promote its interests in international negotiations.

The author proposes ways for African policymakers to encourage biotech enterprise and investment, collaborative and interdisciplinary research, strategic alliances and public–private partnerships.

This research article assesses the potential for biotechnological approaches to overcome major pests, diseases and weeds undermining food security in Africa. The eight authors review three major constraints — parasitic weeds and herbicide-resistant grasses, insect pests, including those carrying plant diseases, and mycotoxins that damage stored grains.

They note that biotechnological solutions to some of these are already being explored, such as insect resistance in maize, but they say that others, like the control of parasitic weeds, will require longer-term study. The authors argue that these should be prioritised in public research programmes and supported by the private sector through donations of useful genes and technologies.

Their methodical discussion helps identify key priority areas for crop biotech research in Africa. This article will be useful to policy analysts, decision makers and research managers working in the field.