Water scarcity as a lead cause to Obesity and Diabetes: an outlook at the rural California

Although water scarcity affects every continent of the globe with around 1.2 billion people(UN) in dire need, it is now becoming very clear that places such as California are not spared of this preventable problem.
I read an interesting article written by Colleen Curry in the Vice News that rural communities in California have increased their intake of sugary and soda drinks thus predisposing them to Obesity and Type 2 Diabetes.
The report, which was contained in a policy paper, also noted that even those that have access to clean drinking water do buy the sugary and soda drinks out of the fear of consuming contaminated water.
Still, and to show the increasing disparity between the affluent and the low-income minority populations, it was observed that the prevalence of Type 2 Diabetes and Obesity is higher among the low-income population. The other factors to this growing scourge include environment hazards, lack of education, and lack of access to healthy foods and nutrition.
Arguably this could be considered as one of the negatives of Globalization; hence the need for global public health leaders to come together once again and address the ever increasing health inequality.

WHO experts chart next steps for Ebola vaccine trials

I am sharing this beautiful piece on Ebola vaccine trials that I read on the CIDRAP website; enjoy.

The next steps in testing Ebola vaccines as well as a picture of how they might be used in West Africa’s outbreak region became clearer today as officials from the World Health Organization (WHO) shared the outcome of yesterday’s high-level meeting in Geneva.

Large phase 3 trials in West Africa’s outbreak setting will be next up to see if the vaccines work, with the studies designed to collect more safety data, a task usually covered in phase 2 trials, experts involved in the meeting said today at a WHO media telebriefing. However, as Ebola infections drop off in the outbreak region, scientists face a closing window of opportunity to see how the vaccines perform in a real-life setting.

Experts also signaled a possible role for two Ebola vaccine formulations: a single-dose vaccine providing shorter-term immunity that could be used to tamp down Ebola flare-ups and a prime-boost vaccine that may provide more durable immunity and could be used for other immunization strategies.

Vaccine landscape evolves
Marie-Paule Kieny, PhD, the WHO’s assistant director-general for health systems and innovation, said the group’s review of phase 1 clinical trials of the two vaccines furthest along in testing found acceptable safety profiles, but information on what dose stimulates an ideal immune response won’t be known for 2 to 4 more weeks.

While 2014 will be remembered as the year Ebola challenged humanity, 2015 will be remembered as the year humanity used the best scientific minds to fight back against the disease, she said, and the fast-tracking of the vaccines has been unprecedented. “I can assure you there has been no holiday for the many people working on that.”

Helen Rees, MBBS, a professor at the University of Witwatersrand who led the meeting, told reporters that progress made at the meeting was very encouraging and that each of the affected countries had strong delegations that were deeply engaged.

Yesterday’s meeting was the second to work out details about Ebola vaccine clinical trials and how to finance eventual vaccine deployment to curb spread of the virus in Guinea, Liberia, and Sierra Leone. Since the first meeting on Oct 23, a third Ebola vaccine has entered phase 1 trials: a prime-boost combination from Johnson & Johnson, based on AdVac technology from Crucell Holland BV and MVA-BN technology from Bavarian Nordic.

Clinical trials have been under way for the past few months for the two other vaccines: a US-GSK vaccine known as ChAd3 that uses a chimpanzee adenovirus with a Zaire Ebola virus gene spliced into it, and VSV-EBOV, developed by Canadian researchers and licensed by NewLink Genetics and Merck, which uses a vesicular stomatitis virus (VSV) to carry an Ebola gene.

Developers of the Johnson & Johnson vaccine, for which phase 1 trials just launched, have overcome some delays and successfully gained some ground, Kieny said, adding that additional Ebola vaccines, including ones from groups in Russia and China, are at different stages of development. “Last year at this time the cupboard was dry, but now the cupboard is filling quickly,” she said.

The next phase of testing will take place in all three West African countries, using three completely different trial designs, which Kieny said will give researchers several good points for evaluating the vaccines.

Phase 3 study details
A randomized trial in Liberia will involve three arms (single doses of ChAd3, VSV-EBOV, and placebo), with 9,000 volunteers in each. In Sierra Leone, investigators will conduct a trial of a still-undetermined vaccine using a step-wedge design, with a goal of enrolling about 6,000 people. Meanwhile, teams in Guinea will vaccinate frontline health workers at trial sites where they will use a ring-vaccination design involving about 4,500 people, similar to an intervention used to vaccinate against smallpox.

Kieny said researchers hope to begin the Liberian trial at the end of January, with trials in Sierra Leone and Guinea projected to begin in February. She said efforts—such as sensitizing the population—are already under way to prepare for the vaccine trial. Study sites are getting special freezers to store the vaccine, but she added that developers are working on formulations that potentially allow the doses to be stored at refrigerator temperatures and that might be available in the next few months.

Experts at the meeting discussed concerns about how a continued drop-off in cases could affect the trials, Kieny said. She noted that investigators could include larger populations if they need to, though doing so might lead to some delays.

Weighing vaccine choices, outbreak needs
Looking ahead to production capacity for the three vaccines that are furthest along in trials, Kieny said robust quantities in the tens of millions are expected for VSV-EBOV as well as for Johnson & Johnson’s prime-boost vaccine, which can be stored at refrigerator temperature. However, the quantity for ChAd3 will depend on the dosage level, with a few million doses available by the middle of the year.

Rees said a separate WHO working group is exploring different strategies for deploying vaccines once they are available. Immunization plans will account for different epidemiologic patterns in each of the countries.

When asked if all the vaccine studies were taking up too much research space, Rees said there is capacity to do more than one phase 3 study and that having several vaccine candidates in the pipeline is desirable. “We can’t assume that anything is going to work,” she said, adding that once correlates of protection are known, scientists will look at how to improve the products.

She said the experts have addressed whether the vaccines will really make a difference in West Africa’s outbreak. Different epidemiologic patterns in the region will require different control approaches, and even if vaccines have limited utility in the current outbreak, they will be ready for the future. “We anticipate that this won’t be the end of Ebola.”

Other developments
In the wake of West Africa’s Ebola outbreak and criticism of slow international response, 95 members of the global health academic community signed on to a letter published in The Lancet today urging countries to redouble their efforts to invest in the WHO. They said an analysis of how the group performed in the outbreak is warranted, but added that an independent review should also consider the impact of budget cuts to the WHO and the need for sustained funding. They said international forums are floating the idea of a new “first responder” United Nations agency but that the WHO already has a system in place and any new agency would face the same funding challenges.

Urgent studies should be done to explore possible benefits of loperamide use, in combination with oral rehydration, for treating diarrhea in Ebola patients, three US-based researchers wrote yesterday in a commentary in the Journal of Infectious Diseases. In West African settings that lack the ability to provide electrolyte monitoring and replacement, antidiarrheal agents may be useful, but their use isn’t often reported and there are no safety and efficacy data to guide their use. Clinicians may be reluctant to use the drug, because it hasn’t shown a benefit for cholera-related diarrhea and can result in problems when used for some bacterial causes of diarrhea. However, they said studies have shown a benefit for other types of infectious diarrhea in adults and children older than age 2, with few safety problems. Use of loperamide seems like a rational approach that could also reduce environmental contamination, making it worthy of more study, the authors wrote.

The number of Ebola infections in the three most affected countries has risen to 21,086, with the number of deaths increasing to 8,289, the WHO said today in a brief update. The totals reflect an increase of 114 illnesses and 30 fatalities since the WHO’s update yesterday. Today’s count includes cases reported in Liberia and Sierra Leone through Jan 6 and in Guinea through Jan 7. With 10,030 illnesses reported to far, Sierra Leone remains the hardest hit country. However, Liberia still has the most deaths, with 3,515.


8 Ebola Terms You Need to Know

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Incubation period: The time between exposure to a virus and when symptoms start to present, which is two to 21 days in Ebola’s case.

Symptomatic: A patient becomes symptomatic when they present symptoms of Ebola, which include fever, muscle pain, headache, sore throat, vomiting and diarrhea.

Contagious: People with strains of the Ebola virus in their blood are only contagious when they are presenting with symptoms (see above). The virus cannot be transmitted before a person is symptomatic, which means that people on the same airplane as Thomas Eric Duncan could not have caught the virus from him.

R0: Also called R-nought, it refers to the “estimated reproduction number for infectious diseases.” Put more simply, it’s a formula predicting how contagious a virus is. NPR has a handy graphic on their site showing that Ebola has an R0 of 2, meaning the likely number of people…

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Ban on BPA in Food & Beverage Containers Introduced in Congress.

Senator Markey, Representatives Capps and Meng seek to increase FDA’s authority to require safer food additives.
(SAN FRANCISCO) Bisphenol A (BPA), the notorious chemical banished from baby bottles due to concerns about its impact on the health of young children, is the target of federal legislation that would ban BPA from food and beverage containers and require the FDA to review the safety of other potentially toxic chemicals used in food packaging.
The “Ban Poisonous Additives (BPA) Act of 2014” was introduced into both chambers of Congress today. Senator Edward J. Markey (D-MA), a long-time champion of this legislation when serving in the House of Representatives, introduced the Senate bill, while Representatives Lois Capps (D-CA) and Grace Meng (D-NY) took the lead on companion legislation in the House. If passed, the bill will empower the U.S. Food and Drug Administration (FDA) to remove BPA from food packaging, label food packaging that still contains BPA while alternatives are developed, encourage manufacturers to replace this hazardous chemical with alternatives that are safer for workers and consumers, and require the agency to review the safety of all food contact substances.

“It’s time to take the worry out of the workplace for our factory workers by taking the BPA out of canned goods and other food and beverage containers,” said Senator Edward J. Markey.
For more details, visit: http://www.BreastCancerFund.org

WHO warns on global malaria resurgence

I came across this article from Punch Nigerian Newspaper and would like to share it with you all:

The World Health Organisation warns there could be a resurgence of malaria in countries where much progress had been made over the past decade.

The WHO has released its annual World Malaria Report, which warns of funding and resource shortfalls.

The WHO’s Richard Cidulskis says the past decade had seen a concerted effort by endemic countries, donors and others to ”strengthen malaria control around the world.” He said many lives were saved.

”Tremendous progress in that we estimate there have been 1.1 million deaths averted from malaria. Those 1.1 million deaths, the majority of them, have been averted in the 10 highest burden countries in Africa.

The other progress we’ve seen is 50 countries out of 99 with ongoing transmission are on track to meet international targets of reducing malaria incidence by 75 percent by 2015,” he said in an interview with the Voice of America.

However, those 50 countries represent only three per cent – or seven million people – of the malaria cases that were estimated to have occurred in 2000.

WHO said the 2000 estimate is the benchmark against which progress is measured.

There had also been a large increase in the availability of rapid diagnostic tests and in artemisinin combination therapy.

Cidulskis is the WHO’s coordinator for strategy, economics and elimination in the Global Malaria Programme.

He said, ”One of the concerns is the amount of money available for malaria control seems to be plateauing. In previous years, we’ve seen it rise to a large extent year on year.

“In 2011, however, the amount of money for malaria control was actually less than in 2010 and amounted to $2.3 billion.

“That’s a lot of money, but it’s well short of the $5.1 billion that are needed to ensure everybody has access to malaria interventions.”

There are other concerns. The number of long-lasting insecticide-treated bed nets – delivered to endemic countries – has dropped from a high of 145 million in 2010 to 66 million in 2012.

What’s more, the World Malaria Report said the ”expansion of indoor residual spraying programmes has levelled off, remaining at 11 percent of the population at risk.”

”If we don’t scale-up control operations in 2013, it is likely that we’ll have [a] major resurgence of malaria in sub-Saharan Africa,” said Cidulskis.

The WHO report said the malaria burden is concentrated in 14 endemic countries that account for 80 percent of malaria deaths. Most are in sub-Saharan Africa.

Nigeria and the Democratic Republic of Congo are the hardest hit in that region, while India is the most affected in South East Asia.

It’s estimated there are 219-million malaria cases worldwide. About 660,000 people die every year from the disease.

”Each one of those cases and each one of those deaths is preventable,” he said.

Cidulskis said the levelling-off of funding is due in part to the global recession. But he also said most of the countries where malaria is endemic are poor. And while they’ve been increasing spending on control and treatment programmes, their resources are limited.

The WHO report called for strengthening malaria surveillance programs and ensuring affected countries have all the medicine and bed nets they need.

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