Harnessing research for better health
Health research towards the achievement of the Millennium Development Goals (MDG) was theme of the 10th anniversary celebration of the University of the Philippines-National Institutes of Health on February 12. MDG refers to the eight development targets that all countries and the world's leading development institutions, under the leadership of the United Nations, agreed to achieve by 2015. They range from halving extreme poverty to halting the spread of HIV/AIDS and providing universal primary education. Dr. Ramon Arcadio, chancellor of UP Manila, said research is a powerful resource to understanding and solving health-care problems. It serves as basis for the formulation of policies, regulations, and decisions. "Measures and intervention are based on evidence so that the research available to support these measures are used in the most efficient and effective way possible," he said, adding that the country needs to continuously generate data and information to show how far it has gone and what aspects need more focus in its effort to achieve the MDGs. Addressing the celebration, Health secretary Dr. Francisco Duque III cited the country's gains over the past years, among them, reduction in poverty from 24.3 percent in 1991 to13.5 in 2003 and in infant deaths from 54 per 1,000 live births in 1990 to 24 in 2006. He stressed, however, the efforts must be stepped up in other areas particularly in towns and provinces under extreme poverty. The recent outbreaks of diarrhea and cholera in some rural and urban areas, high maternal mortality rate (10 per day) because of unsafe delivery, 500,000 children per year unreached by effective vaccines, and TB/malaria manifesting in more resistant forms are just some of the challenges that government and the private sector must jointly face, Duque said. He lauded the NIH for being a strong partner of the Department of Health (DOH) "in improving the lives of our people and solving health inequities [through] education and health research," citing among other achievements, the NIH's role in the establishment of the Philippine National Health Research System. For his part, Sen. Edgardo Angara stressed the need to make health-care universal, saying it is "central" to any modern society. He, however, lamented the poor state of the health-care system-the flight of health-care professionals to more lucrative jobs overseas, the high cost of health-care, among others-and stressed that unless immediate measures are instituted, the system could collapse in five years. He suggested a road mapping exercise to determine the following: how we educate health professionals, the proper direction of research and development, and the appropriate manner of health-care financing. "I share the belief that the responsibility for uplifting the condition of humanity does not only rest on the shoulders of the medical professionals. It is an obligation where all of us are answerable," commented Dr. Emerlinda Roman. However, at the end of the day the challenge is to "translate the research that we have into something more meaningful and useful and which will serve directly the people." M Mabelle Aban
SYDNEY An Australian girl spontaneously changed blood groups and adopted her donor's immune system after a liver transplant, in what doctors treating her said was the first known case of its type. Demi-Lee Brennan was aged nine and seriously ill with liver failure when she received the transplant at the Children's Hospital at Westmead. Nine months later they discovered she had changed blood types and that her immune system had switched over to that of the donor after stem cells from the new liver migrated to her bone marrow. She is now a healthy 15-year-old, said Dr. Michael Stormon, a hepatologist treating her. He said he had given several presentations on the case around the world and had heard of none like it. "It is extremely unusual-in fact we don't know of any other instance in which this happened," Stormon said. "In effect she had had a bone marrow transplant. The majority of her immune system had also switched over to that of the donor." An article on the case was published on January 24 in The New England Journal of Medicine. Brennan's mother, Kerrie Mills, described the recovery as "miraculous" while the patient herself told a news conference that doctors had given her life back to her. "I just can't thank them enough. It's like my second chance at life," Brennan said. Doctors who treated Brennan are interested to know if the case could have other applications in transplant surgery, where rejection of donor organs by the recipient's immune system is a major hurdle. Stormon said it appeared that Brennan may have been fortunate because a "sequence of serendipitous events," including a post-transplantation infection, may have given the stem cells from her donor's liver the chance to proliferate in the bone marrow, where blood cells develop. The task now was to establish whether the same sort of outcome could be replicated in other transplant patients, he said. "The challenge for us now is to try and figure out how this occurred," Stormon said. One possibility is that the series of events she experienced all weakened her immune system enough for the stem cells to migrate to the bone marrow and proliferate, Stormon said. These factors include the particular type of liver failure she had, a postoperation infection with the virus cytomegalovirus, and immunosuppressive drugs. "To try to replicate that is easier said than done," Stormon said, but added the case could still potentially be crucial. "The Holy Grail of transplant medicine is immunotolerance. She exemplifies that this can occur." M AFP
PARIS Scientists lifting the veil on a sting operation that netted drugs counterfeiters in China said it was vital for Asia's police and pharmaceutical watchdogs to work more closely in tackling these dangerous cheats. In a paper published in the online journal Public Library of Science (www.plos.org), the scientists describe an unprecedented undercover mission that led to the arrest of a Chinese gang peddling fake antimalaria pills. Bogus treatments for malaria are rampant in Southeast Asia, placing lives at risk, they warn. These pills are unlikely to contain enough artesunate-the active ingredient that kills resistant malaria parasites in the blood-and may even contain toxic substances that could sicken or kill the patient. The investigation, dubbed Operation Jupiter, was coordinated with the help of Interpol and the World Health Organization (WHO). Lab experts with Britain's University of Oxford and Wellcome Trust analyzed 391 samples of genuine and counterfeit artesunate, collected in Myanmar, Laos, Vietnam, Cambodia, and on the Thai-Myanmar border. They used a spectrometer to get a chemical ID of the pills and found that 195 out of 391 samples-49.9 percent-had no or only small amounts of artesunate. They also put the pills' packaging through a battery of tests, finding changes in hologram seals that, only to the expert eye and with the help of a microscope and ultraviolet light, pointed to fakery. Many of the fake seals bore the logo "Guilin Pharma," the name of a large pharmaceutical company in Guilin, southern China. But the ace in the hole was to use an advanced technique called forensic polynology that not only found minute traces of pollen in the samples but identified their origin. At least some of the counterfeit artesunate came from southern China, and this was supported by examination of the mineral calcite, found in some of the samples. Armed with this information, the Jupiter chiefs handed the evidence to China's ministry of public security in March 2006. A police swoop netted a suspect in Yunnan province who had bought a quarter of a million fake "Guilin Pharma" blister packs from a man with a counterfeit factory in Guangdong province. The packs had been sold across the border in Myanmar and probably accounted for as many as the genuine Guilin Pharma treatments sold there. The paper says the unique collaboration between forensic scientists, detectives, doctors and pharmacists should be the model for future offensives against the scourge of counterfeit drugs. But, they say, "there are very few laboratories (only one in Asia/Pacific) with the appropriate reference collection [of genuine drugs] and ability to analyze pollen assemblages in tablets, and the work is very labor-intensive and specialized and therefore expensive." "If a collaborative forensive approach is to succeed, [drug regulatory authorities] and their international collaborations will need to be strengthened and regional laboratories able to provide actionable evidence will be required." The problem of counterfeit artesunate in Southeast Asia first surfaced in 1998. Among the many concerns raised by this traffic is the fear that, by taking an insufficient dose of artesunate, patients will help the malaria parasite to become resistant to the only widely available, cost-effective drug. M AFP
In its bid to raise public awareness on the dangers posed by rabies infection and the ways to prevent it, the Department of Health (DOH) will spearhead this year's observance of Rabies Awareness Month in March. Dr. Raffy Deray, program manager of the National Rabies Prevention and Control Program, said among this year's activities is a three-day training course on rabies and animal-bite management on March 24 to 26 at the Research Institute for Tropical Medicine in Alabang. There will be a motorcade and mass dog immunization in Zamboanga City on March 4 and a summit on rabies on March 11, and a multisectoral meeting in Western Visayas on March 12. The DOH will also issue the implementing rules and regulations for Republic Act 9482 or the Anti-Rabies Act of 2007. In Africa and Asia, some 55,000 people die from rabies every year-one person every 15 minutes. The situation in the Philippines is not as bad, with about 300 to 600 people, mostly children aged below 15 years old, who die each year because of the virus. And in most cases, the cause of infection is dog bites. Which is why the DOH stresses in its campaign the need for pet owners to have their dogs vaccinated against rabies. It also conducts health seminars and lectures to give people basic knowledge on first aid for animal bites and exposure to rabies. More animal bite centers have also been established nationwide to provide immediate and appropriate medical care to victims of animal bites. Last year's observance of Rabies Awareness Month featured a nationwide information caravan on rabies prevention and control, which included forums and lectures that extended until World Rabies Day on September 8. In Siquijor, for instance, the campaign included dog shows and seminars on animal welfare and responsible pet ownership. The provincial veterinarian's office conducted free vaccination and grooming for dogs. In Marikina, the city government held lectures in all public high schools to increase public awareness on ways to combat the disease. Films on rabies awareness were also shown at the city hall lobby and in 17 health centers and different barangay halls in the city. M Gayleen Caballero
PARIS In a surprising reversal of roles, nanotech-nology scientists outrival the general public in seeing a cause for concern in some aspects of their work, according to a recent study published in Nature. Nanotechnology-the science of making things measured in units 10,000 times smaller than the width of a human hair-holds spectacular promise in virtually every sector. Hundreds of consumer products already contain nano materials, most of which are cosmetics, sunscreens, and cleaning products with microscopic particles. But this is the only first step in what promoters of nano say is a revolution whose impact will be outsized compared to the technology's tiny scale. In medicine, potential applications range from in-body diagnostic devices to tissue engineering to pinpoint drug delivery. Nano materials far lighter and stronger than anything in use today could revolutionize the auto and airplane industries, and parallel developments are underway for robotics, computers, clothing, energy storage and air purification. Two surveys conducted among 363 nanotechnology scientists and engineers and among 1,015 US adults find an intriguing contrast in attitudes about this fast-moving yet untested technology. The average Joe and Jane are more worried than the experts that nano will cause job losses, an arms race, and a loss of privacy. The scientists, unsurprisingly, say their work will lead to major breakthroughs in medicine, environmental cleanup, and national defense. But they are also significantly more concerned than the public about the risk of more pollution and unforeseen health problems from nano. The authors of the study, led by Dietram Scheufele of the University of Wisconsin-Madison, chalk up this gap in viewpoints to two things. One is that scientists have already launched a debate among themselves about nano-related risks, and lament a lack of research in this field. At the same time, the media promote the potential benefits of nano and downplay the risk aspect, thus giving a distorted view to the public. Researchers looking at nano risks are focusing on any effect on health from minute particles that are breathed into the lungs or from putative nano robots that would be inserted into the body to repair damaged tissue. Questions have also been raised as to whether nano materials could be toxic for health and the environment. "The nano story is one of very slow and rather weak regulatory responses," commented nanotechnology expert Nigel Cameron, head of the Institute on Biotechnology and the Human Future at the Illinois Institute of Technology. "Public and political awareness of the technology-even though we have been talking about it for some time-is amazingly low," he said. "Nanotechnology may ... be the first emerging technology for which scientists may have to explain to the public why they should be more rather than less concerned about some potential risks," said Scheufele. M AFP |
