News Article | May 23, 2017
Having witnessed the success of combination therapy in HIV, cancer and heart disease, the time has come for Alzheimer’s disease. At meetings convened by the Alzheimer’s Association and others, a consensus is emerging that the most effective Alzheimer’s treatments may be those that attack the disease on multiple fronts. Looking back for a moment… In the 1980s, the world faced a new, unknown virus. HIV/AIDS was spreading virtually unchecked, devastating millions of lives and spurring lively scientific debate. Today, an HIV diagnosis is no longer a death sentence. AIDS-related deaths have fallen by 45 percent since their peak in 2005 according to UNAIDS, a United Nations program for global action against the spread of the virus. As researchers learned more about HIV, they developed new classes of antiviral medications—each attacking the virus in a unique way. Physicians eventually began prescribing two or more of these drugs together and emerging scientific evidence started revealing the most effective combinations. Today, a powerful three-drug antiviral “cocktail” is allowing people with HIV to live long lives. Advances in understanding the progression of Alzheimer’s point to a number of underlying biological processes involved in the development of the disease. By leveraging this knowledge, we now have a singular opportunity to pioneer new approaches against Alzheimer’s, including combination therapies. The Alzheimer’s Association has partnered with the Alzheimer’s Drug Discovery Foundation (ADDF) to challenge the research community to propose promising drug combinations to find more-effective treatments. The joint effort, known as the Alzheimer's Combination Therapy Opportunities (ACTO) grant initiative, will provide $2 million this year for testing approaches that simultaneously target two or more processes believed to underlie, exacerbate, or occur in the disease. An ACTO-funded study must involve repurposed drugs—those that have been determined safe for use in treating other conditions. With some information about safety already available, there is the potential to deliver new treatments more quickly than testing novel drugs, which take an average of 12 years to make it to pharmacy. ACTO will announce its initial award the first half of 2017. The predominant theory of how Alzheimer’s develops is that buildup of two characteristic lesions in the brain—amyloid plaques and tau tangles—leads to the death of nerve cells. Plaques are deposits of a protein fragment called beta-amyloid that build up in the spaces between nerve cells; tangles are twisted fibers of another protein called tau that build up inside the cells. The majority of Alzheimer's drug candidates currently being tested in clinical trials target species of amyloid and/or the plaques. Numerous other studies suggest brain inflammation and problems with blood circulation in the brain play a role in the disease’s progression. Other studies have identified an additional abnormal protein in the brains of people with the disease—and that this protein may explain why some people have Alzheimer’s changes in their brain but do not experience dementia. Because of the complexity of Alzheimer’s and its multiple causal factors, it may not only be preferable to use combination therapy, but necessary. Research on potential Alzheimer’s combination therapies in mouse models is showing promise. One study in mice found that using a combination of experimental anti-amyloid drugs could more effectively reduce amyloid plaque buildup and prevent new plaques from forming than either candidate alone. A second study in mice found that using leptin, a hormone that inhibits hunger, in combination with pioglitazone, an approved diabetes drug, could reduce both amyloid plaque accumulation and brain inflammation. Our hope is that testing multi-drug approaches is just the initial stirring of the innovation pot for Alzheimer’s combination therapy. Currently, the best evidence for reducing the risk for cognitive decline as we age through lifestyle is also a combination approach, including regular physical activity, mental stimulation, and a brain/heart-healthy diet. [alz.org/10ways] This begs the question, could Alzheimer’s combination therapy also take the form of drug therapy plus lifestyle changes? A combined lifestyle-drug approach is now common for lowering risk of heart disease; many people pair healthy diet and exercise with cholesterol and/or blood pressure medications. While combination therapy for Alzheimer’s is a promising strategy, studying it presents unique challenges. These include both science- and business-related obstacles. For example, few companies have a diverse enough pipeline of Alzheimer’s therapeutic agents in development to carry out combination therapy trials alone. Most would need to collaborate with another company or research center while protecting their intellectual property. Fortunately, partnership models exist in ongoing Alzheimer’s prevention trials where companies, academic researchers, government, non-profits and private charities have joined forces to test potential Alzheimer’s drug therapies. This approach makes it possible for companies to negotiate intellectual property concerns and spread the risk of therapy development across multiple stakeholders. Nonetheless, there remain many issues to untangle in this area. Another challenge is determining which treatment combinations to test. In April 2015, the Alzheimer’s Association convened an expert workgroup of leaders from academia and industry, and a former member of the U.S. Food and Drug Administration, to identify challenges and solutions to developing Alzheimer’s combination therapies. The group recommended that researchers collaborate to bring forward combinations of drug candidates previously tested in Alzheimer’s animal models and with known safety in humans. These candidates, they said, would yield the best chances for success and ensure speedier clinical trials. At the same time, we need more basic research to better understand how Alzheimer’s develops and progresses. Calling on lawmakers to increase federal Alzheimer’s research funding is something virtually anyone can do. Those who want to get involved can visit alz.org/advocacy. We are at a juncture of unprecedented promise in Alzheimer’s research. A few decades ago, we knew virtually nothing about how Alzheimer’s develops or progresses. Today we are looking at the possibility of combination therapies that attack the disease in multiple ways. With continued commitment from government, companies, academic researchers, and nonprofit research funders, we can unlock the combination to better Alzheimer’s therapy. This post includes excerpts from “Challenges, solutions, and recommendations for Alzheimer’s disease combination therapy,” a review article published in March 2016 in Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association.
News Article | May 23, 2017
Outgoing Director-General Margaret Chan (L) poses with Tedros Adhanom Ghebreyesus after his election as Director General of the World Health Organization (WHO) during the 70th World Health Assembly in Geneva, Switzerland, May 23, 2017. REUTERS/Denis Balibouse GENEVA (Reuters) - Ethiopia's Tedros Adhanom Ghebreyesus won the race to be the next head of the World Health Organisation (WHO) on Tuesday, becoming the first African to lead the Geneva-based United Nations agency. The former health minister and foreign minister, who vowed to make universal health care his priority, won over half the votes from 189 member states in the first round and prevailed in a third-round ballot against Britain's David Nabarro. "It's a victory day for Ethiopia and for Africa," Ethiopia's ambassador to the U.N. in Geneva Negash Kebret Botora said. Tedros, as he is widely known, told health ministers at the WHO's annual assembly after his election: "All roads lead to universal coverage. This will be my central priority. "At present, only about a half of the world's people have access to health care without impoverishment. This needs to improve dramatically," he added. Six candidates sought to take the helm at the WHO, which is tasked with combating disease outbreaks and chronic illnesses. The WHO said Tedros had led a "comprehensive reform effort" of Ethiopia's health system, creating health centres and jobs. UNAIDS, the vaccine alliance GAVI, U.S. Health and Human Services Secretary Tom Price and the International Federation of Pharmaceutical Manufacturers welcomed his appointment. "Tedros has the power to herald a new era in how the world prepares for and responds to epidemics, including building partnerships, strengthening public health systems, and developing new vaccines and therapies that are available to all who need them," Jeremy Farrar, director of the medical charity Wellcome Trust, said in a statement. Tedros will begin his five-year term after Margaret Chan, a former Hong Kong health director, steps down on June 30. Chan leaves a mixed legacy after her 10 years on the job, especially because of WHO's slow response to West Africa's Ebola epidemic in 2013-2016, which killed 11,300 people. In a last pitch before voting began, Tedros appealed to ministers by promising to represent their interests and to ensure more countries got top jobs at the Geneva-based WHO. "I will listen to you. I was one of you. I was in your shoes and I can understand you better," he said. Tedros was widely seen as having the support of about 50 African votes, but questions about his role in restricting human rights and Ethiopia's cover-up of a cholera outbreak surfaced late in the race, threatening to tarnish his appeal. "You now have a clear mandate. We welcome your promises on transparency, delivery and reform," said Sally Davies, Britain's medical chief officer.
News Article | May 3, 2017
In “What Makes Us Human? The Story of a Shared Dream” (published by Balboa Press), Jean-Louis Lamboray tells the stories of communities whose members shed their titles and prejudices to appreciate their strengths and embark on a common journey as human beings. He further explains how a culture of appreciation changes society’s relationship to facts, money, ethics and expertise. According to Lamboray, the shared dream of the Constellation, an international non-profit organization founded in 2004, is becoming a reality. “From the outset, we dreamed of a world where communities act based on their strengths to realize their dreams,” Lamboray explains. “Our job would be to stimulate and to connect local responses.” In the book, Lamboray discusses how the Constellation is now connected to communities in more than 60 countries who mobilize their own resources to address a wide range of life challenges such as AIDS, gender violence, neighborhood security, waste management and inclusion of migrants in society. “The world requires a new frame of reference, and it is emerging,” says Lamboray. “As communities recover their right to dream they build the world to which they deeply aspire.” “What Makes Us Human?” By Jean-Louis Lamboray Hardcover | 6 x 9 in | 110 pages | ISBN 9781504363709 Softcover | 6 x 9 in | 110 pages | ISBN 9781504363723 E-Book | 110 pages | ISBN 9781504363716 Available at Amazon and Barnes & Noble About the Author Jean-Louis Lamboray worked as a public health physician at Belgian Aid, the World Bank and UNAIDS. The red line in his career is trust in the potential of human beings. He now serves happily as a voice of the Constellation. Balboa Press, a division of Hay House, Inc. – a leading provider in publishing products that specialize in self-help and the mind, body, and spirit genres. Through an alliance with indie book publishing leader Author Solutions, LLC, authors benefit from the leadership of Hay House Publishing and the speed-to-market advantages of the self-publishing model. For more information, visit balboapress.com. To start publishing your book with Balboa Press, call 877-407-4847 today. For the latest, follow @balboapress on Twitter.
News Article | May 3, 2017
DUBLIN--(BUSINESS WIRE)--Research and Markets has announced the addition of the "Western Blotting Market Analysis By Product (Gel Electrophoresis, Blotting Systems, Imagers, Consumables), By Application (Biomedical & Biochemical Research, Disease Diagnostics), By End-Use, And Segment Forecasts, 2014 - 2025" report to their offering. The global western blotting market is anticipated to reach a value of USD 958.4 million by 2025. Rising number of cases with HIV are increasingly contributing towards the growth of western blotting market. This kind of testing is highly effective in detecting HIV among people. According to UNAIDS, nearly 36.7 million people were living with HIV throughout the world in 2015. Such high prevalence of HIV is expected to accelerate the demand for products used in western blotting. Lyme diseases also require western blotting to detect Borrelia burgdorferi (Bb), which causes such diseases. Other diseases which require western blot for detection of specific proteins include mad cow disease, hepatitis, and feline immunodeficiency. Moreover, significant investments in R&D activities made by pharmaceutical and biotechnology companies are expected to foster growth of western blotting market. According to a news journal, biotech companies spent USD 40.1 billion in 2015 on R&D activities, which was a 16% rise from their 2014 investments. Hence, with rising number of R&D activities, there is an expected rise in the demand for western blotting tests in the near future. Further key findings from the study suggest: Some of the key players are For more information about this report visit http://www.researchandmarkets.com/research/3jk52g/western_blotting
Buse K.,UNAIDS |
Hawkes S.,University College London
Globalization and Health | Year: 2015
The Millennium Development Goals (MDGs) galvanized attention, resources and accountability on a small number of health concerns of low- and middle-income countries with unprecedented results. The international community is presently developing a set of Sustainable Development Goals as the successor framework to the MDGs. This review examines the evidence base for the current health-related proposals in relation to disease burden and the technical and political feasibility of interventions to achieve the targets. In contrast to the MDGs, the proposed health agenda aspires to be universally applicable to all countries and is appropriately broad in encompassing both communicable and non-communicable diseases as well as emerging burdens from, among other things, road traffic accidents and pollution. We argue that success in realizing the agenda requires a paradigm shift in the way we address global health to surmount five challenges: 1) ensuring leadership for intersectoral coherence and coordination on the structural (including social, economic, political and legal) drivers of health; 2) shifting the focus from treatment to prevention through locally-led, politically-smart approaches to a far broader agenda; 3) identifying effective means to tackle the commercial determinants of ill-health; 4) further integrating rights-based approaches; and 5) enhancing civic engagement and ensuring accountability. We are concerned that neither the international community nor the global health community truly appreciates the extent of the shift required to implement this health agenda which is a critical determinant of sustainable development. © 2015 Buse and Hawkes.
Larmarange J.,University of Paris Descartes |
AIDS | Year: 2014
Objectives: A better understanding of the subnational variations could be paramount to the efficiency and effectiveness of the response to the HIV epidemic. The purpose of this study is to describe the methodology used to produce the first estimates at second subnational level released by UNAIDS.Methods: We selected national population-based surveys with HIV testing and survey clusters geolocation, conducted in 2008 or later. A kernel density estimation approach (prevR) with adaptive bandwidths was used to generate a surface of HIV prevalence. This surface was combined with LandScan global population distribution grid to estimate the spatial distribution of people living with HIV (PLWHIV). Finally, results were adjusted to national UNAIDS's published estimates and merged per second subnational administrative unit. An indicator of the quality of the estimates was computed for each administrative unit.Results: These estimates combine two complementary approaches: The prevR method, focusing on spatial variations of HIV prevalence, as well as national estimates published by UNAIDS, taking into account trends of HIV prevalence over time. Seventeen country reports have been produced. However, quality of the estimates at second subnational level is highly heterogonous between countries, depending on the number of units and the survey sampling size. In some countries, estimates at second subnational level are very uncertain and should be interpreted with caution.Conclusion: These estimates at second subnational level constitute a first step to help countries to better understand their HIV epidemic and to inform programming at lower geographical levels. Further developments are needed to better match local needs. © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins.
Sexually transmitted infections | Year: 2010
The Spectrum projection package uses estimates of national HIV incidence, demographic data and other assumptions to describe the consequences of the HIV epidemic in low and middle-income countries. The default parameters used in Spectrum are updated every 2 years as new evidence becomes available to inform the model. This paper reviews the default parameters that define the course of HIV progression among adults and children in Spectrum. For adults, data available from published and grey literature and data from the ART-LINC International epidemiologic Database to Evaluate AIDS (IeDEA) collaboration were combined to estimate survival among those who started antiretroviral therapy (ART). For children, a review of published material on survival on ART and survival on ART and cotrimoxazole was used to derive survival probabilities. Historical data on the distribution of CD4 cell counts and CD4 cell percentages by age among children who were not treated (before treatment was available) were used to progress children from seroconversion to different CD4 cell levels. Based on the updated evidence estimated survival among adults aged over 15 years in the first year on ART was 86%, while in subsequent years survival was estimated at 90%. Survival among children during the first year on ART was estimated to be 85% and for subsequent years 93%. The revised default parameters based on additional data will make Spectrum estimates more accurate than previous rounds of estimates.
Sexually transmitted infections | Year: 2010
The number of HIV-positive pregnant women receiving antiretroviral drugs (ARVs) to prevent mother-to-child transmission (MTCT) of HIV has increased rapidly. To estimate the reduction in new child HIV infections resulting from prevention of MTCT (PMTCT) over the past decade. To project the potential impact of implementing the new WHO PMTCT guidelines between 2010 and 2015 and consider the efforts required to virtually eliminate MTCT, defined as <5% transmission of HIV from mother to child, or 90% reduction of infections among young children by 2015. Data from 25 countries with the largest numbers of HIV-positive pregnant women were used to create five scenarios to evaluate different PMTCT interventions. A demographic model, Spectrum, was used to estimate new child HIV infections as a measure of the impact of interventions. Between 2000 and 2009 there was a 24% reduction in the estimated annual number of new child infections in the 25 countries, of which about one-third occurred in 2009 alone. If these countries implement the new WHO PMTCT recommendations between 2010 and 2015, and provide more effective ARV prophylaxis or treatment to 90% of HIV-positive pregnant women, 1 million new child infections could be averted by 2015. Reducing HIV incidence in reproductive age women, eliminating the current unmet need for family planning and limiting the duration of breastfeeding to 12 months (with ARV prophylaxis) could avert an additional 264000 infections, resulting in a total reduction of 79% of annual new child infections between 2009 and 2015, approaching but still missing the goal of virtual elimination of MTCT. To achieve virtual elimination of new child infections PMTCT programmes must achieve high coverage of more effective ARV interventions and safer infant feeding practices. In addition, a comprehensive approach including meeting unmet family planning needs and reducing new HIV infections among reproductive age women will be required.
Sexually transmitted infections | Year: 2010
An estimated 4.9 million adults received antiretroviral therapy (ART) in low and middle income countries in 2009. A further estimated 700000 adults received ART in high-income countries. The impact of providing ART is not often quantifiable due to limited monitoring systems. One measure, life-years gained, provides a standardised measure that shows the survival impact of ART on the population while controlling for variations in underlying survival. Measuring life-years gained allows a comparison of the impact of ART between regions. Using the Spectrum computer package, two different scenarios were created for 151 countries. One scenario describes the results of providing adults with ART as reported by countries between 1995 and 2009, the second scenario describes a situation in which no ART was provided to adults living with HIV between 1995 and 2009. The difference in the number of life-years accrued among adults in the two scenarios is compared and summarised by geographical region. An estimated 14.4 million life-years have been gained among adults globally between 1995 and 2009 as a result of ART. 54 % of these years were gained in western Europe and North America, where ART has been available for over 10 years. In recent years the growth in life-years has occurred more rapidly in sub-Saharan Africa and Asia. The substantial impact of ART described here provides evidence to argue for continued support of sustainable ART programmes in low and middle-income countries. Strengthening ART monitoring systems and mortality surveillance in low and middle-income countries will make this evidence more accessible to programme managers.
International Group on Analysis of Trends in HIV Prevalence,UNAIDS
Sexually transmitted infections | Year: 2010
In 2001 the United Nations (UN) Declaration of Commitment was signed by 189 countries with a goal to reduce HIV prevalence among young people by 25% by 2010. Progress towards this target is assessed. In addition, changes in reported sexual behaviour among young people aged 15-24 years are investigated. Thirty countries most affected by HIV were invited to participate in the study. Trends in HIV prevalence among young antenatal clinic (ANC) attendees were analysed using data from sites that were consistently included in surveillance between 2000 and 2008. Regression analysis was used to determine if the UN target had been reached. Trends in prevalence data from repeat national population-based surveys were also analysed. Trends in sexual behaviour were analysed using data from repeat standardised national population-based surveys between 1990 and 2008. Seven countries showed a statistically significant decline of 25% or more in HIV prevalence among young ANC attendees by 2008, in rural or urban areas or in both: Botswana, Côte d'Ivoire, Ethiopia, Kenya, Malawi, Namibia and Zimbabwe. Three further countries showed a significant decline in HIV prevalence among young women (Zambia) or men (South Africa, Tanzania) in national surveys. Seven other countries are on track, whereas four are unlikely to reach the goal by 2010. Nine countries did not have adequate data to assess prevalence trends. Indications suggestive of changes towards less risky sexual behaviour were observed in the majority of countries. In eight countries with significant declines in HIV prevalence, significant changes were also observed in sexual behaviour in either men or women for at least two of the three sexual behaviour indicators. Declines in HIV prevalence among young people were documented in the majority of countries with adequate data and in most cases were accompanied by changes in sexual behaviour. Further data, research and more rigorous analysis at country level are needed to understand the associations between programmatic efforts, reported behavioural changes and changes in prevalence and incidence of HIV.