Olympic Athletes: Trouble Breathing In Beijing?

When the world’s top athletes convene next month for the Beijing 2008 Olympic Games, some will face a challenge that tests more than their athletic abilities. Heavy pollution in the Chinese capital could pose problems for competitors, especially those with asthma, according to the American Academy of Allergy, Asthma & Immunology (AAAAI).

The ozone, sulfur dioxide, nitric oxide and other pollutants in Beijing’s hazy air are asthmagenic – meaning exposure can inflame the airways of sensitive people and even cause an asthma attack. Similar problem were witnessed in past Olympic host cities of Atlanta, Athens and Seoul, but Beijing’s place among the world’s worst in air quality has experts concerned.

“Not only will athletes have irritated eyes, but a good portion may have decreased potential to be competitive,” said Timothy Craig, DO, FAAAAI, and chair of the AAAAI Sports Medicine Committee. “Exercise can enhance the adverse effects air pollutants have on health. Rigorous exercise combined with pollutants can sometimes stimulate an asthma attack.”

Research points to EIA origins

New research to be presented next month in the Journal of Allergy and Clinical Immunology (JACI), the official scientific journal of the AAAAI, investigates the origins of exercise-induced asthma.

Sandra D. Anderson, PhD, DSc, and colleagues report that exercise-induced asthma results from injuries to the airway caused by breathing poorly conditioned air – particularly cold, dry air – over long periods of time. The researchers concluded that cold-weather athletes and swimmers, who train in irritant environments, may be at risk of airway injury leading to increased airway sensitivity.

In a European study of adolescent elite swimmers, Lars Pedersen, MD, and colleagues found that young competition swimmers had the same healthy airways as their non-swimming peers after two years in the sport. However, previous studies have shown a higher prevalence of respiratory symptoms among adult endurance athletes, suggesting that these sensitivities develop over time and repeated exposure to the pool environment.

EIA common among athletes

Exercise-induced asthma (EIA) affects an estimated 20 percent of top athletes and an estimated 1 in 6 of all Olympic athletes, according to the AAAAI. EIA frequently affects individuals who do not suffer from chronic asthma.

Typically, athletes with EIA experience difficulty breathing 5-10 minutes after exercise. Other symptoms include:

- Wheezing
- Chest tightness
- Coughing
- Chest pain
- Prolonged or unexpected shortness of breath

Prescription asthma medications, including controller and rescue medication, can be used to control and treat EIA. Due to anti-doping regulations, which restrict the use of many asthma medications at the Olympic Games, athletes must obtain official approval for many medications.

Tactics that can help mitigate EIA include warming up before exercise and keeping hydrated.

Spectators should also prepare
In addition to athletes, high pollution levels threaten to take a toll on spectators with a history of allergies or asthma.

“Spectators may develop the same symptoms as the athletes and need to be prepared to treat their asthma and other allergic diseases if they develop or worsen,” Craig said. “Remember to take your asthma medication as prescribed and carry albuterol and hydrating eye drops at all times to treat symptoms. Think ‘avoidance’ and be willing to stay indoors on a very poor air quality day so the rest of your trip is completed in health.”

The AAAAI represents allergists, asthma specialists, clinical immunologists, allied health professionals and others with a special interest in the research and treatment of allergic disease. Established in 1943, the AAAAI has more than 6,500 members in the United States, Canada and 60 other countries.


AIDS Research Boosted By $8.5M Grant Award To UMass Medical School

As the HIV/AIDS epidemic continues around the globe laying claim to more than 25 million lives and infecting over 39 million, researchers continue to search for both a cure and improved treatments for those suffering with this disease. Now the leading cause of death worldwide among 15 to 59 year olds, AIDS is a remarkably resilient adversary with the potent ability to evolve rapidly. This evolution dramatically complicates treatment, decreasing the effectiveness of existing drugs and necessitating the continual development of new therapeutics. University of Massachusetts Medical School Professor of Biochemistry & Molecular Pharmacology Celia A. Schiffer, PhD, is at the forefront of investigations to elucidate how HIV develops resistance to current drugs.

As a principal investigator of a National Institutes of Health Institute of General Medical Sciences Program Project Grant first awarded in 2001, Dr. Schiffer has comprised a stellar team of scientists from around the nation to develop HIV drugs that are less vulnerable to drug resistance. In recognition of the success of her efforts, Schiffer was recently awarded a full, five-year renewal of the project, “Targeting Ensembles of Drug Resistant HIV-Protease.” The renewal, totaling more than $8.5 million, will speed studies that seek a better understanding of inhibitor recognition and the development of new methodologies for designing inhibitors against HIV and other viruses and infections that have a propensity for acquiring drug resistance.

According to Terry R. Flotte, MD, executive deputy chancellor of UMMS and dean of the School of Medicine, the renewal reflects the NIH’s confidence in Schiffer’s scientific aims. “This work clearly illustrates how the advance of molecular biology can lead to direct benefit to patients. Dr. Schiffer’s efforts to define exactly how HIV can become resistant to current drugs are vital to the development of better strategies to control HIV/AIDS.”

While highly active antiretroviral treatment (HAART) including inhibitors that target HIV-1 protease — a protein that allows viral maturation through cutting and releasing key viral components in the immature virus — has been remarkably successful in decreasing mortality, the emergence of mutations of HIV-1 that are resistant to current drug regimens is a critical factor in the clinical failure of antiviral therapy. With this renewed funding, Schiffer and colleagues will continue to address this challenge with a comprehensive approach that integrates clinical data, structural biology and biophysical chemistry, medical informatics and biostatistics, biochemistry and molecular virology, computational chemistry and computer-aided design, and synthetic and medicinal chemistry. The integrated program embraces two overarching goals: to clarify the role of compensatory mutations in HIV-1 protease in conferring drug resistance and to develop new HIV-1 protease inhibitors that are more robust against drug resistance.

“The occurrence of drug resistance negatively impacts the lives of millions of patients by limiting the longevity of many of our most promising new drugs. Through this integrated approach, we look forward to contributing to the development of drugs that promise to be more effective against HIV. Importantly, the new strategies we develop may also reduce drug resistance in other quickly evolving diseases, including lung cancer and hepatitis C,” Schiffer said.

To date, Schiffer and collaborators have made a number of advances. In 2004, for example, they were able to determine the crystal structures of many of the substrates — the sites HIV-1 protease cuts in the immature virus allowing viral maturation — and to compare their shape with the existing drugs. They found that while the sequences of the sites that are cuts were different, they all fit within a similar space, which they dubbed the “substrate envelope.” Significantly, the investigators found that most of the currently used inhibitors protrude beyond the substrate envelope, and many mutations that cause drug resistance occur where the inhibitors protrude away from the substrates. Drug resistance occurs since mutations at these positions limit drug binding, but allow HIV-1 protease to continue to function by recognizing and cutting substrates, thereby permitting the virus to mature.

In 2006, expanding upon this work the investigators reported on a new strategy to reduce the probability of drug resistance, by designing and synthesizing novel inhibitors to fit within the substrate envelope. This strategy should greatly retard the occurrence of drug resistance as any mutation that would confer drug resistance would simultaneously impact substrate recognition, thereby preventing HIV protease from functioning. Thus inhibitors developed by this method should be more robust against resistance occurring. Confirming the validity of this strategy, the scientists have designed, synthesized and are evaluating a novel series of highly potent HIV protease inhibitors that appear promising against drug resistant variants of HIV protease.

In addition to Schiffer, the principal investigator for the grant, other researchers closely involved include: UMMS Professor of Biochemistry and Molecular Pharmacology and Director of Chemical Biology Tariq Rana, PhD; Stanford University Medical Center Associate Professor Robert Shafer, MD; University of North Carolina School of Medicine Professor Ronald Swanstrom, PhD; and Massachusetts Institute of Technology Professor Bruce Tidor, PhD. Dr. Rana, in addition to his work on therapeutic RNAis, uses synthetic organic chemistry and high throughput chemical screens to focuses on HIV-related targets. Dr. Shafer is a physician specializing in drug resistance in infectious diseases and is the developer of a widely used patient-derived HIV sequence database of protease and reverse transcriptase. Dr. Swanstrom uses molecular virology and biochemistry on retroviruses in general and mechanisms of HIV drug-resistance in particular. Dr. Tidor develops computational methods for drug design utilizing the inverse design of optimal charge interactions and complementarity within a ligand binding pocket.

About the University of Massachusetts Medical School

The University of Massachusetts Medical School, one of the fastest growing academic health centers in the country, has built a reputation as a world-class research institution, consistently producing noteworthy advances in clinical and basic research. The Medical School attracts more than $176 million in research funding annually, 80 percent of which comes from federal funding sources. The work of UMMS researcher Craig Mello, PhD, an investigator of the prestigious Howard Hughes Medical Institute (HHMI), and his colleague Andrew Fire, PhD, then of the Carnegie Institution of Washington, toward the discovery of RNA interference was awarded the 2006 Nobel Prize in Physiology or Medicine, hailed as the “Breakthrough of the Year” in 2002 by Science magazine and has spawned a new and promising field of research, the global impact of which may prove astounding. UMMS is the academic partner of UMass Memorial Health Care, the largest health care provider in Central Massachusetts. For more information, visit umassmed/

Source: Kelly Bishop

University of Massachusetts Medical School

International Scientific Workshop Focuses On New Methods For Vaccine And Antibody Development

Leading scientists
from around the world will meet in Wilmington, Delaware next week to
discuss innovative approaches for producing life-saving vaccines and
antibodies. More than 125 scientists and business leaders will be
participating in “New Cells for New Vaccines II: Focus on Respiratory Virus
Diseases” on September 17-19 at the Hotel du Pont. The international
scientific workshop is being organized by the Fraunhofer USA Center for
Molecular Biotechnology (CMB) and InB:Biotechnologies, Inc. of Newark,
Delaware, under the auspices of the International Association for
Biologicals (IABS).

According to Dr. Vidadi Yusibov, Executive Director of the Fraunhofer
USA Center for Molecular Biotechnology, “The past fifty years have seen an
increase in the types of cells that can be used for vaccine and antibody
production, however, there remains a need for new cell substrates that can
provide safer, faster and more cost effective production alternatives to
current techniques, especially with the potential threat of an influenza

“A key aspect of the success and viability of a vaccine development
project is the choice of an appropriate cell substrate,” said Dr. Geoffrey
Schild, Chief Scientific Officer of InB:Biotechnologies and a Director of
IABS. “The advantages of plant, animal and insect cell systems are
increasingly being recognized and many projects are in progress
internationally, including development of respiratory virus, cervical
cancer, anthrax and malaria vaccines, as well as therapeutic antibodies to
treat influenza infections.”

New Cells for New Vaccines II: Focus on Respiratory Virus Diseases will
be of interest to scientists and business leaders in the biotechnology and
pharmaceutical industry involved in vaccine development and production, as
well as public health officials, medical and veterinary experts. More
details and registration information are available on the meeting web site

About Fraunhofer USA Center for Molecular Biotechnology:

The mission of Fraunhofer USA CMB is to develop safe and effective
vaccines targeting infectious diseases and autoimmune disorders. CMB’s
technology provides a safe, rapid and economical alternative for vaccine
production. Fraunhofer USA CMB is part of Fraunhofer USA, Inc., a
non-profit research and development corporation, with headquarters in
Michigan. It operates through technology centers that are partnered with
major research universities in the United States and also with parent
research institutes in Germany.

Fraunhofer USA

Safety Of Biologic Treatment For Arthritis Depends On The Drug

Some biologic drugs may be safer than others according to a new systematic review by Cochrane researchers. Biologics are a broad class of drugs based on biological molecules. The drugs are used to reduce inflammation in diseases such as rheumatoid arthritis and inflammatory bowel disease.

Although the effectiveness of biologics is now well established, it is thought that some may have rare but serious side effects related to their immune-suppressing activities. Links have been made to increased risk of infections, reactivation of tuberculosis (TB), cancer and congestive heart failure.

The review is based on data from 163 studies focused on nine different biologics used to treat arthritis and other conditions. A total of 50,010 patients took part in the studies. Adverse events and TB reactivation were more likely among those taking biologics compared to controls. Serious side effects, lymphoma and congestive heart failure were no more likely. When compared to each other, two drugs, adalimumab and infliximab, caused more adverse events, whereas abatacept and anakinra were associated with fewer serious adverse events. Taking certolizumab pegol was more likely to result in a serious infection compared to several other biologics.

The researchers say the results should be treated cautiously. “The data provides some guidance for clinicians and patients as regards the safety of different biologic drugs, but we should remember that these are not head-to-head trials.” said lead researcher Jasvinder Singh of the Birmingham VA Medical Center in Birmingham, Alabama. “There is still an urgent need for more research into the safety of these drugs, and in particular their comparative safety.”

Some adverse events were so rare that it was difficult to establish whether or not they were linked to the drugs. “Biologics did not seem to increase the likelihood of congestive heart failure or cancer compared to placebos, but there were few cases in total, so we can’t be very confident about these results,” said Singh. “The studies we looked at did show a few more people suffering from tuberculosis with biologics, but again total numbers were low.”

Jennifer Beal


Alzheimer’s Society Comment On Nuffield Council On Bioethics Report

People with dementia, carers and doctors are not getting the support they need to deal with the ethical issues they face-a new report from the Nuffield Council on Bioethics reveals.

The authors call for better training for doctors, nurses and professional carers and emphasise the responsibility we all have to support people with dementia to live well.

The report highlights that it’s not just the big decisions but also the ordinary things that cause distress, such as whether people with dementia should be given the freedom to carry on with potentially risky activities like cooking or driving. The report also looked at the acceptability of lying to people with dementia if it is seen to be for their benefit.

Neil Hunt, Chief Executive, Alzheimer’s Society says,

‘This report provides compelling evidence of the need for better public understanding of dementia, more support and greater investment in research.

Families, carers and professionals face a range of complex and distressing ethical issues when caring for a person with dementia. Decisions can be hugely emotional and there are no right or wrong answers. The Nuffield council recognises the need to combat stigma and emphasises how important it is to value the person with dementia and treat families as partners in care.

One in three people over 65 will die with dementia. We need to ensure that carers are supported in making difficult ethical decisions and people with dementia are involved in this process wherever possible.’

Sue Baker, who has a father with Alzheimer’s disease has faced her own ethical dilemmas.

‘As a carer it’s pretty normal to have to make difficult choices on a regular basis but that doesn’t make it any easier. When Dad was diagnosed with bowel cancer we chose not to tell him as having Alzheimer’s disease was already more than enough for him to deal with and it would only have caused unnecessary pain. You have to look at your individual situation and act with the best interests of the person with dementia in mind.’

The report was released following a year’s work involving consultations with experts, including Alzheimer’s Society. Alzheimer’s Society worked with its members to feed the experiences and views of people with dementia and their carers into this process.


Summary of key points from the report:

- Dementia is a medical condition but dementia services are often classed as social and not made available until a crisis point occurs. People with cancer would not be expected to wait for a crisis point and neither should people with dementia.

- People should have access to good quality assessment and support from the moment they or their families become concerned about symptoms

- Families should be treated as ‘partners in care’ by professionals.

- Risk assessments should be replaced by ‘risk-benefit assessments’ that take into account the quality of life of the person with dementia.

- The Equality & Human Rights Commission should highlight the legal duties of shops and restaurants to ensure people with dementia can use their services.

- Greater guidance is needed on how to apply mental capacity legislation and the process of appointing a welfare attorney should be easy and free.

- There should be more funding for dementia research, including research into how people with dementia can be supported to live well.

Alzheimer’s Society

Smarter Spending Would Help To Contain Cost ‘Timebomb’ – Alzheimer’s Society, UK

Alzheimer’s Society is supporting a call by national charity Counsel and Care to spend smarter to help the financial crisis.

Counsel and Care want government and local councils to use social care funding more wisely to deliver better care for Britain’s ageing population. Counsel and Care believes smarter spending could release up to 3 billion pounds that could be redirected to provide better care and support for the growing number of older people and their carers.

Alzheimer’s Society comment:

‘Action to address the current funding crisis is urgently needed and at the top of the agenda must be better spending on care for older people. Getting better at supporting people earlier can avoid costly hospital visits and can help carers carry on caring for people at home delaying or avoiding residential care. With the number of people with dementia set to reach a million in 15 years dementia has been described as a ‘timebomb’, but with proper planning and better use of resources the cost can be contained.’

Ruth Sutherland
Chief Executive (Acting)

Alzheimer’s Society

Comment On The Study ‘Filaggrin Gene Defects And Risk Of Developing Allergic Sensitisation And Allergic Disorders: Systematic Review And Meta-analysis

Dr Elaine Vickers, Research Relations Manager at Asthma UK, says: ‘This is an important piece of research which helps to explain why the majority of children with severe eczema go on to develop asthma in later childhood, as a result of their genetic make-up.

‘It may help us to understand why more than a million children in the UK are affected by asthma and identify those children who are at an increased risk of developing the condition after having eczema when they were younger.

‘This could be a significant step forward in helping to improve the diagnosis and treatment of children with allergy-related conditions, and reducing the numbers affected.’

Asthma UK

Disability Resulting From Long-Term Rheumatoid Arthritis Reduced With Biologic Treatment

New data demonstrating the safety and efficacy of Enbrel® (etanercept) in the treatment of rheumatoid arthritis (RA) patients over the long-term were presented today at the EULAR (European League Against Rheumatism) congress (1). Over 2,000 patients receiving this biologic treatment for up to nine years, saw improvements in disability whilst safety was also sustained over the long-term.

Biologics, such as etanercept, work by blocking the action of a naturally occurring protein in the body called ‘tumor necrosis factor’ that is involved in causing inflammation (2). When combined with methotrexate, etanercept, also known as an anti-TNF therapy, has been shown to halt radiographic damage in patients with moderate RA activity over multiple years – which means the disease is halted at that stage (3).

Professor Lars Klareskog of Karolinska Institute Karolinska University Sweden, said, “These strong data should give doctors the confidence to consider a biologic earlier in patients with aggressive and progressive rheumatoid arthritis, and patients should now have the prospect of less disability with a treatment which has also proven to have a good long-term safety”.

The analysis includes over nine thousand patient years of data from a total of 2,054 patients who were monitored for serious adverse events (SAEs), serious and opportunistic infections, sepsis, malignancies and lymphomas. Overall rates of SAE’s were similar to control groups (0.11 pt-yr and 0.17 pt/yr vs 0.11-0.20/pt yr), as were serious infections, and reports of opportunistic infection were rare (1).

Professor Emilio Martin Mola of the Rheumatology Unit at Hospital Universitario La Paz, Spain added: “With both earlier and continuous use of Enbrel we can prevent the debilitating affects of RA taking hold and maintain this response for many years. It’s critical that appropriate funding for biologics is sourced to continue the fight against serious inflammatory diseases, such as RA.”

The economic burden created by RA in Europe is significant due to costs from work disability and 20-30% of patients become permanently disabled during the first two or three years of the disease (4). This latest study adds to the clinical evidence highlighting the role of prevention of disease progression through earlier anti-TNF treatment. Given the significant social and economical burden of this disease this makes good sense for patients and healthcare systems alike.

Enbrel has a well characterized safety profile and is well tolerated. Although a rare event, a higher than expected rate of lymphoma was observed in the analysis. However, further study is required to establish whether this is related to TNF antagonist exposure or reflects the elevated risk of lymphoma in patients with RA.

About Rheumatoid Arthritis (RA)

Rheumatoid arthritis (RA) is a chronic inflammatory disease that typically affects the hands and feet although any joint lining may be affected (5). If the condition persists over time, it can cause permanent damage to tendons, ligaments, cartilage and bone, resulting in potential destruction and deformity (5). Potential irreversible joint damage may lead to loss of function and premature death (6). RA is also associated with serious morbidities including coronary artery disease infection and lymphoma (7).

About Wyeth

Wyeth Pharmaceuticals, a division of Wyeth, has leading products in the areas of women’s health care, cardiovascular disease, central nervous system, inflammation, transplantation, hemophilia, oncology, vaccines and nutritional products. Wyeth is one of the world’s largest research-driven pharmaceutical and health care products companies. It is a leader in the discovery, development, manufacturing, and marketing of pharmaceuticals, vaccines, biotechnology products and nonprescription medicines that improve the quality of life for people worldwide. The Company’s major divisions include Wyeth Pharmaceuticals, Wyeth Consumer Healthcare, and Fort Dodge Animal Health. wyeth

1) Klareskog L. Safety and Efficacy of Over 9 Years of Continuous Etanercept Therapy in Patients with
Rheumatoid Arthritis in North America and Europe, EULAR Congress 2007, Poster No. THU0170

2) Weaver, A L, the Impact of new biologicals in the treatment of Rheumatoid Arthritis Rheumatology 2004;43 (Suppl.3):iii17-iii23

3) van der Heijde, D. et al. Combination etanercept and methotrexate halts radiographic damage in patients with moderate RA activity on methotrexate, EULAR Congress 2007, Poster No. THU0213

4) Sokka T. Work disability in early rheumatoid arthritis. Clinical and Experimental Rheumatology 2003;21 (Suppl.31) S71-S74

5) Lee DM, Weinblatt ME. Rheumatoid arthritis Lancet 2001; 358: 903-911

6) Callahan LF, Pincus T. Mortality in the rheumatic diseases. Arthritis Care Res 1995;8:229-41

7) Gabriel SE. The epidemiology of rheumatoid arthritis. Rheum. Dis. Clin. North Am. 2001;27:269-281

View drug information on Enbrel.

Allergy & Asthma Network Mothers Of Asthmatics Provides Tips To Asthma Patients For Dealing With Swine Flu

Today Allergy & Asthma Network Mothers of Asthmatics (AANMA), the leading patient advocacy group for allergy and asthma, provided guidelines for people with asthma to prevent H1N1, often referred to as swine flu, and prepare themselves in the event they contract this virus that is threatening to become a global pandemic.

Although those with asthma are not necessarily more prone to coming down with H1N1 flu, their symptoms can be worse due to their compromised immune systems.

Influenza attacks the respiratory system, which means that those with asthma, chronic obstructive pulmonary disease (COPD) and related respiratory conditions are also at higher risk of developing complications from the virus. As a result, prevention and preparation are essential.

Nancy Sander, President and Founder of AANMA, said, “If symptoms occur, early intervention is critical. Just because we are at greater risk of serious flu complications doesn’t mean we can’t be well-armed and weather the storm. The best insurance plan is to have a written asthma action plan consistent with the federally funded, evidence-based National Asthma Education and Prevention Program (NAEPP)’s Guidelines for the Diagnosis and Management of Asthma. Access to inhaled corticosteroids and other appropriate medications, annual flu shots and specialty care are among top recommendations that, when followed, eliminate death and suffering and reduce direct costs as high as $37 billion each year.”

AANMA offers the following tips:

– Make sure you have an up-to-date, written asthma-management plan from your physician, as detailed by the NAEPP Guidelines.

– Make sure you have a fresh, full supply of medications.

– Practice good hygiene, especially hand washing.

– Stock up on food and entertainment (movies, books, games) to minimize time spent in public places.

Symptoms of H1N1 flu include:

– fever

– extreme tiredness

– lack of appetite

– coughing

Some people with the virus have also reported a runny nose, sore throat, nausea, vomiting and diarrhea.

People with asthma are also advised to steer clear of Relenza, an antiviral medication sometimes prescribed for the flu instead of Tamiflu. Some patients using Relenza have had bronchospasm (wheezing) or serious breathing problems. Many but not all of these patients had previous asthma or COPD. Relenza has not been shown to shorten the duration of influenza in people with these diseases.”

Sander continued, “The key is to treat symptoms early according to the written asthma action plan. Although the NAEPP Guidelines are federally funded and proven to save lives, reduce suffering and save money many Medicaid children and disabled adults do not have access to this level of care and necessary medications. For this reason, on May 6, 2009, we are asking Congress to ensure that all patients, including those who receive federal and state health assistance, have access to NAEPP Guidelines care. By making this goal a reality, we can eliminate suffering and death due to asthma and greatly reduce direct costs associated with poorly managed symptoms.”


Founded in 1985, Allergy & Asthma Network Mothers of Asthmatics is the leading national nonprofit family organization dedicated to eliminating suffering and death due to asthma, allergies and related conditions. AANMA’s core areas of expertise are education, advocacy and outreach.

On May 6, 2009, the organization will host its 12th annual Asthma Awareness Day Capitol Hill to support disease-specific and patient-centric healthcare reform initiatives that will save lives and money. Members of Congress and the media will attend a breakfast briefing to meet families whose life-and-death stories demonstrate need for action, healthcare experts whose programs currently save lives and money in America’s lowest income, hardest hit populations, and nonprofit organizations who provide free quality services to patients. According to the Centers for Disease Control and Prevention (CDC), asthma affects 23 million Americans and causes 3,884 deaths a year.

Source: Allergy & Asthma Network Mothers of Asthmatics

View drug information on Relenza; Tamiflu capsule.

Donors And International Health Agencies Are Failing Africa On Malaria Control

Lack of coordination between donors and international health agencies is leading to the needless deaths of too many African children from malaria,
says a team of health researchers from Burkina Faso and the University of Heidelberg.

Bocar Kouyat?© (Centre National de Recherche et de la Formation au Paludisme, Ouagadougou, Burkina Faso) and colleagues show how this lack of
coordination is preventing health professionals in Burkina Faso from getting life-saving treatments to children with malaria.

The World Health Organization (WHO) recommends that the best treatment for malaria in sub-Saharan Africa is artemisinin-based combination therapy or
“ACT” (a combination of drugs, one of which is from the artemisinin group of malaria drugs). The standard treatment, choloroquine, is much
cheaper but it is practically useless in this part of the world because the malaria parasite has become resistant to it.

As a developing country, Burkina Faso cannot afford to purchase ACT, so it must rely on support from the Global Fund for AIDS, Tuberculosis, and
Malaria. However, Kouyat?© and colleagues explain that the Global Fund turned down Burkina Faso’s request for financial assistance to purchase ACT.
“There is the clear impression in Burkina Faso that this decision was mainly motivated by financial problems of the Global Fund,” say the

Given that the Global Fund denied this assistance, as a pragmatic interim measure Burkina Faso’s national malaria control program asked the World
Bank to finance an alternative treatment to chloroquine, a combination of pyrimethamine/sulfadoxine and amodiaquine that is cheaper than ACT.

But the World Bank refused. “This request was rejected,” say Kouyat?© and colleagues, “with the argument that WHO is recommending only ACT. As
a result, chloroquine remains factually the malaria first-line treatment in Burkina Faso.”

The authors call for “more realistic” malaria control policies and their rapid and comprehensive implementation in Sub-Saharan Africa.

“Too many African children are dying these days from a disease against which effective and cost-effective prevention and treatment options have long
been developed.”

Kouyat?© B, Sie A, Y?© M, De Allegri M, M??ller O (2007)
The great failure of malaria control in Africa: A district perspective from Burkina Faso.
PLoS Med 4(6): e127.
Link here

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PLoS Medicine is an open access, freely available international medical journal. It publishes original research that enhances our understanding of
human health and disease, together with commentary and analysis of important global health issues. For more information, visit

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