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Rachel Nugent at Global Health Policy reminds us that it’s World TB Day. She’s got good news and bad news about tuberculosis around the globe. On the plus side, tuberculosis control funding has reached an all-time high, and the number of TB cases per capita has dropped. On the minus side, the number of cases is increasing, and more and more of these cases are turning out to be resistant to many of the drugs generally used to fight them.
In today’s New York Times, Celia W. Dugger looks at the lives of South Africans with MDR and XDR TB (MDR is multi-drug-resistant, XDR extensively drug-resistant). Many of them are held in a hospital that’s essentially “a prison for the sick”:
Revere at Effect Measure addresses a troubling article, published in yesterday’s Atlanta Journal-Constitution, about the Centers for Disease Control and Prevention’s handling of the Andrew Speaker tuberculosis case. You might remember the case, because it got a lot of media attention. Speaker was the Atlanta lawyer who was thought to have XDR TB and boarded a plane to return home from Italy despite having been told not to by health authorities. CDC issued an isolation order for Speaker, and held a press conference about how he could’ve spread the disease aboard his international flight. It was later determined that Speaker had multi-drug-resistant (MDR TB) rather than the more-feared XDR form.
Now, Alison Young reports in the AJC, “The handling of the Speaker case was so unusual that it has raised questions among other TB experts, including whether CDC publicized Speaker’s case in a quest for more money.”
by Susan F. Wood, PhD
Today’s Washington Post writes about one more instance where women’s health and children’s health were a lower priority than the interests of a powerful group. In this case, it was breastfeeding vs. the formula industry.
Marc Kaufman and Christopher Lee write:
In an attempt to raise the nation’s historically low rate of breast-feeding, federal health officials commissioned an attention-grabbing advertising campaign a few years ago to convince mothers that their babies faced real health risks if they did not breast-feed. It featured striking photos of insulin syringes and asthma inhalers topped with rubber nipples.
Plans to run these blunt ads infuriated the politically powerful infant formula industry, which hired a former chairman of the Republican National Committee and a former top regulatory official to lobby the Health and Human Services Department. Not long afterward, department political appointees toned down the campaign.
The ads ran instead with more friendly images of dandelions and cherry-topped ice cream scoops, to dramatize how breast-feeding could help avert respiratory problems and obesity. In a February 2004 letter, the lobbyists told then-HHS Secretary Tommy G. Thompson they were “grateful” for his staff’s intervention to stop health officials from “scaring expectant mothers into breast-feeding,” and asked for help in scaling back more of the ads.
By Liz Borkowski
After former U.S. Surgeon General Richard Carmona testified that White House officials tried to weaken or suppress important health reports for political purposes, Washington Post reporters Christopher Lee and Marc Kaufman followed up on the case of a 2006 surgeon general’s report on global health (draft here) whose publication was blocked.
Carmona’s report described the global nature of diseases and the many factors involved (including food and nutrition, water and air, and violence), and concluded with a call for international collaboration to improve overall global health. Who decided that this important public health message shouldn’t be shared with the public? Lee and Kaufman followed the trail to William R. Steiger, head of HHS’s Office of Global Health Affairs. Given Steiger’s record over the past few years, this latest revelation isn’t surprising.
Yesterday the Libyan Supreme Council commuted the death sentences of five Bulgarian nurses and a Palestinian-Bulgarian doctor to life in prison. The Tripoli 6 became a cause célèbre in the scientific and diplomatic communities when Libyan courts, after holding them in prison for eight years, refused to hear solid scientific evidence exonerating them from a charge they deliberately infected over 400 children in the Al-Fateh Hospital in Benghazi. in 1998 (for more background, see here). Poor hospital hygiene is the presumed source of the tragic infections which so far have claimed the lives of over 50 of these children. Life in prison would seem an unhappy kind of victory in this case, but as with all things connected with it, it is not yet the last word. Read the rest of this entry »
When a man with extremely drug-resistant tuberculosis (XDR-TB) is told not to board a plane and then does so anyway, you have to expect the public health bloggers to come out in force. Tara C. Smith at Aetiology has been on top of this from the start, first laying out the story, then explaining its implications, and finally letting readers know why indignation is necessary for responding to a case like this. Revere at Effect Measure explores the legal angle of isolation and quarantine, and provides details about air circulation in aircraft cabins; that blog also features a post about XDR-TB that was published just before this news hit the wires. The Examining Room of Dr. Charles and Cervantes at Stayin’ Alive chide us for focusing on the threat of contracting XDR-TB when we should be concerned about larger problems, and N=1 at Universal Health suggests that this kind of communicable disease problem might increase the U.S. demand for universal healthcare.
In a lead-up to the June 13th Leadership Forum on Pandemic Preparedness the U.S. Department of Health and Human Services is hosting a Pandemic Flu Leadership Blog. During its first week, bloggers – including Greg Dworking, founding editor of the Flu Wiki and Flu Wiki Forum – focused on the need to prepare; now, they’re looking at the roles different kinds of leaders can and should play.
Elsewhere:
U.S. environmental regulations were on several bloggers’ minds this week. Frank O’Donnell at Blog for Clean Air explains that EPA’s new rule on particle soot is terrible, while Mike Dunford at The Questionable Authority warns that Bush administration is about to release a set of administrative rules changes that would completely eviscerate the Endangered Species Act. At least The Olive Ridley Crawl has some good news: the National Marine Fisheries Service is proposing stronger regulations to reduce sea turtle bycatch.
Infectious diseases were a hot topic, too. Tara C. Smith at Aetiology observed World TB Day with a post on the global tuberculosis situation; Mike the Mad Biologist reminds us that annual flu deaths are preventable; and Revere at Effect Measure delves into a paper that uses a mathematical model to investigate the spread of antiviral resistance in the control of pandemic influenza (the first post at the series is here; find links to all of the previous installments at the end of the most recent post).
In fact, this week brought blog posts galore on environmental and medical topics, including:
by Revere, cross-posted from Effect Measure
While finishing drafting a series of posts on how Tamiflu resistant virus might spread as a result of intense use for influenza control, Melanie at Just a Bump in the Beltway posted this to remind us that drug resistant organisms spread for reasons much less useful than trying to stop people from dying. Like treating cows so they can be killed later and we can eat them and make money for agribusiness:
By Liz Borkowski
Last week, Revere at Effect Measure used extremely drug-resistant tuberculosis (XDR TB) as an example of why the world needs a resilient and robust public health infrastructure (and just a few days later, an article on an XDR outbreak in South Africa made it to the New York Times’ list of the 10 most e-mailed articles). Earlier this month, Laurie Garrett, a senior fellow for global health at the Council on Foreign Relations, published an article in Foreign Affairs (subscription only) in which she listed TB as one of the diseases that’s been getting more money and attention recently – and warned that new resources might not improve health if infrastructure isn’t strengthened.
By David Michaels
It came as no surprise to some observers that VaxGen (a biotech company in Brisbane, California) failed to meet the specifications of its contract to provide the US government with 75 million doses of a new anthrax vaccine. VaxGen has been playing fast and loose for quite some time – most notably with a famous instance of data dredging in the analysis of the clinical trials for AIDSVAX, its failed AIDS vaccine. I’ll come back to that below.
On Tuesday, the Department of Health and Human Services announced was ending its sole-supplier contract with VaxGen, which would have been worth up to $877.5 had the company been able to produce vaccines that worked. HHS officials would not discuss the reasons of the cancellation, but, according to Renae Merle’s piece in today’s Washington Post, “HHS evidently canceled the contract after VaxGen missed its deadline Monday to begin human testing because of concerns at the Food and Drug Administration about the product’s reliability.”
by Revere, cross-posted on Effect Measure
On December 11, The Institute of Medicine, one of the four constituent parts of the National Academies of Science, released a “letter report” reviewing the scant information on effects from non-drug measures to slow or contain spread of an influenza pandemic (available as a free download here). The report was produced after a special workshop on October 25 in which the panel participants heard from a variety of experts, with subsequent deliberations that produced the summary letter report and its recommendations.
By Laura H. Kahn
The medical community is devoting a lot of effort to researching bioterrorism agents and diseases that could become human pandemics. But in many cases, they’re overlooking a potentially critical resource: veterinarians.
Zoonoses are diseases of animals that can be transmitted to humans. These diseases include: SARS, West Nile virus, HIV/AIDS, and recently avian influenza (H5N1). Many of the agents of bioterrorism are zoonotic in origin such as anthrax, tularemia, and plague. Veterinarians have long recognized the interconnectedness between human and animal health and gave it the term “One Medicine” to reflect this fact. Historically, human and animal diseases have largely been treated as separate entities since physicians and veterinarians do not commonly communicate or collaborate with each other. In the course of my research on emerging infectious disease outbreaks, I came to the realization of the importance of zoonotic diseases after reading the veterinary medical literature.
