MOST EFFECTIVE DRUGS FOR HIV/TB NOW OUT! September 8, 2008

Erle Frayne Argonza

Tuberculosis could be a way to contract HIV, and cases encountered in the field are replete with this route to the dreaded disease.

From Cape Town comes a welcome news about a wonder drug that is most effective for treating patients who become sick of HIV precisely thru the TB way.

The good news is contained below.

[28 August 2008, Quezon City, MetroManila]

 

Scientists reveal ‘most effective’ drug for HIV/TB patients

Carol Campbell

15 August 2008 | EN | 中文

Efavirenz capsules

Flickr/MikeBlyth

[CAPE TOWN] The antiretroviral drug efavirenz has been recommended for tuberculosis patients who then contract HIV.

Researchers compared the effectiveness of the antiretroviral drugs efavirenz and nevirapine in 4,000 South African HIV patients. Some already had tuberculosis (TB) and were taking rifampicin.

Nevirapine — the cheaper of the two drugs — was found to be less effective in patients with existing TB, with higher HIV loads in their blood than those on efavirenz.

HIV-infected patients who were already on antiretroviral drugs when they subsequently developed TB were unaffected, highlighting the complexity of treating concurrent HIV and TB infections.

Researchers from the Western Cape provincial health department, Médecins Sans Frontières and the University of Cape Town (UCT) published their findings in the Journal of the American Medical Association (6 August).

Study leader Andrew Boulle warns that the research is not a rejection of nevirapine, which is popular in the developing world because of its low cost, simplicity of use and its safety for pregnant HIV-infected women.

“Four out of five of our patients in the study continued to do well on nevirapine,” said Boulle, a public health specialist from the School of Public Health and Family Medicine at UCT.

The long-standing anti-TB drug rifampicin slows down the liver’s ability to process nevirapine, making the anti-HIV drug less effective and causing an increase in virus levels.

Efavirenz is only slightly affected by rifampicin, said Katherine Hildebrand, another UCT researcher. But it costs twice the price of nevirapine. “We need to get the price of efavirenz down in places with high HIV/TB co-infection,” she told SciDev.Net.

The research also disproves earlier assumptions that people with both TB and HIV may need increased doses of efavirenz. Researchers found that efavirenz in normal doses was ideal for HIV patients regardless of whether they had TB or not.

“Efavirenz should be used unless there are compelling reasons not to use it. Unfortunately many developing countries do not have access to efavirenz which is more expensive,” said Gary Maartens from UCT medical school’s clinical pharmacology division. Botswana and South Africa both use efavirenz extensively.

Link to abstract in Journal of the American Medical Association

 

VOUCHER SYSTEM FOR DISEASE: US EXEMPLAR September 5, 2008

Erle Frayne Argonza

 

The United States seems to have come a long way in strengthening the institutional aspects of development concerns, by way of voucher systems. I still remember the voucher system instituted as intervention scheme to salve education ailments early this decade, and I hope evaluation studies were conducted to measure the levels of success of that intervention from state to state.

 

Here comes another voucher system by the United States, this version being applicable to tropical diseases. Accordingly, it is a boost for tropical disease drugs, which is welcome news for many developing countries. Among diseases that are eligible to the system are sleeping illness, leprosy and malaria.

 

The news is contained in an article below.

 

[28 August 2008, Quezon City, MetroManila. Thanks to SciDev database news.]

 

 

 

US voucher system to boost tropical disease drugs

Source: Intellectual Property Watch

14 August 2008 | EN | FR

A patient with malaria, one of the tropical diseases eligible for the scheme

Flickr/.ash

The United States is set to launch a prize system to encourage pharmaceutical companies to develop drugs for tropical diseases.

Sixteen tropical diseases, including sleeping sickness, leprosy and malaria are listed as eligible for the scheme.

Under the system, companies producing a drug or vaccine for a tropical disease can apply for a Priority Review voucher, which allows them a shorter approval time for another drug at a later date.

The shorter approval process would take approximately six months instead of ten, meaning that drugs could hit the market sooner and potentially be more lucrative. Thus, the vouchers are estimated to be worth around US$300 million.

Companies can also take advantage of the Orphan Drugs Act, under which drug developers receive tax credits, a waiver of the US Food and Drug Administration’s user fee and seven years market exclusivity on drugs that have no economic viability.

The first vouchers can be legally issued from 27 September 2008.

But the wording of the voucher law needs tightening up, say commentators, and some aspects — such as a rule stating that drugs can’t contain active ingredients that have been approved in another application — could restrict eligibility.

The Food and Drug Administration is currently drawing up guidelines on how the law will work in practice.

Link to full article in Intellectual Property Watch 

COMMUNITY-DIRECTED HEALTH CARE August 22, 2008

Erle Frayne Argonza

Who says that community-based health care systems won’t work? In the Philippines this has been an on-going effort, with the University of the Philippines leading. Couples of communities were adopted by the U.P. Manila in other regions precisely to study the effects of intervention via community organization.

Below is a news caption about a study that shows the effectiveness of community-based health care. Community-based health care has already been revolutionizing access to health care by many poor folks in the south.

Enjoy your read!

[02 August 2008, Quezon City, MetroManila. Thanks to SciDev database news.]

Community-directed healthcare ‘effective’, finds study

Abiose Adelaja

23 June 2008 | EN

In the strategy, family members help deliver drugs and administer treatment, instead of patients visiting a clinic

Flickr/CharlesFred

Community-administered healthcare is effective in combating a range of illnesses including river blindness and malaria as well as micronutrient deficiencies, according to a study of over two million people in three African countries.

The researchers say restrictive health department policies on who can administer medications should be altered so that other illnesses can be tackled in a similar fashion.

Community-directed drug intervention (CDI) has proved successful in delivering the drug Ivermectin to treat river blindness, also known as onchocerciasis. In the strategy, family members help deliver drugs and administer treatment, instead of patients visiting a clinic.

The study looked at the effectiveness of CDI in strategies to fight river blindness, later pairing it with treatments against malaria, tuberculosis and micronutrient deficiencies, in Cameroon, Nigeria and Uganda. Community dispensing of drugs, vitamin A supplements and insecticide-treated mosquito nets was compared with conventional delivery strategies over three years.

Researchers found that the number of feverish children receiving the right antimalarial treatment doubled, exceeding the 60 per cent target set by the Roll Back Malaria campaign. The use of insecticide-treated bednets also doubled.

Vitamin A supplementation coverage was also significantly higher in districts using CDI compared with those that did not. But community-directed interventions for tuberculosis proved only as effective as treatment from clinics.

Samuel Wanji, a researcher at the University of Buéa who conducted the southwest Cameroon part of the study, says the African Programme for Onchocerciasis Control — linked to the WHO and with 19 health ministers on the board — has given the go-ahead to extend the use of CDI for river blindness in countries that have lower, but still significant, levels of the disease.

The expanded programme will investigate whether CDI works as well in places where disease infection is less intense, and is scheduled to begin before the end of the year. Dispensing of other medications will be added as the programme progresses.

“The study’s approach is very useful for increasing access to health and will reduce the burden on health facilities,” says Hans Remme of the WHO Special Programme for Research and Training in Tropical Disease.

But a shortage of drugs and other materials remains a drawback, according to a WHO report of the study.

 

Link to WHO CDI report