Another Disease in the Crowd? Pneumonia back in the spotlight on World Pneumonia Day

Nearly every disease, cause, and social issue claims a calendar date for itself to raise awareness, from well-known causes such as HIV/AIDS and cancer to somewhat more obscure issues, such as parental alienation.  World Pneumonia Day, which was yesterday, is no exception.  It, like many others, came amid general fanfare, advocacy, and, well, awareness, but it will undoubtedly step back into the crowd of causes competing for attention and funding.

But should it?

In this climate of fiscal austerity, foundations and organizations competing for an ever narrowing stream of donor funding.  Times are tight, so each disease has to make its case, so to speak.  Without a doubt, all of them are worth funding, but none of them will get the funding they need.  The question, then, becomes one of priority: how do donors decide how to make their dollars count?

Pneumonia can make a compelling case for being at the front of the line.  It is simultaneously the world’s number one killer of children under five and one of the world’s most preventable diseases.  We have effective vaccines and proven interventions, including reducing indoor air pollution (which will also make the clean cookstoves people happy) and increasing breastfeeding during the first six months (which will make the breastfeeding advocates and MCNH people happy).

Unfortunately, the impact of pneumonia and the ease of treating it do not diminish the importance of other diseases.  Many NTDs, for example, are extremely debilitating and only cost of a few cents to treat.  Tuberculosis is re-emerging with a vengeance and frightening antibiotic resistance. And recent shortfalls in contributions to the Global Fund endanger the gains we have made against HIV/AIDS, TB, and malaria.

So what is a cause to do? Own its awareness day and get the word out, which is precisely what the major players, like the GAVI Alliance and IVAC at Johns Hopkins, have done.  Dr. Orin Levine is making his usual rounds.  IVAC
has published a report card on the progress made by the 15 countries with the highest rates of childhood pneumonia, which examines their vaccination, treatment, and breastfeeding rates, in addition to progress in reducing pneumonia-related mortality.  Extra points for getting their recent
vaccine drive in Nicaragua on PBS, too.

I am no judge of which global health causes should be prioritized when it comes to funding – but then again, who among us is?  All advocates can do is make their own individual cases.  Let us hope that pneumonia can get the respect it deserves among the other worthy global health causes and not just go back to being another disease in the crowd after World Pneumonia Day.

Global Health News Last Week

SECTION NEWS

The following announcement, from Eric Williams, calls for any IH section members interested in assisting efforts to address federal global health and HIV/AIDS funding.  Please see the text of the announcement below.  Eric can be contacted by e-mail at ericwms@gmail.com.

Dear Colleagues,

I’m writing to request assistance in a “grasstops” effort to address federal global health and HIV/AIDS funding. As you are likely well aware, there have been serious threats and concerns regarding global health funding over the last several years. There is a real need to mobilize influential members of our community in an effort to ensure that Congress does not backtrack on our global health commitments.

I am doing some consulting work with amfar and they want to identify experts, donors, high-profile individuals and/or organizations in select states who can reach out to key Senate leadership. We need these individuals/organizations to show and voice their support for continued and sustained commitments for global health.

States of focus include Nevada (Sen. Harry Reid), Iowa (Sen. Tom Harkin), and Washington (Sen. Patty Murray). We believe these senators are in key positions to influence appropriations decisions and sure up support for global health.

The aim of this effort is to:

1. identify grasstop individuals/organizations and
2. plan, coordinate, and carry out outreach efforts to Senate leadership in a variety of ways, including state-level meetings, Hill visits, op-eds, sign-on letters, and so forth.

If you are interested or able to provide assistance in helping to identify and/or reach out to the above stakeholders, I would be very interested in speaking. If there is strong support for this I would be happy to facilitate a conference call to discuss in full.

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August 19 was World Humanitarian Day.

POLITICS AND POLICY

• The CDC has made updates to its flu vaccination recommendations aimed at children and people with egg allergies.
• The United Nations has released a list of 248 organizations from 48 nations that are accredited to attend the UN High Level Meeting (HLM) on non-communicable diseases (NCDs) during September 19-20, 2011.  Meanwhile, as has been widely reported (including here and here), negotiations have stalled over an “outcomes document” that is to be approved at the meeting.
• The World Health Organization is calling for a ban on a common blood test for TB, saying the test is unreliable.
• Twenty-two children in Kancheepuram, Indiawho were not allowed to go to school because they are HIV positive have been ordered to return to school after a court ruled in favor of the students.
• International funding for HIV fell by 10 percent in 2010 from the previous year, according to the Kaiser Family Foundation and UNAIDS; activists worry that a continued reduction will undermine progress in global HIV prevention and treatment efforts.

PROGRAMS

• A study from Senegal published in the Lancet at the beginning of this month raises doubts over Gates’ plant to beat malaria, blaming mosquitoes’ growing resistance to insecticide and decreased immunity to malaria among the local population.
• The Bill & Melinda Gates Foundation and the Japan International Cooperation Agency have announced a strategic partnership to ensure continued progress in the fight against polio, including an innovative financing agreement to support polio-eradication efforts in Pakistan.
• USAID announced the expansion of its Indoor Residual Spraying program. The $189 million, there-year contract awarded by USAID to Abt. Associates will cover the implementation of IRS activities in Angola, Benin, Burkina Faso, Ethiopia, Ghana, Liberia, Madagascar, Mali, Mozambique, Nigeria, Rwanda, Senegal, Zambia, and Zimbabwe.
• WHO has released Psychological First Aid: Guide for Fieldworkers, a guide intended to provide field workers the tools to provide psycho-social support to themselves and those affected by a disaster or humanitarian crisis.
• The first comprehensive etiology study of childhood pneumonia in 3 decades has been launched. Pneumonia Etiology Research for Child Health (PERCH) will be a collaboration between sites in Africa, Asia and the International Vaccine Access Center at Johns Hopkins Bloomberg School of Public Health.

RESEARCH

• USAID has announced a partnership with the Infectious Disease Research Institute that will provide support for the research of a malaria vaccine at Walter Reed Army Institute of Research.
• UNDNJ researchers have discovered a link between TB and parasitic worms which act to thwart the body’s natural defenses against Mycobacterium tuberculosis.
• A Canadian study has found that a pregnant woman suffering from depression can lead to brain changes in their children.
• Researchers have identified 17 new antibodies with broad activity against HIV; some of which are 10 times more potent than previously discovered antibodies.
• The recent news about hiding vegetables by puréeing them and then adding them to recipes may make meals healthier, but if children don’t know they are eating vegetables, they won’t know to seek out those foods and eat them in future, says Isobel Hoskins on the CABI Global Health blog.
• Microcalorimeters may be the key to achieving TB diagnosis in a quicker and cheaper manner, say researchers in a recently published article in the Journal of Applied Microbiology.
• According to a recent UN study, 9 million lives can be saved over the next 10 years if average global salt consumption levels dropped by 15%.

DISEASES AND DISASTERS

• The WHO Says Libya is facing a medical supply crisis.
• The United Nations food agency called on Thursday for long-term aid for farmers in the Horn of Africa, saying constant crises in the region should shame the world.
• A report by the National Institute of Malaria research in Delhi has found that climate change will enable malaria to move to new areas.
• New research finds that radiation from the nuclear plant accident in Japanin March reached Californiawithin days, showing how quickly air pollution can travel, but scientists say the radiation will not hurt people.
• According to an article published in Science, 19 August, cases of Chagas disease are rising outside Latin America, because large numbers of people who are already infected are migrating fromLatin America.
• Len Rubenstein comments on the attacks on healthcare personnel inBahrain and the recent progress made to protect healthcare workers in conflict zones.

INFOGRAPHICS AND OTHER INTERESTING VISUALS

• Sarah Arnquist at the Global Health Hub has put together an open source timeline of global health milestones from the past century.
• The GAVI Alliance has released this infographic on the importance of childhood vaccines.
• This infographic on maternal mortality from Maternal Health Taskforce has caught the attention of Jen Quraishi at Mother Jones for the choice of data used to fill it out. She argues that comparing total maternal deaths rather than per capita rates makes it hard to assess nations side by side.

Thanks to Tom Murphy and Mark Leon Goldberg, Larry Johnson (filling in for Tom Paulson), Isobel Hoskins, and Jeff Meer.

Announcement: World Pneumonia Day 2011 Grants

Below is an announcement calling for submissions for a grant from the 2011 Small Grants for World Pneumonia Day Advocacy program:

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World Pneumonia Day 2011 is coming on November 12th and applications are being accepted for the 2011 Small Grants for World Pneumonia Day Advocacy program. Starting August 5, 2011, ideas are being sought for World Pneumonia Day events that tackle pneumonia where it has the biggest impact. Winning submissions will be eligible for grants of up to US$10,000 of funding. We are looking for well-thought out, innovative and impactful ideas that will put a spotlight on pneumonia as a problem that can be solved. Ideas will be evaluated on not only how well they promote change but also how well they incorporate this year’s World Pneumonia Day theme: “I am the face of pneumonia.” This theme strives to connect the personal, human stories that illustrate pneumonia’s direct impact. Find out more about the 2011 Small Grants Program and submit your application before the August 18th deadline!  Additional questions can be sent to info@worldpneumoniaday.org.
 
Full article and application at: http://worldpneumoniaday.org/news/2011-small-grants/

Global Health News Last Week

The Supercourse team at the University of Pittsburgh has taken the initiative to spread the WHO’s definition of health, “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.”  They have translated the definition into over 60 different languages using Google translate and have asked health professionals to review them to make sure they are correct.  This global health knowledge campaign is being developed by the Supercourse team, WHO Collaborating Centre, University of Pittsburgh.  Please contact Dr. Ronald LaPorte, Director, Professor of Epidemiology, University of Pittsburgh, for more information.

July 28 was the first-ever World Hepatitis Day.

POLITICS AND POLICY

• As the UN gears up for its Summit on Non-Communicable Diseases this September, blogger Michael Hodin argues that by focusing on this issue, the world body has a “new shot at relevance” in an era where its importance is decreasing (and countries contemplate cutting its funding).
• Former U.S. Ambassador on HIV/AIDS Jack Chow says the CIA’s fake vaccination scheme in Pakistan, aimed at locating Osama Bin Laden, threatens to undermine a broad set of American global health initiatives.
• The U.S. government and the Gates Foundation were responsible for 85% of the steep increase in malaria funding between 2007 and 2009. Richard Tren argues that we need to diversify funding sources and focus on control efforts.

PROGRAMS

• The Bill & Melinda Gates Foundation has teamed up with FC Barcelona to promote the polio eradication campaign.
• To raise awareness about violence against women in Europe, the UN has opened up a contest to design a newspaper advertisement in support of the UN Secretary-General’s UNiTE to End Violence against Women campaign. View submissions and the winning entries here.
• Seattle-based development blogger Tom Paulson continues to raise some interesting issues regarding the Gates Foundation’s funding of media coverage for global health issues.  Their latest venture is a weekly program on the BBC.

RESEARCH

• Researchers have cracked the DNA code of the strain of E. coli that originated in German sprouts and killed over 50 people this summer.
• A cell phone that doubles as a blood-oxygen tester is one of the 77 mHealth innovation finalists for the Saving Lives at Birth: A Grand Challenge for Development competition.
• A study conducted by the WHO found that France, the U.S., the Netherlands, and India have the highest rates of depression in the world, while China has the lowest.  Detailed interviews were conducted with over 89,000 individuals in 18 countries.
• It is becoming more apparent that one of the most effective ways to deal with HIV/AIDS is to address neglected tropical diseases, argues the Public Library of Science in Eureka Alert.
• A study of the lifespan of HIV patients receiving combination ARV therapy by researchers at University of Ottawa has found that patients can expect to live a near normal lifespan.
• Researchers at Oklahoma University believe that a protein-based vaccine could prevent many cases of childhood pneumonia.
• Dutch researchers have found that children who were not breastfed were more likely to develop respiratory problems such as asthma.
• The first stage of trials for a new malaria vaccine by Swiss researchers in Tanzania have shown promising results.
• Has announced in a study in Pediatrics that the varicella vaccine for chickenpox has reduced the annual death toll in the United States from 105 to 14. Tests are in progress that could lead to major family planning advances. The New York Times reports on some innovations in male contraceptives that could offer safe and effective contraception.

DISEASES AND DISASTERS

• The Agbogbloshie slum outside of Accra, Ghana, is a major electronics waste dump.  This site is an example of what happens to “donated” discarded electronics: residents burn them to extract precious metals and simultaneously exposed to a host of hazardous chemicals, as the goods release lead, mercury,
  thallium, hydrogen cyanide, and PVC.
• A recent article by a global panel uses startling images to call attention to the woeful state of neglect and inadequate treatment of mental illness in developing nations.

Global Health News Last Week

Note: I apologize for the hiatus in the news round-up; I went to a major conference for work in April and was very busy with preparations and then wrap-up afterwards.

April 25 was World Malaria Day. According to the WHO, world malaria deaths have fallen 20% from 2000 to 2009.

The Global Health Hub has developed a really nifty global health timeline. It is interactive and open – meaning it can be edited by anyone.

POLICY

• USAID Administrator Rajiv Shah this week announced the agency has transformed its Economic Growth, Agriculture, and Trade (EGAT) Women in Development Office into a new Office of Gender Equality and Women’s Empowerment.
• A new report by USAID calls for changes to the nutritional content of the food aid that the U.S. provides to the world’s poor, particularly for children under two and pregnant women.
• WHO delegates are scheduled to discuss the possibility of destroying the world’s last known stockpiles of smallpox during the annual assembly in May.

RESEARCH

• Scientists have isolated the tuberculosis enzyme that destroys lung tissue, MMP-1. The discovery could speed up the search for treatments, as current regimens do not prevent the lung damage caused by TB infection.
• Results from a recent study indicate that advances in antiretroviral therapy over the last 15 years have considerably improved outcomes for children with HIV who are entering adolescence and young adulthood.

DISEASES AND DISASTERS

• Aging populations on Japan’s northeast coast are struggling to recover from last month’s devastating earthquake and tsunami, and health officials are concerned about increased incidence of pneumonia, influenza, respiratory illenss, and blood clots in the legs of older individuals.
• The first WHO Global Status Report on Non-communicable Diseases found that these diseases are the leading cause of death worldwide.

Global Health News Last Week

POLICY

• Assistant Senate Majority Leader Richard Durbin (D-IL) and Senator Bob Corker (R-TN) introduced the Water for the World Act of 2011, a bill in the Senate which will make providing safe and clean drinking water around the world a priority for US foreign aid.
• More than 60 world nutrition experts met at WHO headquarters last week to revise guidelines and to identify solutions to tackle the growing problems of both malnutrition and obesity around the world.
• Ministers of health and other high-level health officials from throughout the Americas called for a series of actions to reduce the toll of chronic noncommunicable diseases, in a declaration issued last week in Mexico City.
• The Global Fund announced that former President of Botswana Festus Mogae and former U.S. Health and Human Services Secretary Michael O. Leavitt have agreed to lead a high-level panel of experts that will conduct an independent and thorough review of the Global Fund’s financial safeguards.
• UN agencies are concerned that reduced donor funding due to the recession, combined with free trade agreements, will reduce the availability of low-cost HIV medications in developing countries.
• The United Nations General Assembly will convene a high-level meeting in September this year to discuss the financial burden caused by non-communicable diseases (NCD) on countries.

RESEARCH

• A study done is Malawi by the World Bank attracted attention (and criticism) from Businessweek. Young women were given to stay in school and deter them from accepting money and gifts from “sugar daddies” in exchange for sex. The study found that HIV infection rates were 60% among schoolgirls who received cash compared to those who received nothing.
• A recent review of malaria treatment clinical trial results, published in the Chochrane Library, shows that artesunate was more effective that quinine at treating severe malaria.
• A personalized text messaging reminder service significantly boosted antiretroviral (ARV) adherence over a six-week period compared with a standard beeper reminder system, according to a study published in the March issue of AIDS Patient Care and STDs.
• About 600 people gathered at the Global Health Metrics and Evaluation conference in Seattle to discuss issues surrounding the evaluation of effectiveness of health programs.

PROGRAMS

• Global health blogger Alanna Shaikh discusses how micro-credit and the Green Revolution, two of international development’s biggest successes, are being re-evaluated.
• The Nepalese government is planning launch a large vaccination campaign against elephantiasis in 40 high-risk districts.
• Dubai’s Ministry of Health introduced Pneumococcal Conjugate Vaccine PCV13, a vaccine that protects young children from the worst effects of illnesses including pneumonia, blood infections and meningitis.
• The National Influenza Center of the Chinese Center for Disease Control and Prevention has been designated as a World Health Organization Collaborating Centre for Reference and Research on Influenza, making China the first developing country to house such an institution.

DISEASES AND DISASTERS

• Europe is concerned by the growing incidence of drug-resistant TB, particularly in children.
• The world continues to follow the aftermath of the earthquake and tsunami in Japan, including the unfolding situation at the Fukushima Dai-ichi nuclear power plant. The WHO has assured that there is no danger to individuals being exposed to radiation in nearby nations (e.g. China).
• As if Haiti needed any more bad news, a study published in the Lancet says that the UN estimate of 400,000 cholera cases in Haiti this year is nearly half of what the real projection should be for the recovering nation. Meanwhile, health officials in Lagos have called on residents to observe high standards of personal and environmental hygiene and have designated emergency numbers to call in case of suspected cases; the Ghana Health Service has set up cholera centers in Accra to deal with the outbreak there; and the interim federal government of Somalia on Tuesday denied reports of an outbreak of cholera in the country, responding to an Associated Press story over the weekend that Somali doctors had reported that more than 20 people had died from the disease.
• In the February 2011 issue of PLoS Neglected Tropical Disease Journal, contributing editor Serap Aksoy discussed the triumphs behind the control of human African trypanosomiasis, or African Sleeping Sickness.
• Although women get diagnosed for tuberculosis (TB) later than men, treatment outcomes among women are better than men with higher TB treatment success rate and lower default (drop-out) rate in the female patients. The finding was announced at a meeting on TB and women in New Delhi, India.
• While the total number of newly reported HIV positive people and AIDS patients are still low in Japan compared with other countries, the number of newly HIV-infected people in Japan has doubled in the past decade due to public complacency and lower awareness.

NTV Kenya Video: Saving the children from pneumonia

Pneumonia’s Last Syrah: Raising money (and a glass) to fight the forgotten killer of children

Pneumonia has been called “the forgotten killer of children”¹ by WHO and UNICEF because, despite being the number one killer of children worldwide,² startlingly little attention is paid to this disease.  There are approximately 155 million cases of childhood pneumonia and 1.8 million deaths in children under five worldwide each year.  It kills more children than AIDS, malaria, and measles combined.  Pneumonia can be caused by several different pathogens including bacteria and viruses, but it is easily preventable and treatable, which makes the death toll that much more tragic.  In an effort to raise awareness, the first World Pneumonia Day was observed on November 2 of last year (which we covered on the IH Blog here).

Dr. Orin Levine, a major force in the founding of World Pneumonia Day,³ works constantly to bring more attention to the issue and to “get pneumonia some respect.”  So when NYT wine critic Eric Asimov began a column about syrah with a joke about pneumonia,

What’s the difference between a case of Syrah and a case of pneumonia? You can get rid of the pneumonia. 

This photo was voted Most Outstanding Entry. A mother comforts her daughter, who is receiving treatment for pneumonia. In Pangalengan, Bandung, capital of West Java province in Indonesia, a number of displaced earthquake victims contracted pneumonia. © 2009 Arie Basuki

Dr. Levine wasted no time in using it to raise awareness and funding for childhood pneumonia vaccines and treatments.  In an article in the Huffington Post, he called on winemakers and retailers to donate $10 from every case of Syrah sold to the GAVI alliance, which provides immunizations for children in developing countries.  Several wineries immediately jumped onboard, and enough support was rallied to organize Pneumonia’s Last Syrah, which was hosted by the International Vaccine Access Center and the GAVI campaign.  This photo exhibit (judged by Nicholas Kristof and Ann Curry) took place in New York City during the MDG Summit.  Over 250 people attended, including Eric Asimov (whose joke inspired the whole thing) and CDC Director Dr. Thomas Frieden, who spoke to the audience about his own son’s case of severe pneumonia.  GAVI and the Rhone Rangers (a coalition of over 100 American Syrah producers) announced a partnership at the event: $10 from every case of Syrah sold in November will be donated to GAVI, and the wineries will work to raise awareness of childhood pneumonia as well.

World Pneumonia Day will be observed on November 12 of this year.  As November rolls around, let us raise a glass to the partnerships in global health that get respect for the diseases that affect so many and, in the case of pneumonia, are so easy to treat and prevent.  Many thanks to Ms. Monica Gray of +gmmb who invited me to attend.  Unfortunately, I am based in Austin, Texas and could not make it; however, there is a participating winery here, so I can still raise my own glass to toast to pneumonia’s last syrah.

A list of wineries participating in the fundraiser can be found here.
The winners of the photo competition can be seen here.

World Pneumonia Day

November 2, 2009 is the first annual World Pneumonia Day, recognizing the world’s leading child killer as a global public health issue. A network of nearly 100 IGO, NGO, research and academic institutions, foundations, and community-based organizations have joined forces to raise awareness and urge governments and policymakers to combat this preventable illness. Each year, over 2 million children under the age of five die from pneumonia and pneumonia-related complications.

Although this is a great venture, it is surprising to see that this is the first campaign of its kind. Being the leading killer of children, it is outrageous to know this disease is not only treatable, but preventable. It leads me to wonder: “Why hasn’t more been done?” Mary Beth Powers, Campaign Chief of Save the Children said in an interview about pneumonia, “The sad thing is this is a disease that is largely preventable, and highly treatable.” This is not a disease that requires decades of scientific research to find a cure. Watch the movie.

According to leading public health organizations such as the World Health Organization (WHO) and UNICEF, many deaths can be prevented through early vaccination, proper medication (antibiotics) and nutrition, and vitamin supplements, such as zinc that is not typically found in a lower-income diet. Read more about the cause, prevention and treatment of pneumonia at the World Pneumonia Day website.

I would encourage everyone to spread the word about World Pneumonia Day, so greater awareness is made. The coalition firmly believes these deaths can be avoided, and encourages others to join the fight against pneumonia by:

1. Signing the pledge to fight pneumonia
2. Joining the coalition
3. Donating to the cause
4. Educating others about pneumonia prevention, diagnosis and treatment
5. Participating in a World Pneumonia Day event