Health Meaning

links increasingly strong between the spread of Zika and microcephaly newborn led the World Health Organization (WHO) today to declare a public health emergency of international concern.

WHO Director-General Margaret Chan in Geneva, Switzerland, said this on the advice of a committee of 18 experts and advisers, who she said "accept a causal link between infection Zika during pregnancy and microcephaly is strongly suspected but not scientifically proven. " Zika, a virus transmitted by mosquitoes, is currently spreading across 24 countries in Latin America and the Caribbean and Cape Verde, an island off West Africa. Chan noted that there were "particularly strong association in time and space" between the arrival of the virus and microcephaly detection and other neurological disorders. Although Brazil has had more than 4,000 suspected cases microcephaly, he confirmed 270 cases of the harmful brain disease in children born to mothers who had proof of having been infected with the virus.

Although Brazil is the only country microcephaly report a peak in the current outbreak, French Polynesia in 2014 was up in this rare disease concurrent with viral propagation, Chan said. Brazil, El Salvador, and French Polynesia also suspect Zika could lead to an increase in cases of a neurological disorder in adults, Guillain-Barre syndrome, which causes temporary paralysis. "the committee said the group microcephaly and other neurological complications constitute an extraordinary event and public threat to other parts of the world, "said Chan. She was careful to note that his concern centered reporting on these groups and not spread the virus itself, which does not cause symptoms in 80% of those it infects, and rash and acute fever in the other 20%.

Many criticized the WHO for not ringing the alarm when the Ebola outbreak first surfaced in 2014. "It was a very difficult decision to discern between what is urgent public health and international significance which should be precautionary measures because of a possible connection between Zika and these groups, "said the committee chairman, David Heymann epidemiologist at the London School of Hygiene & Tropical Medicine.

Chan suggested that pregnant women who do not live in the affected Zika countries may want to delay travel to these areas, but has not issued a formal travel warning for them, as the US Centers for Disease Control and Prevention did. Chan stressed that "the committee found no public health justification for restrictions on travel or trade to prevent the spread of the virus Zika." Many countries ignored similar recommendations during the Ebola outbreak in West Africa and has imposed that WHO saw travel as unnecessary and even against-productive and. trade restrictions

parallel to the statement, the committee made two major recommendations: Standardize monitoring microcephaly and other neurological disorders in areas where Zika spreads, and more research to discern whether the if clusters are really related to the virus.

"There is an urgent need to do much more work," said Chan. She also stressed that the world had to step up fight against mosquito efforts, monitoring of Zika and efforts to develop a vaccine. "Can you imagine if we do not do all this work now and wait until scientific evidence comes out?" She asked.

Lawrence Gostin, a lawyer entitled global health at Georgetown University in Washington, DC, says the statement, but said in a press release that WHO needs to define more explicitly how it will respond. "Margaret Chan was silent on the strategy of the organization will take to the field to check Zika and how it will mobilize the major funding needed for surveillance, mosquito control, and critical research, "argued Gostin." Without a clear strategy and sufficient resources , sounding an alert is just not enough. "

When a field is besieged by failures, small forward as look great triumphs. This is the case with the last effort to protect women at high risk of HIV infection. Two largest test a vaginal ring that slowly secretes an antiretroviral drug in the vagina have found that it reduced infection of about 30%. The placebo-controlled trials involved a total of 4,500 women in four countries in sub-Saharan Africa. "It's a huge win," said Sharon Hillier, a specialist in infectious diseases of reproduction at the University of Pittsburgh in Pennsylvania, who helped coordinate ASPIRE, the largest of the two studies and conducted trials of . Similar interventions have failed

others who are not involved in the studies are measured "the good news is the tests provide a consistent conclusion. the ring provided modest protection" says Mitchell Warren, head of AVAC, a nonprofit in New York that advocates for HIV prevention. "But it's oh so modest."

along Researchers have attempted to develop a preventive HIV specifically for women. But the most promising candidate compounds called vaginal microbicides that thwart the virus on the site of infection have failed repeatedly in clinical trials. "This [set of studies] was the last hope for Microbicides in many ways," says Thomas Hope Feinberg School of Medicine at Northwestern University of Chicago, Illinois. Hope, who was not involved with the new study, said. "I expected the results to be depressing"

The ring, a silicon band that releases an experimental antiretroviral called dapivirine, was tested South Africa, Malawi, Uganda and Zimbabwe, among 18 to 45 years. the ASPIRE trial found 27% overall efficiency, while the second trial called the Ring Study-found efficiency of 31%.

But the ring did not make nearly as much for women aged 18 to 21, giving a simple protection of 15% in the study and had absolutely no ring in the ASPIRE trial. in women over 21, however, the efficiency reached 56% in ASPIRE, Ring the study showed 37% protection in the older group No serious safety concerns emerged in both studies

.. the results were presented to the public for the first time today at a press conference at the Conference on retroviruses and opportunistic infections (CROI) in Boston. ASPIRE results also appear in a paper published online today in The New England Journal of Medicine . Researchers from both trials will present their findings in more detail later this week in the scientific sessions at CROI.

Each holding-study in parallel to speed regulatory approval cost of about $ 72 million. The National Institute of Allergy and Infectious Diseases of the United States provided the main funding ASPIRE, which has been run by the Network for microbicide trials that Hillier leaders. The International Partnership for Microbicides (IPM), a nonprofit headquartered in Silver Spring, Maryland, led the study Ring. IPM has also developed the ring and allowed Dapivirine Sciences Janssen Ireland UC.

"I think it is a bold step in the right direction, and it gives the field a thing to build on," said Robin Shattock, studying mucosal immunology and HIV transmission Imperial College London and chairs the scientific board of IPM. "Scientifically, there is much that can be done to improve it and make it better."

Preliminary data suggest the ring offered less protection for young women because many do not wear for all 28 days between study visits. Dapivirine levels that descend each day that the rings used were higher in some rings used than others. Greater protection took place when there was less left Dapivirine. "It is a little a while 'duh'," said epidemiologist Zeda Rosenberg, CEO of IPM. "Everything will work if it is used."

obstinate adherence problems have other pre-exposure prophylaxis, or PrEP, strategies to prevent infection with HIV, most of which require taking anti-HIV pill every day. But researchers had hoped that a ring that can be inserted once a month and left alone would circumvent this problem. Based on samples of blood monthly, Hillier said they initially thought they were right. But they may have been misled by the trial participants who reintegrated rings before study visits to please the researchers. "We call this effect" white coat "," Hillier said, explaining that if women inserted the ring the day before the test, they would have ample drugs in their blood.

Biological factors could also help to explain the lower effectiveness in younger women. "the differences in the genital tract can make them more susceptible to infection," said Shattock. Another possibility is that they had more sex with partners infected with HIV. But ASPIRE, the rate of new infections among women who received rings containing placebo was 5.4% per year in the 21 and under a similar group in the incidence of 6.1% per year in the slice age 22 to 26.

in the future, the researchers hope to test higher levels of antiretroviral drugs or more powerful-in vaginal rings. IPM provides a ring to which secretes the drug for 3 months. And researchers think that many women find most attractive product if it combines the anti-HIV drugs with hormonal contraceptive, which are already sold worldwide in vaginal rings.

Whatever the shortcomings of the ring Dapivirine 28 days tested both studies, IPM plans to seek regulatory approval in about 1 year. Rosenberg provides that each ring initially will sell for about $ 5.

Andrew Witty, who led GlaxoSmithKline (GSK) since 08, recently announced his retirement in March 2017 . But the 51- year Witty, a marathon runner who has been with the company for the whole of his career, has a vision for the pharmaceutical giant that extends well beyond its mandate. A central tenet is the belief that big pharmas need to be more in tune with the global society needs. And finish line for GSK is to give poor countries faster access to medicines against cancer if they are effective.

The construction out of a system, the company used for its anti-HIV drugs, GSK announced today its intent to sign agreements on drugs in its cancer portfolio with "Medicines Patent Pool, "an organization supported by the United Nations that helps license generic manufacturers and produce products. GSK said it also plans to adopt a more" flexible "approach to deposit and enforce patents other medicines to encourage generic companies to make and provide GSK products now available mainly in developed countries.

Under Witty, GSK has taken several actions that may seem unusual, a pharmaceutical company focused on profit from public property. in an attempt to discourage sales representatives hyping the value of GSK's drugs, the company stopped paying commissions. Similarly, he does not pay physicians to give lectures to colleagues -which often occurred in restaurants-about its novelty products. (GSK in 2012 agreed to pay a fine of $ 3 billion to the US government for illegally promoting prescription drugs, but the company says that the new policies are not related.) A push for more transparency leads to GSK also create a database that includes the results of all clinical trials, regardless of whether the drug worked or failed.

Witty spoke with science Insider on March 30, and with the candor of a CEO who is not afraid of job security. This is a condensed and edited version of that interview

Q:.? Why are you concerned about your future drugs reaching poor countries

A: We try to streamline and simplify our overall approach to intellectual property (IP) in the world and to graduate essentially what we do around IP as economic maturity of the country. We do not believe that you should treat Malawi in the same way that you treat Britain. It should be more personalized in many dimensions.

With Oncology I am eager to move forward from where the world has reached with HIV 20 years ago. [It took nearly a decade before most poor countries could access anti-HIV drugs proven effective in 1996.] We are very excited about what we have in oncology; we have great leadership and epigenetic immuno-oncology. Whether or not they will do so, we must wait and see, but we try to lay the foundations

Q :. The great excitement in the cancer immunotherapy, and these products will potentially be very expensive. Are you including those

A: They would be included. Not only are they likely to be expensive, but they will require fairly sophisticated technology and medical systems around them. I'm not saying this will solve everything. He will not be. Some of these things are just out of reach in some of these countries. But we would like to say that if there are opportunities for our drugs to be accelerated in terms of access in the developing world, and if the systems are capable of using them, so we want to ensure that this is done.

Q: Pharmaceutical companies exist to make money. It is clear that companies want to be seen in a good light, but you have shareholders. How do you separate make a profit and do good

A: You start by trying to do good and do the right thing first, and try to profit maximize second. We've all seen examples of many companies in many sectors that have done the other way. They look great for a few years and then something terrible happens. Somehow, the newspapers tend to catch the business section.

In recent years, we have increasingly been willing to challenge and change our basic business model. Rather than saying we're going to compete in the marketplace like everyone else, we'll instead ask how we can fundamentally change the way we operate. Each of the things we've done has led to a sudden inspiration by others, but over time people have followed us. And if you look at the fourth quarter of last year, 16.5% of our pharmaceutical sales came from new products, which is the highest for a big pharma. That said, you can indeed innovate your business model to do something that I think is more in tune with society and at the same time do very, very well for shareholders

Q: . Is expanding your markets developing countries paid financially

A: Certainly, we expanded our position dramatically in emerging markets. We absolutely an average selling price lower than our competitors, but we have a significantly higher volume. About a third of all GSK worldwide, we manufacture and sell in India

Q :. But there is a gap between the desire to do good and do good. GSK has its HIV dolutegravir drug, which has become extremely popular in rich countries, a patent pool in April 2014 , but it is still not widely available in developing countries.

has: In America, Europe, and Japan, dolutegravir very well one of the main drugs of choice, but has just started happening on a very expedited basis during the last year or two. Always time for setting up a treatment protocol to flow through the overall market and in the development of global programs. And inevitably, particularly with countries that must husband their resources very carefully, they rightly take some time before adopting new drugs.

We expect a voluntary license shall be issued to a generic manufacturer to dolutegravir in the next 18 months. Hopefully this coincides with the increasing uptake of the drug

Q :. You talk about how the company wants to position itself to improve the way it is perceived by society. We are emerging from a time when the pharmaceutical industry has been vilified. Are these new initiatives

A:. Every industry has had its share of challenges and criticism

Do not underestimate our long-term commitment. It is useless to have a business model or a state of mind which was in the 1980s You have to have a mindset that matches the 2020s, the 2030s and 2040s it n 'there is no value in innovation that does not reach those in need.

She was not either / or choice. Could we were slightly more short-term success? May be. But would we have had more long-term success? I do not think we could.

Inflammation can help you fight invading microbes, but it can also kill you, which leads to insufficient blood circulation and the same organ failure. A new study shows that some drugs against cancer may be able to allay excessive inflammation that occurs in conditions such as sepsis, which is responsible for over 250,000 deaths in the US each year.

Inflammation is a normal immune response to a pathogenic threat, involving the production of various chemical signals and activation of immune cells such as neutrophils. Yet its effects can kill on a massive scale. Researchers suspect, for example, that the 1918-1919 pandemic flu, which killed more than 40 million, was so deadly because it sent an inflammation spiral out of control. Over-the-top Inflammation is also a characteristic of sepsis, wherein the body overreacts to an infection. There are a few options for treating people with sepsis, which can cause organs to stop working and can be fatal within hours.

molecular biologist Ivan Marazzi Ichan of Medicine Mount Sinai School in New York and his colleagues set out to discover how different cells control the activity of genes that promote inflammation. They exposed human cells and mouse to one of the two viruses, activation of immune cell genes. The team then tested many different compounds that affect how DNA is packaged in cells, the idea being that the compounds could alter the activity of these genes. One of the compounds which hindered gene activity, camptothecin is a cancer treatment. Among the compounds tested, said Marazzi. "It would probably have been the last" he would have expected to work.

Camptothecin kills cancer cells by blocking the enzyme topoisomerase I, which eliminates kinks from DNA so it can be duplicated or read to produce proteins. The findings of the team suggest that topoisomerase I also helps orchestrate the immune response to pathogenic attack.

To determine whether blocking topoisomerase I could counteract the inflammation out of control, the researchers injected mice with a poison that triggers bacterial septic shock, a severe form of sepsis, and then assayed some of mice with camptothecin. All untreated mice died within 40 hours, while 0% of the mice that received camptothecin survived, the researchers report online today in Science . The drug has also allowed 70% of the mice to live by infection with the bacterium Staphylococcus aureus , which can cause sepsis in humans. Only 11% of untreated animals survived the infection. People with influenza are particularly susceptible to bacterial infections that can lead to sepsis. Marazzi and his colleagues found that mice protected captothecin suffering from these infections, saving 94% of them, while all untreated mice died.

The study "provides a very interesting and promising strategy," said immunopathologist Peter Ward of the University of Michigan, Ann Arbor, who was not connected to the research. But he wants to other animal studies to confirm that blocking topoisomerase is effective against other types of bacteria that most often cause septicemia in people.

the results are encouraging, says molecular biologist Murat Kaynar of University of Pittsburgh School of medicine in Pennsylvania. However, he warned that many potential treatments for sepsis that were promising in animal studies do not pan in human studies. "We've had many attempts have failed," he said.

Although the topoisomerase I enzyme is not a specialized immune system, the researchers found that it has a great impact on certain genes that control inflammation, said molecular immunologist Stephen Smale University California, Los Angeles. Thus, "the study by Marazzi and his colleagues shows the value to broaden the search for inhibitors inflammatory responses," he said.

Camptothecin is one of several topoisomerase I-inhibitor drugs cancer who have received approval from the Food and Drug administration. Marazzi said he and his colleagues are working with a pharmaceutical company to organize a clinical trial to test whether blocking topoisomerase I is beneficial in sepsis. Although such inhibitors can trigger problems such as bleeding and infection, with sepsis patients would only need a small number of doses, so these side effects are less likely, Marazzi predicted. "We have a potential treatment for a deadly disease that kills millions of people worldwide. "

If you are a transit fan, you probably expect subway cars crawling with bacteria, after all thousands of people ride daily. But a new analysis of the Boston subway system says maybe not: The seats, hanging straps, and even ATMs in the transit system did not contain higher levels of harmful microbes most people encounter in everyday life. In the first survey on transport microbes common to watch a variety of surfaces and materials, the scientists took 100 samples from three distinct lines of railway, six different types of rail surfaces and ticketing machines in stations. After sequencing swabs, the researchers found fewer germs associated with antibiotic resistance found in the intestines of a normal person, they report today in MSystems . Overall, only 46 antibiotic resistance genes have been found in the Boston subway system, much less than the 1000 antibiotic resistance genes found in the human intestine. The most common microbe was Propionibacterium acnes , the bacterium of the common and harmless skin known to cause acne. human intestines, oral, vaginal and even microbes were found in lower amounts in the whole system. The most bacteria charged surface was suspended handles the metro, followed by seats and touch-screen ticket machine. The researchers concluded that, apart from the flu or other epidemics, risk subway riding diseases are quite low. They do not tell how their findings will apply to other transit systems, but they hope they can be used to improve the design of public spaces to contain epidemics. Meanwhile, however, there is no need to wear gloves while driving.

A new study has raised hopes that the immune system can be strengthened with one of his chemical messengers to increase the effectiveness of drugs against the virus AIDS.

in a report in the October 31 New England Journal of Medicine , Joseph Kovacs, Clifford Lane, and colleagues at the National Institute of Allergy and Infectious Diseases treated 60 people infected HIV with either a combination of anti-HIV drugs or drugs and an immune system protein called interleukin-2 or IL-2. After 1 year, 29 patients who received IL-2 were more than twice as CD4 - white blood cells that HIV targets -. That controls

"I'm very enthusiastic about it," said Jay Levy, a retrovirologist at the University of California, San Francisco. "We need more studies of this nature that aim to restore the immune and not only focus on the destruction of the virus function."

In the IL-2 group, the number of CD4 cells increased an average of 428-916 per cubic millimeter of blood. In the control group, meanwhile, CD4 dropped from an average of 406 to 349. (health, uninfected people tend to have a number greater than 0.) The results verify similar results from a pilot study by Kovacs and Lane group published last year in the same journal.

researchers have yet to prove that patients with higher CD4 counts are healthier. And that gives clinicians AIDS as Robert Schooley of the University of Colorado serious reason to break. Although the data are "fascinating," said Schooley, it is concerned about the high costs of treatment and heavy fatigue, it tends to cause. ongoing studies, however, are intended to answer the big question :. If IL-2 regimen will lead to longer, healthier life for people infected with HIV