Despite Ebola and Zika, here’s why 2016 ends well for public health
After devastating Ebola, which killed more than 11,300 people in west Africa before migrating to the US and Europe, and Zika, which put a generation of babies at risk of being born with abnormally small heads (microcephaly) and underdeveloped brains, 2016 appears to be ending on an upbeat note on the public health front.
Two scientific breakthroughs announced on Thursday that stop a terrifying infection and treat a deadly superbug offer hope in a year marked with political uncertainty, new threats to health and terror.
An experimental Ebola vaccine provides 100 per cent protection against the virus that devastated West Africa for more than two years, showed results of major trial in Guinea published in The Lancet. The vaccine, which is the first to prevent infection from one of the world’s most deadly infections, is yet to be approved by regulatory authorities, but is considered so effective that 300,000 doses have been stockpiled for use against potential outbreaks in the future.
Since Ebola was identified in the former Zaire in 1976, efforts to develop a vaccine have failed against this highly-contagious infection that causes death from bleeding from every oriface of the body.
The new vaccine, called rVSV-ZEBOV, was studied in a trial involving 11,841 people in Guinea in west Africa during the fag end of the Ebola outbreak in 2015 and found to be highly effective in preventing infection. There were no Ebola cases among the 5,837 people vaccinated 10 days or more after vaccination, compared to 23 cases among the group that was not vaccinated.
The vaccine is expected to hit the global market soon as the manufacturer, Merck, Sharpe & Dohme, have been given Breakthrough Therapy Designation from the US Food and Drug Administration and PRIME status from the European Medicines Agency to fast-track regulatory review.
On Thursday, scientists announced the development of an experimental antibiotic that kill MRSA (Methicillin-Resistant Staphylococcus aureus), a common and deadly drug-resistant superbug that causes skin, lung, and heart infections and is among the leading cause of fatal hospital-acquired infections. The scientists targeted the bacteria’s use of vitamin B9 to prevent evade all forms of antibiotic treatment, US researchers report in Cell Chemical Biology.
The safe and inexpensive drug trimethoprim-sulfamethoxazole is the first treatment of choice for MRSA, but close to one in three infections are resistant to it and other standard antibiotics such as erythromycin and tetracycline. Stronger treatments cause side effects that people at risk — people in intensive care units, people ages 65 and above, and those with low immunity — cannot bear.
To develop the new drug, scientists targeted the bacteria’s use of Vitamin B9, also known as folate. Blocking its action shuts down a vital enzyme pathway, which kills the bacteria. Trimethoprim is currently the only available antibacterial antifolate, but MRSA has evolved different versions of the folate enzyme that aren’t impaired by it. The new antifolate binds the enzyme in a way that makes it harder for the bacteria to evolve resistance.
Around 40% of all people with HIV (over 14 million) do not know they are infected, which prevents them from seeking free antiretroviral therapy (ART) to treat their infection to stay healthy and lower their chances of infecting others.
Earlier this month, the World Health Organisation (WHO) pushed for HIV self-testing that involves using saliva or blood- finger-pricks to discover their status at a convenient time and place. The test result is ready within 20 minutes and those who test positive are advised to seek confirmatory tests at health clinics, where they also get counselled and referral to prevention, treatment and care services.
Between 2005 and 2015, the number of people with HIV who learned of their status increased from 12% to 60% globally, which led to more than 80% of people diagnosed with HIV receiving ART, which is given free in many countries, including India.
Testing is low among people at high-risk and their partners — particularly men who have sex with men, sex workers, transgender people, people who inject drugs, and people in prisons — who comprise around 44% of the 1.9 million new adult HIV infections each year. Up to 70 % of partners of people with HIV are also HIV positive, but many are not getting tested.
Compared to standard testing, self-testing nearly doubles the frequency of HIV testing among men who have sex with men and among male partners of pregnant women. A home-test will be a game changer and help hundreds of thousands stay healthy.
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