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Post00246 DISEASE CONTROL AND VACCINES 2 May 2000 CONTENTS 1. WORLD BANK APPROVES TWO CREDITS TO INDIA FOR POLIO ERADICATION + POVERTY 2. CIRO DE QUADROS AWARDED ALBERT SABIN GOLD MEDAL 3. NEWS ITEMS 1. WORLD BANK APPROVES TWO CREDITS TO INDIA FOR POLIO ERADICATION + POVERTY ___________________________________________________________________________ News Release No: 2000/314/SAS Contact Person: In Delhi: Geetanjali Chopra 91 11 461-7241 e-mail: [email protected] In Washington: Rebeca Robboy (202) 473-0699 E-mail: [email protected] World Bank Approves Two Credits To India For Polio Eradication And Rajasthan District Poverty Initiatives NEW DELHI, April 26, 2000--The World Bank's Board of Executive Directors yesterday approved two credits to India worth a total of more than US$243 million. The India Immunization Strengthening Project (US$142.6 million) will benefit millions of children countrywide with intensified efforts to eradicate polio and reduce vaccine preventable diseases, while the Rajasthan District Poverty Initiatives Project (US$100.48 million) will empower the poor to develop their communities in the Indian state of Rajasthan. ? Immunization Strengthening Project The World Bank will support India's efforts to intensify immunization campaigns and eradicate polio through the Immunization Strengthening Project. India has the largest remaining pool of polio transmission in the world; although its immunization program has included polio for more than a decade, India accounted for more than two-thirds of the cases reported worldwide for 1998. The project will provide support for polio vaccines and social mobilization for National Immunization Days. Social mobilization activities include training, communication, surveys and evaluations, and other efforts to assure coverage of children in target groups. The project will also support activities to improve the quality of routine immunization by addressing critical weaknesses in program management and upgrading equipment. "The Bank is assisting the Government of India and its development partners to marshal the massive additional resources needed for polio, in time for its 2001 target date for eradication to be met. The project will save millions of children from lifelong handicaps, deformities, and deaths resulting from polio and other preventable diseases. Since these diseases disproportionately affect poor families and coverage is lowest in poorer and socially disadvantaged groups, the project is largely self-targeted to the poor in terms of incremental benefits," says Indra Pathmanathan, Senior Public Health Specialist in the World Bank's South Asia Health, Nutrition, and Population Unit. The Bank has been working to support the global effort to assist the Government of India's massive immunization drive. At the government's request, the Bank previously allocated US$50 million out of the existing Bank-assisted Reproductive and Child (RCH) Program to support the National Immunization Days over the past six months, which resulted in the vaccination of 130 million children. Under the RCH Program, special efforts will be made in the weaker performing states to ensure that children who receive at least one immunization complete the full schedule before their first birthday and reach out to those who have not been covered. Total project costs are US$158.80 million, to which the Government of India will provide US$16.2 million. The US$142.6 million interest-free credit is provided by International Development Association (IDA), the World Bank's concessionary lending affiliate. The credit is provided on standard IDA terms with 35 years to maturity and 10 years grace. ? Rajasthan District Poverty Initiatives Project About 1.6 million people living in 7,000 villages in some of Rajasthan's most economically disadvantaged areas will benefit from improved economic opportunities and social development under the Rajasthan District Poverty Initiatives Project. "The project is part of a series of new lending operations in India that seeks to improve opportunities for the rural poor to meet priority social and economic needs through community-driven participatory approaches and demand-based investment decisions. Specifically, the project will mobilize and empower the poor and help them to develop strong grassroots organizations that enable them to participate in democratic and development processes," says Meera Chatterjee, a Senior Social Development Specialist in the Bank's New Delhi Office. The project seeks to build the capacity of and for the poor by promoting the formation and strengthening of Common Interest Groups and Village Development Associations. Driving this process are community facilitators and local NGOs, which will also receive training and support under the project. Building on national and state-level efforts to decentralize government to the local level, the project will help local government bodies (Gram Panchayats) improve their ability to plan, finance, and implement programs to meet the needs of the poor, especially women. It will also develop group savings, banking, and micro-enterprise at the village level. Total project costs are US$124.8 million to which the government is contributing US$17.7 million and beneficiaries are expected to provide US$6.57 million. The Bank is providing a US$100.5 million IDA interest- free credit with 35 years to maturity and 10 years grace. IDA is the World Bank's concessionary lending affiliate. ____________________________________*______________________________________ 2. CIRO DE QUADROS AWARDED ALBERT SABIN GOLD MEDAL ___________________________________________________________________________ "Polio, Measles Eradication Leader Ciro de Quadros Selected for Albert Sabin Gold Medal" Sabin Institute News Release (02/08/00) Dr. Ciro A. de Quadros has been chosen to receive the Albert Sabin Gold Medal, to be awarded on April 30, 2000 in Washington, D.C. The award is given annually to an outstanding contributor to disease prevention. Ciro de Quadros has played a key role in the effort to eradicate polio from the Western Hemisphere and in the Americas. Dr. de Quadros joined the World Health Organization as chief epidemiologist in 1970, and later joined the Pan American Health Organization (PAHO) in 1976. In 1996 he was given the government of Brazil's highest civilian honor, the Order of Merit of Rio Branco. Dr. de Quadros currently serves as the director of the Division of Vaccines and Immunization at PAHO. ____________________________________*______________________________________ 2. NEWS ITEMS Selected news items reprinted under the fair use doctrine of international copyright law: ___________________________________________________________________________ "How Hard Is it to Learn to Vaccinate?" Journal of the American Pharmaceutical Association ( (04/00) Vol. 40, No. 2, P. 268; Grabenstein, John D. Over 3,000 pharmacists have learned to give vaccines in the past few years. It is not too hard to be adept at vaccinations, even though many pharmacists did not learn extensively about them during their formal education. Vaccination courses offer the curriculum and training necessary to be certified for giving shots. The American Pharmaceutical Association (APhA) recommends an eight-hour self-study component and a 12-hour live program for discussion. Pharmacists must learn the timing of vaccinations as they prepare to eventually conduct their own programs for the community. Before starting a vaccination program, it is important to determine the community's needs, to explore area doctors' ability to help out, consider becoming a Medicare provider, assemble forms, prepare for marketing, and determine how to dispose of syringes. The Centers for Disease Control and Prevention recognized the APhA curriculum as meeting national immunization education standards in 1998. --- "Over 66,000 Children of Chechnya Given Polio Vaccine" Itar Wire Service (04/25/00); Dubovitsky, Grigory More than 66,000 children under the age of five in Chechnya have been vaccinated against polio, according to the Russian Ministry for Civil Defense and Emergencies. Officials noted that health workers are also taking measures to prevent against typhoid fever outbreaks in the Achkhoi- Martan district. --- "Measles Outbreak in the North of Country" PANA Wire Service (04/24/00) A number of measles cases have been reported in Nouadhibou, located in northern Mauritania. The majority of the patients are adults, possibly because a recent immunization effort in the area targeted children under age six. --- "22 Die from Measles" Africa News Online (04/20/00) An outbreak of measles in the Obubra Local Council Area of Cross River in Nigeria has killed 22 children. State House member Sylvan Odung called for medical assistance from the state Ministry of Health. --- "Measles Kills 130 Children" Africa News Online (04/20/00); Momodu, Sulaiman In Sierra Leone, measles has claimed the lives of many children under age five. Cases started to appear in the Tonkolili district last year. Some unofficial reports have put the death toll at over 400, with many children also becoming blind. Disease Prevention and Control Manager Dr. Haroun Turay said that 800 cases have been recorded, with at least 150 deaths. Health officials are working to fight the disease and said they hope it will soon be contained. --- "Needed: A Marshall Plan for Vaccines" Business Week ( (04/10/00) No. 3676, P. 148; Carey, John In a commentary, Business Week columnist John Carey notes the pleas of Harvard School of Public Health Dean Barry R. Bloom for global health considerations have finally reached the ears of the White House. Bloom has long pointed out that AIDS, tuberculosis, malaria, and other diseases take the lives of millions of people every year, and vaccination rates and life expectancy are falling. However, now, with Microsoft head Bill Gates donating hundreds of millions of dollars for vaccines and President Clinton supporting tax credits for vaccine development, public health is a growing cause. According to Harvard's Jeffrey D. Sachs, at least $10 billion in funds or tax credits is needed to buy drugs and to provide incentives for firms to develop additional treatments. U.S. firms are relying more and more on Third World workers, so the heavy investing is, in part, out of self-interest, Carey points out. Sustaining the momentum around vaccine development will be a key factor in conquering disease, but Carey also notes that "the good news is that the political will for these ideas has never been stronger." --- "Afghan Truce to Allow Polio Vaccinations" New York Times ( (04/22/00) P. A5 Conflicting sides of Afghanistan have agreed to a three-day truce for a polio vaccine drive next month. A statement from the United Nations coordinator for Afghanistan said the verbal agreement to UNICEF calls for a cease fire from May 1 to May 3. The effort aims to vaccinate nearly 4.5 million children under the age of five. ---- "What on Earth? A Shot in the Arm" Washington Post ( (04/22/00) P. A10; Smith, Dita Over 80 percent of American children receive early childhood vaccinations for contagious diseases like measles, diphtheria, and polio. However, 25 million children born in developing countries are not immunized, with 3 million dying from preventable diseases every year. The Global Alliance for Vaccines and Immunization, whose goal is to immunize at least 50 percent of the non-immunized children in low-income nations, reports that spending $350 million per year could save millions of lives in countries like India, Pakistan, and Uganda. The five-year effort is expected to cost about $1.75 billion. --- "Prevnar Considered New Key to Child's Health" Minneapolis Star Tribune ( (04/11/00) P. 1E; Burcum, Jill The new Prevnar vaccine is aimed at meningitis, blood poisoning, and other life-threatening illnesses resulting from the pneumococcus bacterium. Dr. Dennis Murray of the American Academy of Pediatrics says the vaccine, which was approved in February, is effective against invasive pneumococcal disease. The vaccine is recommended for most children under age two. The new vaccine is reported 93 percent effective, and parents are being urged to have their children vaccinated. Murray clarifies that Prevnar is not an ear infection vaccine, although it does offer protection against them in some young patients. --- 01:28 PM ET 04/12/00 Central Africa Meningitis Kills 216 BANGUI, Central African Republic (AP) _ A meningitis outbreak in Central African Republic is spreading after claiming at least 216 lives, aid officials said Wednesday. Nearly 1,400 patients were currently registered in hospitals in the capital and rural areas, said Thierry Dumont, a physician with the aid group Doctors Without Borders. Many more infected victims were languishing in their homes without care. The deaths were recorded since the epidemic began in mid-December, although most occurred since March. Doctors Without Borders distributed more than 130,000 vaccines in northern and central areas of the country this week and another 200,000 doses were being prepared, Dumont said. Meningitis, an infection of the membranes surrounding the brain and spinal cord, can be caused by a virus or bacteria. With treatment, only 1 percent of infected people die. Outbreaks are common in Central African Republic, one of the world's poorest countries. Africa suffered its worst meningitis epidemic in 1996 when more than 150,000 people _ most of them children _ were infected in several countries and 16,000 died. Another 16,000 suffered brain damage or paralysis. --- "New Cases of Polio Expected Through 2001" USA Today ( (04/12/00) P. 8D; Manning, Anita The U.S. Agency for International Development believes polio can be eradicated by the end of 2001 or soon thereafter, but not by the end of this year, as had been hoped. Nils Daulaire, head of the Global Health Council, said the extra few months will not be critical, since the disease has been around for ages. Last year, there were 6,659 new cases of polio in 30 nations, down from 35,000 reported cases in 130 countries in 1988, when the polio eradication effort began. The United States will save $230 million a year in vaccine costs once the disease is eliminated and the vaccine is no longer needed, the World Health Organization estimates, with an estimated annual savings of $1.5 billion for the world. --- "A Chance to Help Hundreds of Millions" Washington Post ( (04/12/00) P. C13; Mann, Judy An aggressive international campaign is seeking to eradicate polio worldwide. Rotary International, the U.N. Foundation, the U.S. Agency for International Development, the World Health Organization, and the Pan American Health Organization are leading the polio eradication effort. Accurate reporting of cases is crucial to the efforts, which could be complete by the end of 2001. While Nils Daulaire, head of the Global Health Council notes that the ultimate goal is a malaria vaccine, many drug companies are reluctant to spend money on a product for a market with few resources to pay for it. Daulaire and Harvard economist Jeffrey Sachs believe that giving poor nations relief from international debt would help free money for health services. Currently, the United States allocates about $1.1 billion on international health aid; however, a bill sponsored by Sen. Patrick Leahy (D-Vt.) would increase that sum by $1 billion. Leahy's proposal may prompt other countries to commit money for global health, as AIDS, measles, pneumonia, and other diseases take their toll on undeveloped countries. --- "Some Children Given Too Many Vaccines" Washington Times ( (04/11/00) P. E4; Cortez, Michelle Fay A study of 32,742 children between the ages of 19 months and 35 months shows that 21 percent received at least one extra vaccine and 31 percent missed at least one. The added shot cost $26.5 million a year for the nation's healthcare bill, according to the report in a recent issue of the Journal of the American Medical Association. Researchers from Children's Healthcare of Atlanta and the Centers for Disease Control and Prevention believe parent-held shot cards and state-based registries may be useful in tracking shots better. Over-vaccination costs money, labor, and adds to a child's stress following the shot, according to Dr. Robert Davis of the University of Washington's Immunization Studies Program. The study found that children were most likely to receive an extra dose of polio vaccine, with lesser numbers receiving extra measles, diphtheria, or hepatitis B shots. Extra doses of diphtheria and tetanus shots can cause serious side effects, the researchers noted. --- IAC EXPRESS Subject: IAC EXPRESS #156 April 10, 2000 FDA APPROVES ENGERIX-B PRESERVATIVE-FREE VACCINE On March 28, 2000, the U.S. Food and Drug Administration (FDA) approved the newly reformulated preservative-free Engerix-B pediatric/adolescent (10mcg per 0.5ml) hepatitis B vaccine manufactured by SmithKline Beecham. This vaccine product no longer contains thimerosal as a preservative. --- IAC EXPRESS Subject: IAC EXPRESS #156 April 7, 2000 CDC PUBLISHES CORRECTION TO WEBSITE ADDRESS FOR ALUMINUM IN VACCINES WORKSHOP The Centers for Disease Control and Prevention (CDC) published "Errata: Vol. 49, No. 12" in the April 7, 2000, issue of the MMWR. The second paragraph of this errata states a correction to the "Notice to Readers" titled "National Vaccine Program Office Workshop on Aluminum in Vaccines," which was published in the March 31, 2000, issue of the MMWR. The website address provided in the original article was incorrect. The correct website address is: --- "The Polio War: Rotarians Near a Victory" Boston Globe Online ( (04/09/00) P. A1; Donnelly, John Members of Rotary International have a goal: to eradicate childhood polio worldwide. Last year, there were 6,000 cases of polio in the world, down from about 350,000 in 1985. Increased immunization efforts seek to end transmission of polio by the end of the year, which would make it the second disease to be eradicated, after smallpox in 1979. The project, led by the World Health Organization, UNICEF, and the Centers for Disease Control and Prevention, must face war-torn areas in Asia and Africa to help reach their goal. Rotary clubs have raised $372 million over the years and are now working with media magnate Ted Turner on a $200 million fundraising drive. Despite its efforts, Rotary still has its own problems, with some members advocating a greater focus on their own communities and a declining national membership as fewer people are able to take long lunches for meetings during the work week. --- Measles Kills 900 in Afghanistan 10:44 AM ET 03/28/00 By AMIR ZIA, Associated Press Writer, ISLAMABAD, Pakistan (AP) A measles epidemic that is raging in northern Afghanistan has claimed more than 900 lives, many of them children, the World Health Organization said Tuesday. The sharp rise in the death toll stems from an inability to get medical help to the remote mountainous areas hardest hit by the epidemic, said Sahibjan Kakawazi, the WHO information officer in Pakistan. Most of the deaths have occurred in Afghanistan's northern Badakhshan province and Samangan provinces and western Herat. Since January, nearly 600 children have died in Badakhshan province, 225 miles north of the Afghan capital of Kabul, he said. Dr. Ahmed Zia, a public health officer in Badakhshan, put the death toll at 100. The reason for the discrepancy was not immediately clear, but the areas are remote and difficult to reach and information often takes weeks to reach populated centers. In Samangan's Dara-e-Suf district, where fighting between Taliban and anti-Taliban forces has raged, WHO officials are reporting as many as 250 deaths resulting from measles as a result of inadequate medical help and sanitary conditions. In western Herat, as many as 79 children have died, said Kakawazi. ``We are trying to supply vaccines and medicines to the worst hit areas, but snow and difficult mountain roads are making the task difficult,'' he said. Many of the affected areas are being hotly contested by the Taliban and their opposition, led by ousted President Burhanuddin Rabbani and his defense minister, Ahmed Shah Massood. ``We are rushing in emergency supplies, but often it takes weeks to deliver medicines on donkeys,'' said Kakawazi. Fighting and bad weather have prevented aid workers from getting vaccines into the areas. The Taliban, who rule 90 percent of Afghanistan, including Kabul, are battling the northern-based opposition on several fronts in a bid to extend their rule on the entire country. --- March 31, 2000 WORLD HEALTH ORGANIZATION PUBLISHES SPECIAL ISSUE OF THE "BULLETIN" ON IMMUNIZATION SAFETY The World Health Organization recently published a "Special Theme" issue of the "Bulletin of the World Health Organization" (Vol. 78, no. 2) titled "Immunization Safety." The issue contains 12 articles on vaccine safety, including feature articles on vaccine quality and clinical safety issues, monitoring adverse events, and the Vaccine Safety Datalink; a round table discussion on vaccine adverse events in the new millennium; reprints of several "classic" public health articles on immunization safety; and an editorial on immunization safety as a global priority. Many of these articles are available online as camera-ready documents (PDF format) at: --- "Public Health's Greatest Stride: Controlling Disease" Kentucky Post Online ( (04/06/00); Kramer, Susy The first week of April marks National Public Health Week, celebrating an increase in life expectancy and other achievements. The Centers for Disease Control and Prevention listed 10 achievements for the last 100 years, based on their impact in the United States. These achievements include control of infectious diseases, a decline coronary heart disease and stroke deaths, healthier mothers/babies, family planning, fluoride in drinking water, vaccination, and the hazards of tobacco. Guest columnist Dr. Susy Kramer, medical director of the Northern Kentucky Independent District Health Department, notes that a aggressive childhood vaccination has resulted in the complete or nearly 100 percent reductions in nine vaccine-preventable diseases, including smallpox, diphtheria, pertussis, tetanus, measles, and rubella. Measles vaccinations, for example, have reduced the number of cases in the United States from more than 400,000 in 1920 to just 89 for 1998. --- "Progress in Development of Immunization Registries--United States, 1999" Morbidity and Mortality Weekly Report ( (04/07/00) Vol. 49, No. 13, P. 274 Data from the 1999 Immunization Registry Annual Report (IRAR) surveyed 64 jurisdictions (grantees) that receive federal immunization funds in order to determine how many children under age six are enrolled in a population- based immunization registry. A goal of Healthy People 2010 is to increase to 95 percent the proportion of young children enrolled in the registry. Progress has been made in implementing the registries, as shown through the IRAR questionnaires. A total of 97 percent of the 64 jurisdictions responded, reporting that 5 percent had no registry and 69 percent had started registries. Approximately 32 percent of the target children between the ages of birth and five had at least two doses of vaccine recommended by the Advisory Committee on Immunization Practices. Of the 43 grantees, all had at least one element of the set registry standards, and 95 percent reported registry links with at least one healthcare program. One challenge to the formation of registries is maintaining the privacy of patients and providers who use the systems. This is a necessary prerequisite to vaccination records kept electronically. Two limitations of the report are bias and underestimation of registry activity. -- "Fed: Chickenpox Vax May Wipe Out the Virus, New Study Shows" Australian Associated Press (03/30/00); Rouse, Rada New research from Professor John Mills, director of the Macfarlane Burnet Centre for Medical Research in Australia, shows that the chickenpox vaccine now available in Australia could help to eradicate the disease. Mills recommended that the vaccine be added to the universal schedule of vaccines, noting that one of every 50,000 people who contract chickenpox dies. The National Health and Medical Research Council of Australia has said, however, that it will not subsidize the vaccine until it is combined with another shot. Mills also said that American research has shown the virus lays dormant after immunization, and the vaccine can give life-long immunity, possibly eradicating the disease after several generations of use --- "Notice to Readers: National Vaccine Program Office Workshop on Aluminum in Vaccines" Morbidity and Mortality Weekly Report ( (03/31/00) Vol. 49, No. 12, P. 262 On May 11 and 12, the Centers for Disease Control and Prevention's National Vaccine Program Office will hold a Workshop on Aluminum Vaccines. The meeting--to be held in San Juan, Puerto Rico, after the Metal Ions in Biology and Medicine Conference--will focus on vaccine adjuvants, aluminum salts in vaccines, the pharmacology and toxicology of aluminum, and macrophagic myofascitis. More information about the workshop is available online, at, or by calling (404) 687-6672. --- - $50M GRANT WILL TARGET PREVENTABLE NEW-BORN DEATHS IN POOREST NATIONS. Save the Children (US non-profit) was awarded a 5-year grant last week from the Bill & Melinda Gates Foundation (Seattle). Most of the 5.4M newborn deaths each year (from asphyxia, birth injuries, infection, premature delivery & birth defects) are known to be preventable through simple, low- cost health practices. Save the Children will expand its efforts in Africa & Asia to encourage exclusive breast- feeding, improve hygiene by birth attendants, augment surveillance & referral of high-risk pregnancies & births, increase iron folate & other micronutrient consumption (diet, fortification & capsules) by mothers, medicate for hookworm, malaria, & infections of the umbilical cord & baby's eyes, and encourage birth spacing. From: "[email protected]" To: Subject: ... the humanitarian times... Date: Wed, 29 Mar 2000 10:11:45 -0500 --- Chickenpox shot may boost itself: Study finds vaccine reactivates when immunity declines ASSOCIATED PRESS March 28 The widely used chickenpox vaccine seems to reactivate itself when an individual?s immunity lessens, possibly creating its own booster mechanism, researchers have discovered. ?A latent infection is not like an ongoing illness, it?s just that the virus is never completely cleared from the body.? DR. DENNIS N. KLINMAN FDA THE VACCINE, called Oka, was licensed in 1995 and millions of children receive it every year. It is made from a weakened live virus. Like all vaccines, Oka provokes an immune response from the patient, preparing the body?s defenses to fight in case of infection with the wild form of the virus. When the wild virus later attacks, the body is prepared to respond quickly by boosting the anti-virus material in the bloodstream. Researchers at the Food and Drug Administration did a four-year study of 4,631 children aged 1 to 13 who had received the vaccine against the chickenpox virus, known as varicella zoster. Their findings are reported in the April edition of the journal Nature Medicine. The vaccine establishes a lifelong latent infection, explained Dr. Dennis N. Klinman of FDA?s Center for Biologics Evaluation and Research. A latent infection is not like an ongoing illness, it?s just that the virus is never completely cleared from the body, he explained. Because the virus is weakened it doesn?t cause disease and no symptoms were reported when it reactivated in the children, he said. The researchers found 508 cases in which the antibodies in the youngsters? blood increased 400 percent or more from one year to the next. Such a jump would occur if children were exposed to the wild virus, but the rate of increase is several times higher than would have been expected to occur, the researchers said. They determined that the increases occurred when the children?s resistance to the disease had declined and the latent virus from the vaccine reactivated, causing the body to boost its defensive network. When the body?s resistance is high it keeps both the natural and latent Oka virus in check, Klinman said. When it falls to a lower level the latent virus reactivates. You don?t get sick, but it reactivates your immune system. The stronger natural form of the chickenpox virus also remains in the body permanently once the symptoms of the disease have passed, usually taking residence in nerve fibers. Years later it can reactivate, particularly in people with reduced immunity, causing a painful skin disease called shingles. Klinman said no cases of shingles were found in the youths studied. ? 2000 Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed. --- "Immunisation Should Be Key Focus of Doctors" Irish Times Online ( (03/22/00); Houston, Muiris In Ireland, the Minister of Health and Children has launched a Vaccination Awareness Campaign in the wake of falling levels of childhood vaccinations in Dublin. Health officials attribute a "mini-epidemic" of measles in recent weeks to decreasing immunization rates. The Eastern Regional Health Authority reports about 73 percent coverage for the measles, mumps, and rubella vaccine in the region; however, the rates are much lower in the inner city and some other areas of the city. As part of a vaccination awareness effort, two primary subjects must be addressed: physician issues and patient issues. Doctors must promote immunization, while parents must realize the shots are necessary preventive efforts. --- "Diseases Tighten Grip Worldwide" USA Today ( (03/24/00) P. 1A; Sternberg, Steve; Manning, Anita The Bill and Melinda Gates Foundation has announced health grants totaling $133 million, with $25 million designated to help develop new tuberculosis (TB) drugs. The donation comes at a time when the world is trying to strike at killer diseases that have been neglected. After decades of slow progress, the World Health Organization, the Gates' foundation, and the Global Health Council have sparked a desire to defeat TB, malaria, and AIDS. The Gates' contributions have been the catalyst for others to join the fight, as immunization campaigns received much-needed funds from the Gateses. President Clinton has also set aside over $100 million to fight AIDS, and drug firms have offered millions of vaccine doses for hepatitis B and haemophilus influenzae B. Several other disease-fighting efforts have been launched, both nationally and internationally. The newfound funds for global health come at a desperately-needed time, when life expectancy is down and death rates are rising because of AIDS, malaria, and TB. Nils Daulaire of the Global Health Council highlighted eight conditions that cause health disparities: TB, malaria, childhood pneumonia, diarrhea, measles, HIV, unwanted pregnancies, and risky childbirth. To solve these problems would cost around $13 to $15 a year per person, and many health experts believe these issues can be addressed. Richard Feacham, head of the Institute for Global Health at the University of California at San Francisco, notes that "in the past, we might have been able to hide behind an attitude of 'It's too difficult; the scientists can't solve it, we can't crack that problem.' But it's very hard to take that view now." --- "Gateses Give $133 Million for Medical Advances" Seattle Post-Intelligencer Online ( (03/24/00) The Bill & Melinda Gates Foundation has donated $133 million to improve access for women and children in the developing world to medical advances. The gift includes $25 million to the Global Alliance for TB Drug Development, a new group that aims to find more treatments for tuberculosis. Also, there will be $50 million for Save the Children and $15 million for the Infectious Disease Research Institute, which will use the funds to help develop a leishmaniasis vaccine. The remaining funds will go to the Medicines for Malaria Venture ($25 million) and the Albert B. Sabin Vaccine Institute ($18 million), which is working to create a vaccine against hookworm. --- Immunological basis for immunization In response to many requests to post this series on line, these modules were converted to PDF in January 2000 and are now available, in English (Eng) and French (Fr). Category and Title Format (PDF or WinWord 7.0) Module 1: General immunology,14 pages (WHO/EPI/GEN/93.11) Eng - 306 KB Fr - 467 KB Module 2: Diphtheria,12 pages (WHO/EPI/GEN/98.12) Eng - 264 KB Fr - 330 KB Module 3: Tetanus, 22 pages (WHO/EPI/GEN/98.13) Eng - 727 KB Fr - 636 KB Module 4: Pertussis, 20 pages (WHO/EPI/GEN/98.14) Eng - 543 KB Fr - 562 KB Module 5: Tuberculosis,12 pages (WHO/EPI/GEN/98.15) Eng -1016 KB Fr -1014 KB Module 6: Poliomyelitis, 24 pages(WHO/EPI/GEN/98.16) Eng- 592 KBFr - 631 KB Module 7: Measles,20 pages (WHO/EPI/GEN/98.17) Eng - 547 KB Fr - 378 KB Module 8: Yellow fever,13 pages(WHO/EPI/GEN/98.18) Eng - 673 KB Fr - 620 KB ---- "Malaria Transmission-Blocking Vaccines: How Can Their Development Be Supported?" Nature Medicine ( (03/00) Vol. 6, No. 3, P. 241; Carter, Richard; Mendis, Kamini N.; Miller, Louis H.; et al. Vaccines have proven effective against many diseases, including polio and smallpox. Today, malaria vaccines are being created to protect people and reduce the transmission of malaria in the community. Vaccines for malaria must be created to fight different parasite stages. In a commentary, an international team of researchers notes that development is currently hindered by a lack of commercial interest, since malaria often strikes poorer countries that cannot afford purchase and distribution. Transmission-block vaccines (TBVs) prevent malaria transmission by forming antibodies against antigens found in the sexual stages of the parasites. TBV development continues to be slow, however, without an industrial benefactor. The benefits of such a vaccine are many, including reduction of disease and death. The authors conclude that, "given the present lack of industrial interest in a malaria TBV, the problem remains of how to fund and manage the large-scale developmental research and the human trials of candidate TBVs. The situation calls for a substantial public sector intervention." ____________________________________*______________________________________

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