Disease Dilemmas 2 Flashcards
What is a contagious disease ?
class of infectious disease easily spread by direct or indirect contact between people.
Give examples of contagious diseases
bacterial - typhoid and plague
Viral - yellow fever and ebola.
what are some infectious diseases that are non-contagious
malaria and filariasis - spread by disease vectors such as mosquitos, worms and larvae.
what are zoonotic diseases ?
infectious diseases such as rabies, plague and psittacosis, which are transmitted from animals to humans.
what are non-infectious diseases ? non-infectious diseases ?
nutritional deficiencies
liefstyle
genetic inheritance
what is an endemic disease ?
exist permanently in a geographical area or population group.
what is an example of an endemic ?
sleeping sickness confined to rural areas in sub saharan Africa
Chagas disease - central and south america
what is sleeping sickness caused by ?
parasite transmitted to humans by the bite of an infected tsetse fly
what is an epidemic ?
outbreak of a disease that attacks many people at the same time and spreads through a population in restricted geographical area.
What happened in the 2014 outbreak of Ebola ?
West Africa
year later - 25,000 people infecte
10,500 deaths - Liberia, Guinea
what is a pandemic?
epidemic which spread worldwide
what are degenerative diseases ?
dominant non-infectious
cardiovascular - heart attack and stroke. cancer chronic respiratory diseases
What is malaria ?
infectious
non-contagious tropical disease
where is malaria ?
africa
latin america
south asia
southeast asia
how many people infected with malaria in 2018
220 million people
what is malaria cause by
malarial parasite is transmitted to humans by mosquitoes which thrive in warm, humid envrionments
what is HIV/AIDS ?
infectious
contagious
what is HIV/AIDS spread by ?
human body fluids such as blood and semen
in 2020, how many people had HIV/AIDS ?
38 million
where is HIV/AIDS concentrated in ?
sub-saharan africa
in 2018 how many cases of tb was there ?
iver 10 million cases
1.5 million deaths
what is tb ?
infectious
highly contagious
what is diabetes ?
non communicable
caused by deficiency of insulin, a hormone secreted by the pancreas.
how many people does diabetes affect ?
400 million people
4.2 million deaths annually
where is diabetes concentrated ?
north america
east and south asia
what is CVD?
coronary heart disease, stroke, hypertension, angina
how many CVD deaths per year ?
17 million deaths
80 percent in low ans middle income countries.
what is expansion diffusion ?
disease has a source and spreads outwards into new areas.
Meanwhile, carriers in the source area remain infected.
example is outbreak of TB
what is relocation diffusion ?
occurs when a disease leaves the area of origin and moves into new areas
example is cholera epidemic in haiti 2010
what is contagious diffusion ?
spread of disease through direct contact with a carrier
strongly influenced by distance
ebola 2014 example
what is hierarchal diffusion ?
spreads through an ordered sequence of places, usually from the largest centres with the highest connectivity to smaller, more isolated centres.
what is the physical barriers to diffusion ?
distance
mountain ranges
seas
oceans
deserts
climate
what are political borders to diffusion ?
imposing curfews
what is the neighbourhood effect in hagerstrands diffusion model ?
the probability of contact between a carrier and non-carrier is determined by the number of people living in each 5 x 5 km grid square, and their distance apart =.
Thus people living in proximity to carriers have a greater probability of contracting a disease than those located further awat
what are the two other features of the hagerstrands diffusion model ?
- the number of people infected by an epidemic approximates an S-shaped or logistic curve over time. After a slow beginning, the number infected accelerates rapidly until eventually levelling out, as most of the susceptible population have been infected
The progress and diffusion of a disease may be interrupted by physical barriers
How does relief affect global patterns of disease ?
altitude causes abrupt changes in climate and disease habitats
How many people have dengue fever ?
400 million people annually
25,000 detahs
why does climate change responsible for the spread of lyme disease -
Ticks thrive in warmer conditions
examples of zoonotic diseases ?
malaria
sleeping sickness
dengue fever
when does the probability of zoonotic diseases being transmitted to humans increasem ?
- movement of infected wild animals is unrestricted by physical barriers
- controls on the movement of diseased dmestic animals within countries are ineffective
- urbanisation creates suitable habitats for animals such as foxes, raccoons and skunks
- vaccination of pets and domestic livestock is sparse
- limited control within urban areas of feral dogs and cats
- ## hygiene and sanitation are poor
Synoptic link between dieases and water cycle
River flooding in Bangladesh
Water borne diseases
What is river flooding in Bangladesh ?
Bangladesh - Deltaic country that is inevitably prone to significant annual river floods.
These floods support a still largely rural population by delivering more than 1 billion tonnes of fertile soil.
How many floods have there been in Bangldesh since 2015 ?
6 consecutive years of high magnitude floods.
Does the transmission of water-borne pathogens increase during flood years ?
Yes
What did the Bangladesh 2020 floods trigger ?
epidemic of diarrhoea and other water-borne diseases such as typhoid and hepatitis, as drinking water and food became contaminated by bacteria present in the floodwaters.
Globally how many children die from diarrhoea ?
one child under the age of five dies every two minutes
What happened in the 2020 floods of Bangladesh ?
over 40% of country was flooded
3.3 million people affected
750,000 homes waterlogged
1900 schools destroyed
83 died
What is the solution for diarrhoea ?
provide clean water and efficient sanitation
what policies are the Bangldesh gov and NGO’s proposing for support of the floods ?
- the use of oral rehydration solution
- promotion of breastfeeding and reduction of formula pink
- encouragement of handwashing
- use of water purification tablets
- improvements in female education and nutrition
whos is the epidemiological transition model ?
Abdel Omran
What is the epidemiological transition model
?
describes the relationship between development and changing patterns of population age distribution, mortality, fertility, life expectancy and causes of death. Changes are driven by improvements in health care, standards of living and the quality of environment
what are the three epidemiological phases ?
the age of pestilence and famine
The age of receeding pandemics
in post industial societies the rate of mortality slackens
what is the stage of 1. the age of pestilence and famine
In pre-industrial societies mortality is high and fluctuates from year to year
Life expectancy is low and variable, averaging around 30 years
Poor sanitation, contaminated drinking water and low standards of living make people, especially young children, more susceptible to infectious diseases which dominate mortality
Pop growth is slow and intermittent. Today all countries have passed through this phase
what is the stage of the age of receding pandemics ?
In industrial societies with advances in medical tech, diet and hygiene, and improvements in living standards, epidemics causing large-scale mortality become rare. Life expectancy rises above 50 years and population growth is sustained
There is a shift in the main cause of death from infectious diseases to chronic and degenerative diseases
This phase includes many LIDCS and MIDCS today
what is the stage in post-industrial societies the rate of mortality slackens
Further improvements in medical technology, hygiene and living standards mean that mortality related to infectious diseases is rare. Degenerative diseases becomes the main cause of mortality. Man-made diseases associated with environemtnal change become more common. Emerging ecpnomies such as Brazil and China
what is the potential fourth stage of the epidemiological model ?
Age of delayed degenerative diseases - where medical advances delay the onset of degenerative CVD
Raised life expectancy in AC’s
What are diseases linked to lack of vitamins ?
Rickets (Vitamin D)
Scurvy (Vitamin C)
Pellagra (Vitamin B)
What does high temperatures and abundant rainfalls create ?
increase rates of
malaria
dengue fever
sleeping sickness
yellow fever
ebola
what is the case study for air pollution and cancer
India
How does air pollution in india reduce life expectancy ?
reduces life expectnacy of 660 million indians by more than three years
how many indians breathe polluted air ?
99 % of indias 1.2 billion people breathe air polluted above safe levels
What causes air pollution ?
due to emissions of particulates, nitrogen dioxide, sulphur dioxide and ozone, by motor vehicles and coal-burning power stations and factories.
how is indoor air pollution an issue ?
especially in rural areas, where households lack electricity and depend on biomass fuels such as animal dung for heating and paraffin for cooking and lighting
How many deaths does indoor air pollution cause ?
1 million premature deaths
what is particulate pollution ?
biggest threat to human health
tiny air borne particles smaller than 2.5 micrometres are released by burning fossil fuels and penetrate deep into people lungs
Cause serious respiratory issues as well as lung and heart disease and cancer
what is WHO’s guidelines for safe particulate matter ?
10 micrograms , in India it is 40
How many polluted cities in the world were in Indian in 2018 ?
out of 15, 12 were in India
What has happened to lung function in New Dehli ?
reduced by 40 percent on average
how many people in India were diagnosed with lung cancer in 2020 ?
1 in 68 males
1 in 201 females
what has the indian gov don eabout air pollution levels ?
early 2019, launched National Clean Air Programme
Increase number of air quality monitoring stations
what progress has been made in India to combat air pollution levels ?
- Bihar - chimneys of brick-kilns have been retro-fitted to reduce smoke emissions
- 14 indian cities are currently building rapid transit metro systems
- subsidies for petrol and diesel will be scrapped , 1/3 of all electricity is produced by noxious generators powered by petrol and diesel fuel
- restrictions will be placed on the burning of stubble in fields
what have the EU been doing to reduce air pollution ?
member states allocated 1.8 billion euros to support air quality measures under the European Structural and Investment funds.
2019 - European commision proposed to invest 1 billion euros into 39 clean transport projects to upgrade europe’s rail networks , develop alt fuels infrastructure and try for zero emission water transport
what was World Cancer Day ?
global initiative
drew attention to current cancer ‘epidemic’ and pressing govs to take more action to tackle the disease
what is the case study for malaria ?
ethiopia
where is malaria in ethiopia ?
endemic in 75 per cent of ethiopias land area
hiw many people in ethiopia are at risk of malaria ?
two thirds live in areas at risk of the disease , which kills 70,000 people a year
where are the highest rates of malaria in ethiopia ?
western lowlands
Tigray, Amhara, Gambella provinces
where do mosquitoes thrive ?
warm, humid climates
stagnant surface water
altitude
why is there no malaria in the highlands of ethiopia ?
low average temps
slow the development of mosquitoes and the plasmodium parasite
how does urbanisation increase malaria ?
flooded excavations, garbage dumps, discarded containers and so on provide countless breeding sites
how many episodes do ethiopians suffer of malaria a year ?
5 million
causes 70,000 deaths
how much lost production have sub saharan africa lost to malaria ?
12 billion dol;ars a year
how much of Ethiopians health expenditure does malaria use up ?
40 per cent of national health expenditure
accounts for 10 percent of hospital admissions
12 per cent of health clinic visits
how does malaria have implications for food security ?
western lowlands - resource rich - potential to raise food production
But malaria is endemic in this region
so holds back development
knock on effect in the highlands
cos this region is malaria free , it supports unusually high population densities
as a result, its meagre farming resources have been overexploited for generations, resulting in widespread land degradation
what is the malaria drug of Chloroquine ?
causes the pH in certain parts of the parasites cell to increase, preventing important biochemical reactions
but excessive use can be toxic to humans
what is the malaria drug of mefloquine ?
as people grew resistance to chloroquine, first detected 70 years ago in Thailand, led to the development of alternatives including mefloquine, which unfortunately has psychological impacts on a signifant percentage of those who take it.
What is in the National Malaria Strategic Plan ?
Current methods of controlling malaria interventions implemented in Ethiopia include insecticide-treated mosquito nets, indoor residual spraying, and mosquito larval source reduction.
what is the case study for cancer ?
UK
what causes cancer ?
mutations in cells DNA cause the cell to grow out of control.
Sometimes mutatiojs are caused by chemicals and other toxic substances in the environment
what are risk factors for cancer ?
genetic makeup , lifestyle, diet , overall health, gender, age
What are lifestyle choices that cause cancer ?
sunbeds cause skin cancer
opps for sunbathing have increased in last 50 yrs
wealth = preference for meat and dairy products
fast food + ready meals = increases risk of bowel cancer
alcohol consumption - oral, oesophageal, liver cancer
lack of exercise
how many cancer cases are related to smoking in the UK ?
1/5
how many people are diagnosed with cancer in a day in the UK ?
more than 980
how many people die a day in the uk from cancer ?
440
how have incidence rates of cancer in the UK increased since the early 1990s ?/
by 12%
how many working age people die from cancer in the UK a year
35,000
how many people under the age of 65 are diagnosed with cancer each year in UK ?
650,000
how does cancer affect the workforce ?
many people dont return after because of the after-effects.
they need to leave for treatment
many may change jobs or reduce hours
how many people are caring for someone with cancer in the UK ?
over 1 million
in 2108 how many people under the age of 70 lost their lives to cancer in uk ?
540,000
these individuals would have contributed £585 million to the UK economy
in the next 5 years how much of the workforce will the UK lose ?
over 200,000 potential workers
what does deprivation increase ?
likelihood of
- smoking
- alcohol consumption
- obesity
which UK authority has the highest cancer rate ?
Glasgow
how many more women who are the most wealthy survive bladder cancer than the most deprived in UK ?
14.2% more likely to survive
what is the UK govs target about cancer
to save 5000 lives a year
reduce the gap in survival rates that currently exists between the UK and other european countries
what are governmental direct strategies to mitigate cancer ?
- Investment in advanced medical technology such as more precise forms of radiotherapy, and diagnostic methods such as endoscopy for early diagnosis and intervention
- Mass screening for breast, cervical and bowel cancer is already well established and has proved highyl effective
- Reducing waiting times
what are indirect strategies governemtnal to mitigate cancer ?
Emphasis on changing lifestyle and cancer prevention
Education and health campaigns informing public of the dangers of smoking, excessive drinking and sugary, unbalanced diets can reduce the incidence of preventable cancers
What is the gov doing about skin cancer ?
direct - legislating to control the commercial use of sunbeds, with age limits, and standards of supervision and staff training.
Publicity campaigns warn dangers of sunbathing and advise on sunscreens and clothing
what is the meterological offic doing about skin cancer ?
during summer months, regularly issue forecasts on UV intensities and safe limits of exposure.
what are international agencies and charities doing about cancer ?
The International Agency for Research on Cancer is part of WHO
It conducts epidemiology and lab research into the causes of the disease
Cancer UK - charity that researches the prevention, diagnosis and treatment of cancer. Funded by donations, legacies and cahrity events, iy operates in universities and hospitals in UK
when was WHO established ?
1948
where is the HQ of WHO ?
Geneva, Switzerland
who does WHO work closely with ?
UNICEF
World Bank
NGO’s such as Red Cross and Red Crescent Movement
what does WHO do ?
- gather health data
- provide leadership and identifying prority areas in matters critical to health
reserach health problems
monitor international health situation
support UN member states to devise health strategies
provide technical support during health crises
what did WHO do following the Nepal earthquake disaster
delievered emergency health services in the form of mobile medical units and supported foreign medical teams in areas worst hit by the quake.
when did WHO declare COVID19 as a pandemic ?
11th March 2020
WHen did Haiti get hit by aan earthquake ?
Jan 2010, powerful magnitude 7 earthquake
what was the death toll of haiti earthquake ?
30,000 to 300,000
What is the economic status like in Haiti ?
60% of people survive on less than 2.5 dollars a day
how many people in Port au Prince lived in slums before the haiti earthquake ?
86 % of people , 50% had no access to toilet
when did cholear outbreak begi n after haiti earthquake ?
10 Oct 2010
spread by nepalese soldiers flown in as part of the international effort to cope with the disaster
how many cholera cases were there between initial outbreak and nov 2014 ? haiti earthquake ?
720,000 cases with 8700 deaths
What was the Birthis Red Cross response programme to the cholera outbreak haiti earthquake ?
- deliver clean drink water to 300,000 people living in camp in Port au Prince
- massive hygiene programme, build 1300 latrines for 250,000 people
- provide medical supplies to the main hospital in Saint Marc in affected area
- treat 18,700 cases of cholera in treatment units in La Piste camp in Port au Prince and in Port a Piment camp in southwest Haiti
- raise awareness among local people on how to avoid infection and of symptoms
page 372
What had happened by late December in Haiti earthquake cholera ?
MSF and a brigade of Cuban doctors had treated more than 75,000 cholera cases
Some critics observed that few other agencies were implementing critical cholera control measures, such as chlorinated water distribution and waste management
Very little was done to improve sanitation across the country, allowing cholera to spread at a very rapid rate
What happened to the Nahua tribe ?
In Peru, half the tribe were wiped out by disease following oil exploration on their land,
Where do water borne diseases pose the biggest threat ?
Isolated rural areas
Medical teams and emergency aid have difficulty reaching
Remote ghorka region of Nepal, many settlements are one or two days walk from the main village
During 2015 earthquake , these settlements were cut off by landslides and were without clean water and medical supplies.
Two weeks for medical help to arrive
Why was Ebola contained in 1980s
Communities affected were so isolated in the Congo rainforest that it was contained
What is the dominant theory of COVID 19
Originated in bats or pangolins and was then transmitted to humans
Virus spread to humans in the seafood and animal markets in Wuhan
What is Cuba well known for
It’s healthcare system
Even though it has a GDP per capita of only 8800 US dollars
What did Cuba do about COVID 19
As soon as it broke out in China, it established a commission to deal with covid 19
This was set up in mid Jan 2020,
Cuban personnel travelled to China to learn more about the virus and training courses were run to plan how to deal with the virus when it had arrived
from app March 2020 all arrivals were feted for COVID 19
Lockdown began on 20 March
24 March it closed its borders to non-tourists
By middle of July, the death rates had dropped to usual levels at that time of year
What are the features of cubas healthcare system
Universal free public health care seeking prevention over cure, supported by a network of family doctors
Cubas pharmaceutical industry produces 70% of its own drugs, exporting to mor e than 50 countries
Excellent systems in civil defence and the management of natural disasters
Well deserved reputation for sending health care professionals to assist in other countries, more than 400,000 over the past 50 years
Where do many modern medicines originate from
Natural compounds found in wild plants
How did Hippocrates influence medicine
Greek physician
Recorded more than 300 medicinal plants and herbs which he classified according to to their physiological action
What was the first natural derived medicine isolated from a plant by synthesising in the lab ?
Morphine in the early 19th century
What is morphine extracted from
The latex produced by unripe seed pods of several poppy species
They are sued as analgesics to reduce pain
What was the first semi-synthetic glycoside drug
Aspirin
Based on salicin, isolated from the bark of white willow in 1899
By Aug 2020, how many covid cases did Cuba have
2400
By aug2020, ho a any covid cases did the uk have
285,000
By Aug 2020, how many covid cases did USA have
2,950,000
By Aug 2020, how many Covid deaths in Cuba
86
By Aug 2020, how many Covid deaths in uk
44,200
By Aug 2020, how many Covid deaths in USA
129,500
What is the life expectancy in Cuba and USA
Cuba - 79.1
USA - 79.3
Infant mortality rate for Cuba and USA
Cuba -5.0
USA - 5.9
Maternal mortality rate of Cuba and USA s
Cuba -39.0
USA -14.0
What is the total spending on health as a percentage of GDP in Cuba and USA
Cuba - 8.6%
USA - 17.0%
What is the per capita total expenditure in health at average exchange rate in Cuba and USA
Cuba - 558 US dollars
USA - 8845 US dollars
What is the source of salicin
Bark of white willow and other willow species
What are the growing conditions of salicin
Widespread on river banks, floodplains and wetland throughout the temp zone
Thrives on a range of soils , from light sands to heavy clay
Soil ph from 5.5 to 8.0
What is the medicinal use of salicin
Acts like aspirin. Used for pain relief, gout, osteoarthritis
What is the source of caffeine
Tea
Coffee
Coca
What is the growing conditions for caffeine
Tropical and sub tropical
Temps average 20-27
Abundant rainfall 1000 -2000 mm/year
Soils which are well drained, with good organic content and nitrogen
What is the medical use of caffeine
Stimulant for central nervous system, heart, muscles
What is the source of quinine
Dried bark of cinchona’s evergreen tree
What is the growing conditions of quinine
Average temperatures above 20 degrees
Humid conditions with annual rainfall in excess of 2000mm over at least eight months
No frost
Well drained , fertile soils with abundant organic matter and good moisture holding capacity
What is the medical usage of quinine
Malaria
Kills malarial parasites in red blood cells
What is the source of colchicine
Autumn crocus
What are the growing conditions of colchicine
Moist, temperature climate conditions conditions.
Deep, well drained soils with slightly acidic ph and good moisture retention
What is the medical usage of colchicine
Cancer and gout
What is the source of nicotine
Tobacco plant
What are the growing conditions of nicotine
Optimal mean daily temp 20-30
Rainfall 600-800mm , with 20-30mm every two weeks in the growing season and frost free conditions
Light to medium textured soils with good drainage
What is the medical usage of nicotine
The main active ingredient in new drugs to treat wounds
what is the source of morphine ?
dried latex from seed pods of several species of opium poppy
what are the growing conditions of morphine ?
warm, humid
clear sunny days with temps 30-38
susceptible to frost and wet weather
deep, clayloam, well drained soils rich in humus
soil ph 6-7.5
what is the medical usage of morhpine
anti-malarial agent
what is the source of digitalis ?
foxglove
what are the growing conditions of digitalis ?
temp climatic conditions
tolerates high rainfall, cool summers and acidic soils
what is the medical usage of digitalis ?
dropsy, heart failure
What is the rosy periwinkle ?
small evergreen shrub which is native to Madagascar, although it is now common in many tropical and sub-tropical climate, without regions.
Requires a warm tropical climate, without frost, and where soils are well-drained but mositure retaining, slightly acidic
What is the medical use of rosy periwinkle ?
treatment of wasp stings in India, to diabetes in China and the Phillipines
Popular ornamental garden plant
It contains 70 known alkaoids, several of which have significant medical value.
What are the alkaloids of vincristine and vinblastine ?
treatment for various cancers
Vincristine used in chemo in childhood luekemia and has increased survival rates from 10 percent in 1970 to over 90 today
Vinblastine - proved highly effective in treating Hodgkins lymphoma
What is biopiracy ?
the exploitation of biological resources
Where are medicinal plants manily sourced from ?
wild populations
only a small number of medicinal species like the rosy periwinkle and the foxglove are cultivated
how many people globally rely on traiditonal medicines ?
80 per cent of the popyulation in the developing world (5 billion)
Why can the sourcing of wild medicinal plants be unsustainable ?
Over-harvesting
Reduces plant populations anf their genetic diversity, endgaengering the species.
Can result in extinction
slow growing plants and those occupying highly specialised niches, are especially vulnebrale
How many medicinal plants are under threat ?
at least 4000
14 listed as acutely endangered by the Convention on International Trade of Endangered Species of Wild Fauna and Flora
Include several species of yew and goldenseal
what is yew used for ?
a source fo antu-cancer drug taxol
what is goldenseal used for ?
herbal medicine and native to the USA and Canada
What is another cause of the decline of wild medicinal plants ?
preference of TCM for wild plants rather than cultivates, and the preference for roots rather than leaves, flowers and seeds.
How diverse are tropical rainforests ?
contain 70 per cent of terrestrial plant species, and yet no more than 1 % have been screened for potential medical use
what are the deforesttaion rates of tropical rainforests ?
325km squared/ day
How many medicines are lost due to deforestation ?
at ;east 1 potential major drug is lost every two years due. - Centre for Biological Diversity
How have pharmacuetical companies exploited the rainforests ?
Target medicinal plants for cultiviation and for synthesising chemical compounds
What are pharmacuetucal companies doing in return for indigineous people conserving forests ?
Divert part of their profits from drug royalties to help local communities
Which schemes like this are already happening ?
In samoa and costa rica
In 1980s scientists identified and extracted prostialin, a powerful drug for HIV, from the bark of the mamala tree found in Samoan rainforest
Part of revenues returned to Samoa as compensation for protecting the rainforest and to assist economic development in rainforest communities
What is the case study for a pharmacuetical transnational ?
GlaxoSmithKline
GSK
What are pharmaceutical companies criticised for ?
- Making excess profits well above average
- Overcharging govs and individuals for drugs
- Spending more than any others to ‘lobby’ govs to ensure that national and international regulations favour them
- Concentrating their research on developing drugs that require long-term and repreated prescriptionsuch as anti-depressents
- Neglecting to sufficently fund research in less profitable areas of drug development
- Neglecting to research the development of antibiotics
Where is GSK HQ ?
UK
What was GSk turnover in 2019 ?
£34 billion
What products do GSK make ?
2.3 billion packs of medicines, 701 million vaccine doses and 4.2 billion consumer healthcare products
How are GSK operations global ?
employ nearly 100,000 people
84 manufacturing sites in 36 different countries
large research and development centres in UK, USA, Spain and Chins
In 2019 how many medicines and vaccines did GSK have in clinical development ?
39 medicines
15 vaccines
How does GSK invest in Research and development ?
employs 15,000 people and spends more than 4.6 billion a year researching new medicines
What is unique about GSK ?
one of the few healthcare companies currently researching treatments for WHO’s three priority diseases - HIV, Malaria and TB
What are the disadvantages to developing and testing new drugs ?
long and costly process
subject to high failure rate
What is another problem that GSK faces ?
Demand for new drugs in LIDC’s , often too small to recoup development costs
What does GSK R&d CENTRE IN sPAIN FO ?
Focuses primarily on TB, malaria and tropical diseases
Company is currentyl close to auncing the first effective vaccine against malaria, that infects 200 million every year and has not had a new treatment developed since the 1960’s
Also developing a vaccine for Ebola
What is GSK ethical policy ?
- A commitment to a small return - 5% - on each product sold
- Providing 3 HIV/AIDS drugs to LIC’s at significant discount
- Granting licenses for the manufacture of cheap generic versions of its patented drugs
- Capping the prics of patented drugs to developing countries to 25% of UK price
- Investing 20% of its profits from sales in each developing country
What is being done to eradicate Polio ?
Prior to vaccine in 1952, it killed or paralysed 600,000 people a year
Vaccine developed by virologist Jonas Salk, who chose not to patent his discovery, thus much reducing its cost
Global Polio Eradication Initiative , supported by WHO, UNICEF , teh CDC began in 1988
Programme of Vaccination had successfully eradicated thedisease in Americas and by 2011 the virus was endemic in only Afghanistan, Pakistan and Nigeria.
Why is polio hard to eradicate in Afghanistan, Pakistan and Nigeria ?
Uptake for vaccine to children remains uneven
Political instability, and murder of more than 8p health care workers in Pakistan and Nigeria in recent years by military
Since 2013, new outbreaks have occured in war torn syria and iraq , where vaccine and basic hygiene have reduced
What have Mauritius done good ?
Illustrates how top-down national initiatives can successfully eliminate a disease like malaria and prevent its reintroduction
What is Mauritius history with Malaria ?
Became an endemic in mid-19th cenutry
1867 - killed one in 8 of the population
Major gov backed campaign to eliminate was launched between 1948 and 1951
What did Mauritus do to eliminate Malaria ?
Spraying buildings and breeding sites of mosquitoes with DDT reduced mortality rates from malaria from 6 per 1000 in 1943 to 0.6 per 1000 by 1951 , allowing WHO in 1973 to announce that malaria had been eliminated from the island
What happened after Cyclon Gervaise hit Mauritius ?>
Migrant workers employed in reconstruction reintroduced malarial parasites to the island
1982 - malaria forced the gov to do 2nd elimination campaign
Sparing mosquito breeding sites and indoors resumed , predatory fish that feed on mosquito larvae were introduced,
mass administration of anti-malarial drug chloroquine
What ahs Mauritius done since 1998 ?
Rigourous passenger screening at airport
175,000 passangers per year are screened
Comprise potential carriers of disease such as arrivals from malrial endemic countries and those showing symptoms fo fevere
Peopel are kept under surveillance by healthcare workers for up to 4 months, during which blood samples are taken and anlaysed
How many malaria cases have been in Mauritus since 1997 ?
One
What is a grass root scheme ?
involves and empowers local communities
What is the Guinea Worm eradication programe ?
Ghana, the Guinea worm eradication has partnered the Ghana Red Cross women’s clubs to reduce transmission of Guinea Worm
Involves teaching women volunteers on howit is transmitted and how it can be prevented
Volunteers then visit bvillages and educate locals
Why were male volunteers less successful ?
Men frequently work outside villages and it is mainly women who are responsible for sourcing water and its use for household consumption
Women were abel to appreciate the value of filtering drinking water and avoiding contamination of water sources by people already infected with parasite
what were the respinsiblituies of the women volunteers ?
- monitoring, idenityinf and reporting all new cases of Guinea worm
- ensuring that those infected did not contaminate water
- distrubing,checking and a replaing water filer that remove water fleas from drinking water
- identifyign water souces used by the community and requiring treatment with larvicides.
Why has this grass root scheme been successful ?
guinea worm effectively eradicated from Ghana
WHo reported in 1989 there were more thsn 179,000 cases
by 2010, it reported it last indigineous case of the disease
what is the life cycle of guinea worm ?
1) Entering the body - Person drinks water containing tiny water fleas that are infected with guinea larvae
2) Multiplying - The fleas are digested, releasing the larvae into abdominal tissues, where they mate
3) Growing - Female worms, growing up to 1 m log, move through the body, mostly to lower limbs
4) Leaving the body - About a year later, the worm emerges from the blister it creates. The victim in paun, rushes to coll the limb in water
5) Infesting the water -On contact with water, the worm releases clouds of larvaem
6)Infecting water fleas - Water fleas consume the worm larvae, which resist digestion
