Summit covers health concerns from avian flu to TB


By Linda Bloom

NEW YORK (UMNS) - Old diseases - malaria, tuberculosis and measles - still account for significant death rates in some countries.
Newer diseases -- HIV/AIDS and emerging threats like the avian flu - have an even larger global impact.
Issues surrounding such health crises were addressed during the Nov. 1-3 Global Health Summit in New York, sponsored by TIME magazine and the Bill & Melinda Gates Foundation. United Methodists were among the participants from medicine, government, business, nonprofits, public policy and the arts.
United Methodist Bishop Joao Somane Machado of Mozambique was part of a panel discussion on "How Can Malaria and TB Be Contained?" that was moderated by Philip Elmer-Dewitt, TIME's sciences editor.
The bishop's experience with malaria has been sadly personal. Besides suffering from repeated bouts of the disease since his birth - about 85 times, according to his estimate - Machado lost two nephews to malaria about five years ago. "They died because of (drug) resistant malaria," he recalled. "They were gone in less than a week."
Paul Farmer, a doctor and board member of Partners in Health, wasn't surprised by the bishop's continual re-infection or the drug-resistance problem. "The bishop describes, I'm sorry to say, a very common scenario in Africa," he said.
Charity Ngilu, Kenya's minister of health, added that malaria becomes impossible to treat "when you do not have the drugs" or the ability to hire health care workers. In her country, 20 million are at risk of infection and each year about 3,400 children die and 6,000 women suffer miscarriages due to the disease. Machado noted that while 4,000 malaria deaths of children under five were reported in Mozambique for 2004, the real toll is probably much higher because so many families live far from hospitals.
Treatment for TB also is a problem in Mozambique because when patients improve, they often stop taking the needed medicines. "After one month, they feel a little better," Machado said. "They need to go back to work because the family has no food to eat."
Farmer, who has done extensive work with multi-drug resistant TB, explained that such resistance occurs when TB patients interrupt or change the use of medicine. The only solution, he said, is to have health workers assume complete responsibility for TB patients until therapy is over. That responsibility includes providing supplemental food.
But disease resistance to various drugs continues to grow. And while a handful of public-private partnerships are working on product development, Farmer said, "Very little is known about drug development for TB."
In a Nov. 2 press conference, Bill Gates talked about the need to "pursue many approaches" to eradicate malaria.
Three days earlier, the Gates Foundation had announced the funding of three new grants, totaling $258.3 million, for malaria control. A $107.6 million grant will allow the PATH Malaria Vaccine Initiative to work with GlaxoSmithKline Biologicals and African investigators on testing and licensure of an advanced malaria vaccine.
Another $100 million will be used by Medicines for Malaria Venture to accelerate development of promising new drugs. A $50.7 million grant will allow fast-track development of improved insecticides and other mosquito controls through the Innovative Vector Control Consortium, led by the Liverpool School of Tropical Medicine.
"In the long run, the ideal would be to have a vaccine you have early in life" which would provide permanent protection against malaria, Gates said.
Another long-time killer of children is being pursued by the Measles Initiative, whose partners include the American Red Cross, United Nations Foundation, World Health Organization, Centers for Disease Control and UNICEF.
Despite the availability of an effective, inexpensive vaccine, more than half a million people died of measles in 2003, most of them children under 5. But the death rate is dropping, with more than 200 million children in Africa vaccinated and some 1 million lives saved since 1999, largely due to support of the Measles Initiative and commitment from African governments.
During a summit press conference, Ted Turner, chairman of the UN Foundation, announced the organization was making a further commitment of $20 million to the Measles Initiative over the next four years. The foundation already had contributed $37 million to the project.
Turner called the commitment an effective use of funds. "This is a disease that can be combated with a minimal amount of money in an immunization project," he said.
The concern over a possible avian flu pandemic was addressed at several points during the summit. President Bush announced Nov. 1 that he would ask Congress for $7.1 billion to combat such a pandemic, mainly through research and stockpiling vaccines and other drugs.
In a panel discussion on the "next plague," Irvin Redlener, M.D., director of the National Center for Disaster Preparedness, declared the Bush plan a "catch-up" effort. "This is the biological version of not fixing the levees in New Orleans," he said.
Nils Daulaire, an internationally known public health physician and president of the Global Health Council, was heartened by the emphasis on research for new vaccines in the Bush plan. "We really do need a way to rapidly produce new vaccines," he said during a press conference. "These infections will not wait for the three to five years it takes us currently to develop new vaccines."
He doesn't believe there will be bird flu pandemic next year, but said it could happen sometime over the next decade. The fact that the death rate from infection is far higher than other modern flus gives it "the potential to become a real killer strain," Nils added.
In a speech to summit participants, U.N. Secretary General Kofi Annan outlined seven key priorities to help the United Nations and the international community prepare for the possibility of a pandemic.
Gates teamed with former President Bill Clinton in a Q&A session, hosted by Jim Kelly, TIME's managing editor, on issues ranging from President Bush's efforts on AIDS to public-private partnerships on health initiatives to the idea of a "Medical Peace Corps."
Partnerships were on the mind of Sir Richard Branson, chairman of the Virgin Group of Companies, who said in a press conference that the time he has spent at hospitals in Africa has made him realize "these people are dying unnecessarily."
His hope is that a type of "war room" can emerge from the Global Health Summit "to make sure that best practices are put into action."
The Global Health Summit was held in association with "Rx for Survival," co-produced by WGBH Nova and Vulcan Productions, which aired Nov. 1-3 on PBS.
*Bloom is a United Methodist News Service news writer based in New York.