Healthy Dose July 13, 2011

Top Story

UNITAID Patent Pool Kicks Off

The Medicines Patent Pool, established by UNITAID to share drug patents, has just received its first contribution from Gilead Sciences. Sarah Boseley writes in Guardian Development why this is such a big deal.

Gilead is the first pharma company to agree to put specific drug patents in the “pool”. This will allow generic companies in India to make cheap copies of them for use in poor countries with major Aids epidemics. Even more importantly, the generics companies will also be allowed to make combinations of drugs from different companies (provided other companies follow Gilead’s lead). In an ideal world, anybody with HIV who needed medication would be able to take a single pill once a day in which three or four medicines are combined.

Gilead is to be congratulated. It has agreed to let Indian manufacturers copy and combine not only two important licensed drugs, tenofovir and emtricitabine, but also two drugs that are still under clinical development and do not yet have a licence, cobicistat and elvitegravir. Gilead is itself developing a single pill called the “quad”, which will combine all four drugs. Generics companies will also be allowed to start copying that too. With such a head start, it means that cheap generic versions can be ready for distribution as soon as Gilead gets its licences from the US Food and Drug Administration (FDA).

There is more too. Tenofovir is a hugely important HIV drug, which has lately been considered as a possible tool for preventing infection. It was the drug used in a vaginal gel in the CAPRISA trial in South Africa. The trial found women who used it were 39% less likely to become infected with HIV. Gilead has allowed generic companies to make copies of this important product, but the agreement will ensure access for more countries. The company is also going to allow generic versions for treating hepatitis B, for which tenofovir is also licensed.

The real value of the patent pool starts to become clear in this deal. The big pharma companies with important and lucrative Aids drugs have been willing to allow generic copies to be made, but on the basis of a deal here in India and another there in South Africa. Now – as long as Gilead’s move is just the start – there will conceivably be a “one stop shop.”  Hoen says she will be encouraging generics companies to apply as early as this week. Her vision is of a multitude of generics companies making drugs – and driving the prices down through competition. Now that it has been shown that putting people with HIV on treatment makes them less likely to infect others, there is all the more reason to get good treatment to as many people as possible as early as possible.

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Global Health and Development Beat

HIV/AIDS – A consultant to the government of Zimbabwe has suggested that the loosening of laws against homosexuals and prostitutes can lead to reducing the spread of the virus.

Diarrhea Flooding in Southwest China is to blame for 73 people being hospitalized with diarrhea.

Malaria – Researchers believe that rapid diagnostic tests can be improved by making some simple tweaks to the current tests

Maternal Health – In honor of World Population Day this week, Secretary of State Hillary Clinton called for a greater focus on providing improved health to mothers and children.

Maternal Mortality – India has registered a decline in its Maternal Mortality ratio by 17% during 2007-2009.

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The Players

African Development Bank – Is providing $2 million to address the problem of the lack of access to clean water for 40% of people in the Southern African Development Community.

UNHCR – Is supporting some 84,000 Pakistani’s  displaced due to fighting between the army and insurgents in the northwest.

CDC – Has expressed concern over the recently discovered strain of gonorrhea in Japan that is resistant to all present antibiotic treatments.

AusAID – 39 recommendations have come out of the first review in 15 years including the suggestion to increase aid to South Asia and Africa.

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Buzzing in the Blogs

The ethics of interviewing individuals and writing about rape has become an explosive topic over the past week. Laura Seay takes a look at the issue and explains why she feels it is always better to err on the side of caution.

From my point of view, the basic problem goes back to the question of whether someone who has very recently suffered serious trauma can ever be capable of giving informed consent. I can’t imagine what it is like to be raped in a Haitian camp for the displaced, but I’m pretty sure I wouldn’t be thinking straight had it just happened to me. Add to that the victim’s possible unfamiliarity with what Twitter is or what it means to be written about in the international media – not to mention that saying “yes” to McClelland may well have meant an easier, cheaper, quicker ride to the hospital – and there’s just a load of issues here.

So. A few thoughts for researchers and reporters dealing with victims of violent trauma. First, researchers, this is why we have IRB’s. When your interview subjects are vulnerable and may not be capable of making a well-informed decision about speaking with you, it is your responsibility to think through the implications of their decision. You may need to decide not to use information EVEN IF IT IS GIVEN if you or your IRB suspect that using that information would further endanger or traumatize a subject. It may make your research more challenging to leave that evidence out, but your theory is not more important than another person’s health and safety. And if it’s a good theory, you should be able to find evidence elsewhere…

People can speak for themselves, and, more importantly, can be trusted to determine when they don’t want their stories publicly told. We owe it to anyone who has experienced trauma to let them make real decisions, in their own time and ways. And we can do better.

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Capital Events

Wednesday

9:30 AMA Greener Revolution: Improving Productivity and Increasing Food Security by Enhancing Ecosystem Services – USAID

2:00 PMConservation, Trade Policies Hit Poorest in the World – AEI

Thursday

9:00 AMYoung and Displaced — A Multinational Look at Youth on Their Own, as Refugees, on the Run, and in Need of Help – Urban Institute

12:00 PMThe Broken System of Crop Insurance and Disaster Aid – AEI

12:00 PMRoundtable Discussion on the Health Implications of Japan’s “Triple Disaster” – CSIS

3:00 PMA Dialogue with USAID’s Leaders on Gender Equality and Women’s Empowerment – SID

Friday

10:00 AMOrganized Crime and State Corruption: The Challenge in El Salvador, the Experience of Guatemala – WOLA

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By Mark Leon Goldberg and Tom Murphy; Photo Credit