Thursday, September 24, 2009

Thai Surprise!



Results are in from Thailand, where researchers had mounted the largest clinical trial ever for an HIV vaccine.

Jaws are dropping.

Reuters Health Editor Maggie Fox has a good account here.

The data -- which appear to show the vaccine cut risk of infection by 31.2 percent among 16,402 volunteers -- are an unexpected surprise. When I spoke last year to the U.S. Military HIV Research Program, one of the trial's main sponsors, they seemed resigned to the idea that they were on track for another failure on the heels of the Merck disappointment.

Obviously in the Thai case 30 percent protection is not an unqualified success. But it is something -- and I wonder how much pressure there will be now to roll something out along these lines, even though the Thai vaccine was designed for the HIV strain common there, not the different strains often found in Africa or the United States.

The NIH's Fauci told the Times that scientists would seldom consider licensing a vaccine less than 70 or 80 percent effective, but he added, “If you have a product that’s even a little bit protective, you want to look at the blood samples and figure out what particular response was effective and direct research from there.”

Why and how did this vaccine do its stuff? Will it fire new interest in more clinical trials for different vaccine prototypes? There's certainly a network of trial sites out there looking for work.

We'll see how this plays out in the coming weeks. Meantime I'm afraid my mind has been elsewhere -- specifically at the United Nations, where I am running around after Iran's Ahmadinejad, Libya's Gaddafi and Obama himself. Here's a bit of that effort.

Monday, July 20, 2009

South Africa starts AIDS vaccine trial..and stops funding it!

People knew this was coming, but it's still depressing.

South Africa has started trials of its own locally-developed AIDS vaccine, while at the same time announcing it has run out of money to fund the project. The trial will continue with U.S. money, but this is a blow for what many hoped would be an all-African contribution to the AIDS vaccine effort.

But at least it will keep many of the South African trial sites going, and will keep AIDS vaccine efforts in the news -- even if almost nobody sees any breakthoughs coming soon.

Here's an interesting excerpt of an interview that the Sydney Morning Herald did with Nicoli Nattrass, probably South Africa's best AIDS economist:

AIDS deaths are expected to reach an all-time high in the next 12 months, while the Government's investment in treatments is the lowest per capita in the region, says Nicoli Nattrass, the director of the AIDS and Society Research Unit. "The most recent model [shows] the denialism of the Mbeki era cut off at least 1 per cent of South Africa's growth rate per year over the last 10 years," Professor Nattrass says.

The rest of the article is predictably doom-and-gloom --

Friday, May 15, 2009

A Healthy Development




A step in the right direction, thanks to Swine Flu?


Politics (read: China) has kept Taiwan out of the WHO for decades, but now the island is going to send an observer delegation to the WHO Congress. This is important on a purely practical level -- swine flu didn't amount to much this time around, but what happens if the next bird flu/SARS outbreak comes in East Asia? Getting everybody on the same page is crucial and now Taiwan's public health authorities will have a seat (ok, an observer seat) at the table.


Taiwan to join WHO congress in "huge breakthrough"
* Taiwan set to join World Health Organisation assembly

* Self-ruled island had been barred by China since 1971

* Pandemic flu fears support calls for observer status
TAIPEI/GENEVA, May 15 (Reuters) - Taiwan is set to take part in next week's World Health Organisation annual congress for the first time in 38 years, in what is regarded as a rare diplomatic opportunity for the self-ruled island.

Under an agreement reached with Beijing, 15 people will represent Taiwan at the World Health Assembly under the name of Chinese Taipei.

China has claimed sovereignty over Taiwan since 1949, when Mao Zedong's Communists won the Chinese civil war and Chiang Kai-shek's Nationalists fled to the island. Beijing has vowed to bring Taiwan under its rule, by force if necessary.

"Our delegation will define this trip as a journey of professional studying and sharing," the Taiwanese health department said in a statement on its website on Friday.

"Because our country has not joined any U.N. agencies for 38 years, it's important to study the internal process of the WHO and interact with officials from other countries," it said.

Taiwan is not a U.N. member but is represented at the World Trade Organisation under the name of Chinese Taipei. China, backed by about 170 diplomatic allies including the world's most powerful nations compared to Taiwan's 23, normally stops the island from joining international organisations that require statehood as a prerequisite.

But relations between Taipei and Beijing have improved since the island's President Ma Ying-jeou took office in May 2008, with top negotiators on both sides holding meetings and signing a series of deals to boost trade ties.

Raymond Wu, a political analyst in Taipei, said Taiwan's representation in Geneva may help Taiwanese authorities improve their links with major economies that are allied with China, such as the United States and European Union.

"Symbolically, it's a huge breakthrough for Taiwan," Wu said of the agreement with China announced by Taipei on April 29.

Fears about the newly discovered H1N1 virus added impetus to Taiwan's argument that it should be allowed to observe the WHO policy-setting assembly, where 193 member states will discuss the global response to the flu strain with antiviral drugs and vaccines.

Taipei has long argued its exclusion from the WHO and its meetings has made it tough to handle major health issues such as the 2003 outbreak of Severe Acute Respiratory Syndrome (SARS). WHO laboratories have confirmed four H1N1 flu infections in the Chinese mainland and Hong Kong to date, with none in Taiwan.

Wednesday, May 6, 2009

ZOMBIES!


here's a link to a sort of feeble minded story I did today on social media and pandemic planning, and how the mechanics of public health communication are changing in the new environment.


We've been busy at Reuters with the swine flu tale..and I've been busy otherwise with politics, the Hill and all the other aspects of my non-global health life. I'm going to try to get going on this blog again more seriously now -- but it will be a lot more random. I'll also be twittering now and and again (when I remember to) at http://twitter.com/andrewquinn


Anyway, take a look at Reuters' main H1N1 news page and see what you think....