Tag Archives: hiv/aids

No Cure for Ebola: the Importance of Global Health Research and Development

This blog is part two of a two-part series on Ebola, highlighting critical challenges in global health which have hindered the ability of the world to effectively respond to this emerging health threat.

In this second blog we explore how a lack of investment in research and development (R&D) for poverty-related diseases can have devastating consequences – in the first blog we looked at how weaknesses in health systems have undermined efforts to fight the disease.

Ebola is a scary phenomenon. There are currently no treatments or vaccines specific for the disease, and general anti-viral treatments have not been found to work. It causes internal bleeding, and while patients’ bodies do eventually create an immune response to fight the virus, by this time too much damage has occurred. Death rates are around 50%.

Photo: EC/ECHO/Anouk Delafortrie

Photo: EC/ECHO/Anouk Delafortrie

This has meant that, for the vast majority of the nearly 20,000 Ebola patients in West Africa so far, ‘treatment’ has simply been supportive, helping the patient’s body to maintain hydration and electrolyte levels; whilst trying to prevent further spread through isolation, contact tracing and proper protection from bodily fluids for those interacting with patients.

Yet over the past decade, a wide variety of potential treatments and vaccines have been explored in ‘basic’ and ‘applied’ research studies involving animals, but have then sat on the shelf gathering dust. Only very recently has high political and public interest in developed countries fast-tracked many into either small ‘phase I’ human trials, or even into use as ‘experimental treatments’ for individual patients, in partnerships between pharmaceutical and public funding bodies.

These products include antiviral drugs, blood transfusions from surviving Ebola patients, other antibiotic treatments, and vaccines using Ebola virus particles that are missing genetic materials and cannot replicate. Results have been mixed and inconclusive so far: some patients survive, but attribution is difficult; some sadly do not. Given enough products moving steadily along this ‘pipeline’ – which we have now achieved, albeit belatedly – doctors will eventually get what they need to fight Ebola.

But it will still likely take many months, and would usually would take years, as promising products pass through the final large-scale ‘phase III and IV’ trials to prove safety and efficacy before they become available to the public. The process will not be quick enough to save those facing Ebola now, and of course has already failed those who have died.

This applies not just to Ebola, but to the wider burden of infectious disease that currently causes untold disruption to both health systems and economies in low and middle income countries. As increasing trade and global integration continues, addressing the infectious diseases that affect these countries will become ever more of a global challenge.

The West Africa Ebola outbreak has so far killed just over 7,000 people during its six-month duration; in comparison, HIV/AIDS and tuberculosis (TB) both kill over 4,000 people every day. They are just two of the so-called ‘poverty-related and neglected diseases’ that kill nearly 14 million people every year and for which, as for Ebola, there are no treatments available. For others, such as for TB, the infections have become resistant to existing drugs or the treatments are painful and difficult to use and needed for long periods of time.

Despite these pressures, only 4% of all new products registered over the last decade were for poverty-related diseases. The ‘shelves’ of global health R&D are gathering huge amounts of dust. In asking what can be done to prevent another outbreak of a similar disease – or prevent the daily tragedy of HIV/AIDS or TB – we must therefore ask: how can we ensure that potential products to prevent and treat life-threatening or debilitating conditions are prioritised, funded and brought forward?

The huge under-investment that is delaying and stalling progress has been attributed to flaws in the current method of funding research and development (R&D). At the moment, companies will usually risk investing in a product only if it could generate a significant financial return. Almost by default, this is not possible for many poverty-related and neglected diseases.

However, ways round this problem are already producing strong results. The UK Government has historically been a champion of ‘Product Development Partnerships’ (PDPs), which generate partnership between the sectors, pooling donor and philanthropic funds with academic and private sector expertise and resources, and also building medical research capacity in affected countries.

PDPs have been instrumental in bringing through 37 new therapeutic products for poverty-related diseases registered over the last decade; including a UK-funded paediatric antimalarial, five new diagnostic tests for TB, and the first internal ring to prevent HIV infection in women. The Government is also exploring options to better fund R&D through public money via targeted grants, ‘milestone prizes’, and the further pooling of information and funds with other donors.

Whilst a great start, the gaps in donor finance for global health R&D are still huge – around $1 billion every year for just TB, for example. As Justine Greening said in 2013, “the development of new technologies is vital if we are to improve the health of the poorest people through better treatment and prevention”.

Ebola is just the most recent example of why the Secretary of State is right, and why the UK Government must now follow through on its leadership in investment and support for Global Health R&D.

For more information, please contact Laura Boughey, Health Advocacy Co-ordinator at RESULTS UK, at laura.boughey@results.org.uk.


January action annouced

In February this year, the great and the good of the African mining world will come together for their annual ‘Indaba’, the yearly industry investment conference.

south africa, mining, lungs, tb, hiv, tuberculosis, aids, bed, chest, shirtlessThis represents a golden opportunity to mobilise the vital political will needed to drive real, lasting change for thousands of miners and their families. Its time  to be bold and ambitious and call on the UK to do everything they can to make the event a success.



Materials included this month:


Guest: TBC

This month there are groups meeting to join the conference call in: Central London, South London, Poole, the Stort Valley, Birmingham, Oxford, Macclesfield, Central Sheffield, South Sheffield, Leicester,  Edinburgh, Glasgow, Norwich, Bath, Leamington Spa, Belfast, Reading, Liverpool, Brighton and Linlithgow.  If you would like information on the location of your local group, please get in touch with us in the office at: felix.jakens@results.org.uk

If you would like to join the conference call there are 3 numbers you can call –  0844 762 0762, 0203 398 1398 or 0800 22 90 900. You must then enter the participant code, which is 18723. If you would like advice about which number to call please contact us in the office.

We look forward to you joining us

Nutrition advocate Rufaro Madzima shares her expereinces of meeting UK parliamentarians

Last week, RESULTS were joined by  Rutharo Madzima, the former head of Nutrition at the Ministry of Heath in Zimabawe, for an advocacy tour on nutrition. Have a read of this guest blog from Rutharo and learn more about what she got up to and what she will take back to Zimbabwe from her meetings with UK parliamentaians.

Rutharo Madzima PicA week ago, I took part in a most memorable advocacy tour with RESULTS UK, a charitable advocacy organisation that aims to generate the public and political will to end hunger and poverty. The aim of the tour was to maintain momentum for nutrition in the aftermath of the Nutrition for Growth event held on 8 June 2013. This event saw donors all over the world committing $4.1 billion to nutrition specific interventions. The tour included meeting various members of parliament (MPs), representatives from the media, Civil Society, and RESULTSUK’s grassroots groups. At a seminar   on “Breastfeeding in the context of HIV”, I felt very honoured to share a platform with Sir Richard Jolly, a renowned ‘breastfeeding advocate’, who reminded us all that the week was “Nestle Boycott Week”.

Like any other experience, one has a favourite part. Mine was that of meeting with the UK MPs which taught me many lessons that as a nutrition expert, I often took for granted. During my encounter with them at a panel discussion, and during direct briefings with five MPs, I learnt that MPs can be very valuable advocates for the nutrition agenda, are willing to learn, and eager to participate. I was thrilled to listen to one MP at an UK Parliament Roundtable discussion on “The Importance of Integration in Global Health and Development Strategies”, articulating the long term and development consequences of stunting in children: maternal, infant and child mortality, education outcomes, labour productivity in children.

But how can we make this high level support and commitment for nutrition help to advance the agenda? We need to develop an effective way of communicating and reaching out to MPs to ensure that nutrition outcomes are achieved. Of course there is need to make an effort to appreciate the issues the MPs encounter on the ground and design the messages in a way that makes sense to people who have a constituency to serve, and often have busy schedules. Secondly, we need a system that ensures continuity in engagement. Most ideal would be an approach that encourages them to actively debate with fellow MPs and other stakeholders in decision making.  I was motivated by the “Question and Answer” approach used by RESULTS UK. In addition to this approach, accurate and easy to use data that is gathered in a timely fashion could facilitate participation and encourage MPs globally evaluate progress on meeting the set targets by 2020 which are:

  • Reaching with effective nutrition interventions at least 500 million pregnant women and children under two
  • Preventing at least 20million children under five from becoming stunted
  • Saving at least 1.7 million lives by reducing stunting, by increasing breastfeeding, and through the treatment of severe acute malnutrition

A nutrition advocate in any country, needs to take time think through how to make these figures a reality, make sure that money pledged is programmed in an effective way, reaching the vulnerable groups to achieve the desired outcomes. The momentum on nutrition is just beginning and we need to hold the MPs accountable to the commitments each country made on June 8 including those countries that did not make a commitment on that day.

Major global nutrition issues still to be debated by advocates and needing follow up with our MPs include: accountability mechanisms; addressing data gaps gathered over shorter time scales; monitor stunting and World Health Assembly targets such as promotion of exclusive breastfeeding for 6 months, anaemia and wasting; implementation of the  Catalytic Fund for nutrition; and more research into nutrition sensitive programmes  to advocate for stronger actions to ensure that we are not continuing business as usual.

Nutrition has traditionally had a low profile and has been under-resourced. My interaction with the MPs showed that this can be changed for example with the Nutrition for Growth event. Of course, we should not sit back but we must make sure that the energy, interest and momentum around nutrition is not lost after the big pledging moment.

€1.4 billion pledged for TB, HIV/AIDS and Malaria research and development

RESULTS’ Health Advocacy Assistant, Bruce Warwick, looks at the European and  Developing Countries Clinical Trials Partnership and warmly welcomes recent financial commitments. 

Last week on 10th July the European Commission (EC) approved a proposal for the continued support of the ‘European and Developing Countries Clinical Trials Partnership’ as it moves into its second phase (EDCPT II 2014-2024). This approval now means that Member States and the European Commission have each committed €683 equalling a combined value of €1.4 billion. It was hoped that donors would commit up to €1 billion and so the combined amount of €1.4 billion really is a fantastic win in the effort to eliminate tuberculosis, HIV/AIDS and malaria which still account for 3.5 million deaths every year.

What is the EDCTP?

DSC00272Established in 2003, the EDCTP is an initiative that aims to establish a research and development programme for the development of new or improved clinical interventions to combat tuberculosis, HIV/AIDS and malaria. Clinical interventions include the development of new or improved drugs, vaccines, microbiocides and diagnostics.

It is a partnership between 14 European Union countries, plus Switzerland and Norway, and 47 sub-Saharan African countries. By working in partnership, the EDCTP has been able to pool resources, funding and activities enabling it to achieve a greater impact against the three poverty related diseases (PRNDs) than if countries were acting alone.

Significantly, it also serves to improve the research environment (whether through capacity building of staff, infrastructure etc.) within participating countries in sub-Saharan Africa. This is noteworthy given that the region remains the worst affected by these diseases – TB is a major cause of death among people living with HIV and in Africa alone there were 1.3 million people newly infected in 2010 accounting for 50% of the 2.6 million global new cases. It is noted that: During the first phase of EDCTP (2003-2011) more than 200 African scientists and medical doctors got professional training, research careers were built, many students graduated with Masters and PhD degrees.


With the first phase of the EDCTP coming to an end this year, EDCTP II will launch in early 2014. It is hoped that the partnership, which has proven so successful in the past decade, will be able to replicate these successes in the decade to come. The announcement of €1.4 billion in funding certainly inspires confidence – this amount is significantly larger than the €400 million contributed by the EC and member states between 2003-2015.

Poverty-Related and Neglected Diseases and Research and 


The EU has frequently been called upon to do more for poverty-related and neglected diseases (PRNDs) research and development and we’re happy to see, from this announcement, that the importance of R&D is recognised. For TB in particular the ongoing support or R&D financing is vital. Shockingly, the current TB drug regimen was developed over 40 years ago and there remain no treatment options that are suitable for children. Recent studies have shown that new and improved TB drugs, vaccines and diagnostics could reduce the global incidence of TB by 71% by 2050, a reduction of more than 6.5 million cases.

This funding undoubtedly represents a significant step in the right direction for R&D into PRNDs.  I would urge the UK Government and donors overseas to continue to recognise the crucial nature of investing into R&D and innovation when looking to tackle PRNDs effectively. Along with the EDCTP there are initiatives such as TB REACH or UNITAID that have had a considerable impact.

I warmly welcome the announcement regarding the financing of EDCTP II and hope that with this investment into R&D and new tools we can help empower and make a vast difference to the lives of the millions of people who are currently affected by HIV/AIDS, TB, malaria and other poverty-related and neglected diseases.

The views and opinions expressed are those of the author and do not necessarily reflect the views of RESULTS.

‘The end of the global AIDS epidemic is within our reach’ – MPs debate HIV in developing countries

Just before the Christmas break, Pauline Latham MP (Mid Derbyshire, Conservative) secured a Westminster Hall Debate on HIV in developing countries. During a busy and well-attended debate, Ms Latham pointed out that ‘the end of the global AIDS epidemic is within our reach’ and echoed the slogan used by the Stop AIDS Campaign for World AIDS Day: ‘why stop now?’

Why stop now indeed, especially when we have the tools, the science and the knowledge to turn the tide on this epidemic. Pamela Nash MP, Chair of the All-Party Parliamentary Group (APPG) on HIV/AIDS, reiterated this point and stated “We just need to sustain the political will”.

Undoubtedly political will is vital, but there is another important element to sustain, and dare we say scale up, in response to HIV/AIDS – Tuberculosis (TB) co-infection.

TB is the leading cause of death among people living with HIV/AIDS in developing countries, accounting for one in four deaths, with 1.1 million people acquiring TB in 2011. 79% of patients live in sub-Saharan Africa, yet TB does not get the attention or focus warranted by the suffering and death it causes. Why is this the case?

As Nick Herbert MP, the Conservative member for Arundel and the South Downs and a founding member of the APPG on Global Tuberculosis explained whilst speaking in the debate:

“It is striking that the diagnostic ability and treatment for HIV are much further ahead than they are for TB, yet TB is a more easily and cheaply treatable disease. Why is that? It is straightforwardly because HIV is a disease that affected the west, and TB was a disease that the west believed had gone. Its attention was therefore not on it. The resources and money that were invested in necessarily trying to deal with the terrible and growing problem of HIV were not directed in the same way at TB. Therefore, the diagnosis of TB is not as quick as it should be, and the treatments go on for an extended period, with old-fashioned drugs that must be taken on a continuous basis; if they are not taken in that way, the problem of drug-resistant TB arises—and that is a killer and particularly difficult to deal with.”

Mr Herbert also highlighted that of the estimated 9 million people who get ill with TB every year, 3 million go without proper diagnosis or treatment. Put simply, we fail to reach far too many people—often in the poorest, most vulnerable communities—with quality TB care.

We need to accelerate our efforts to tackle TB, and it is clear that we need to think outside the box.  One way of doing this is through TB REACH, a WHO initiative that gives small grants of up to 1 million dollars to find and treat those who don’t have any access to TB diagnosis or treatment, Mr Herbert added.

He also stated that a longer term solution to tackling TB would be the creation of a new vaccine that could tackle both normal and drug-resistant strains of the disease. This would have implications not only for developing countries, but also for us here in the UK, where rates of TB infection continue to rise.

The importance and contribution of the Global Fund to Fight AIDS, Tuberculosis and Malaria to tackling both HIV and TB was widely recognised by members, as were the wider developmental benefits accrued from continued investment in fighting the three diseases.

Responding to the points raised, the Parliamentary Under-Secretary of State for International Development Lynne Featherstone MP acknowledged the two points raised by Mr Herbert in relation to the TB REACH programme and on vaccination, both of which she said she would consider further. The Minister also highlighted that DFID’s support for TB research includes £205 million to the Global Alliance for TB Drug Development, and £14 million to the Tropical Disease Research Programme.

Ms Featherstone concluded the session by stating: “It is heartening to see so many Members who genuinely hold HIV as a priority and will pursue the wonderful goal of zero infections”.

Politicians and researchers discuss how to build political will to tackle TB/HIV at Aids conference

Left to right: Jirair Ratevosian, Cathy Jamieson MP, Dr Gavin Churchyard, Dr Richard Horton, Pamela Nash MP

On Tuesday 24th July at the International Aids Society Conference in Washington DC, USA, the APPG on Global Tuberculosis hosted the workshop  ‘Politics of Persuasion:  Empowering and Engaging Elected Representatives to Tackle TB/HIV through Research’ . The session was facilitated by Dr Richard Horton, Editor-in-chief of the Lancet, the world’s leading general medical journal on infectious diseases.

An audience of over 200 heard from guest speakers including Cathy Jamieson MP, member of the APPG on Global Tuberculosis, Pamela Nash MP, chair of the APPG on HIV/AIDS, Jirair Ratevosian, Legislative Director of the Hon Barbara Lee – co-founder of HIV/AIDS Caucus in House of Representatives, US Congress, Gavin Churchyard, CEO of the Arum institute and Jennifer Woolly, Director of Advocacy at Aeras.  The panellists discussed the importance of gaining a clear understanding of how researchers can engage with parliamentarians using scientific evidence to build political support and help drive policy change at the national, regional and international level.

The session highlighted the importance of advocacy as an essential communication tool for both parliamentarians and at the community level to raise awareness of latest developments in research and better understanding their full potential and implications for combating TB and HIV. Panellists discussed and demonstrated through their presentations how researchers, advocates and parliamentarians can work in better synergy with each to address these twinned global epidemics.

Dr Richard Horton

In his opening remarks Dr Horton made a  poignant statement:

“why don’t we take TB more seriously when talking about HIV?  It is the leading killer of people living with HIV, accounting for 1 in 4 deaths, yet it does not get the attention the suffering and loss of life it causes warrants”.

Dr Horton pointed to an article in the Lancet published in 2010 called ‘The HIV-associated tuberculosis epidemic—when will we act?’, which highlighted that despite policies, strategies, and guidelines, the epidemic of HIV-associated tuberculosis continues to rage.  Dr Horton stressed how important engagement with policy makers was to ensure appropriate action was taken to address HIV-TB co-infection.

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UK Civil Society reflects on progress towards an AIDS and TB vaccine

This World AIDS Vaccine Day, 18th May 2012, the UK Consortium on AIDS and International Development working groups on TB-HIV and Prevention held an event which sought to address the importance of TB and HIV vaccines in assisting in getting to zero deaths from TB-HIV.  The key message which came across during the meeting was that a vaccine is possible and that we not only have the tools to develop TB and Aids vaccines but we are well on the way towards doing so, with sustained and predictable funding.

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Women at the Forefront of AIDS Vaccine Research

This is an abridged version of a post from Dr. Gaudensia Nzembi Mutua, a research physician at the Kenya AIDS Vaccine Initiative (KAVI) based in Nairobi, Kenya.

Dr. Mutua speaking at the European R&D global health meeting in Madrid, Spain. Photo courtesy of Planeta Salud ©

According to UNAIDS, 59% of all people living with HIV in sub-Saharan Africa are women. What is less well known is the immense contribution African women have made and continue to make to HIV-prevention research. The first clues that an AIDS vaccine might be possible came from African women. These were a small subset of sex workers in Nairobi and the Gambia who had been repeatedly exposed to HIV but not infected; they were apparently able to resist the virus. The finding sparked a search—which continues to date—for a vaccine that can teach the body to protect itself against HIV.

Today it is International Women’s Day, a time to celebrate the contributions women have made to HIV-prevention research. Female researchers, volunteers, advocates and decision-makers around the world dedicate themselves to this cause. It is now more urgent than ever that we sustain support for efforts to develop new tools to prevent HIV infection, specifically ones that address the varied needs of women.

A safe and effective HIV vaccine, used in combination with other prevention strategies, is our best hope of ending the AIDS pandemic. But developing new HIV prevention tools takes resources, people, and time—in the laboratory, in safety tests, and in clinical trials. Sustained investments in HIV vaccine research are therefore critical; so is political support.

African women are playing a key role in the global endeavor to stop HIV/AIDS, and in the years to come will continue to be a central force in making an HIV vaccine a reality.

Journalism competition winner! Anna Gerrard Hughes: We need imagination in medicine

Today we have the winning entry from our student journalism competition. The piece was written by Anna Gerrard Hughes from Manchester university. We selected Anna’s piece out of the hundreds of entries due to its engaging tone, innovative style and advocacy potential. Anna will be joining RESULTS on a parliamentary delegation to South Africa to learn about TB/HIV co-infection and to report on her findings whilst in country.

Anna is the fifth year of a medical degree, currently taking a year out to do a masters at Manchester University in Humanitarianism and Conflict Response. Her interest in Global Health was part of the decision to do medicine in the first place, and she has kept a language up through her degree for this very reason. Her ultimate dream would be to do some international work in global health – perhaps emergency response – and write in a journalistic form about health and all its complications alongside practising as a doctor.

We need imagination in medicine

Doctor uses a stethoscope to examine a child

Image courtesy of Surface Forces under a CC Licence

In Edendale hospital, KwaZulu Natal, South Africa – just a stone’s throw away from where Nelson Mandela made his last, rousing speech before imprisonment – they are fighting a new and different battle against an ever-evolving, terrifying enemy: TB.

Recently, TB has been on the decline, with scientists and physicians alike allowing themselves to imagine a world without it, but with the unprecedented explosion in cases of HIV, particularly in areas such as KwaZulu Natal, TB has returned with a vengeance.

This escalation is all the more worrying because with it comes new killers – multi drug-resistant and extensively drug resistant TB – that have caused the debilitating illness to leap back into the international arena. Suddenly, an illness which was curable by a long, yet simple course of relatively cheap medications becomes one with very limited and expensive medical options, simply because people were not taking the right medications for the right amount of time.

TB and HIV are often partnered together. Both devastating illnesses, HIV has the ability to reduce your body’s own defences, giving TB more of a chance to take hold. TB starts with a terrible cough – sometimes blood-filled – and night-sweats so bad that sufferers complain of completely drenching the sheets. If left untreated, the cough can worsen to the point where moving is too much effort for already laboured breathing, and if oxygen and drugs are not available, many patients are physically unable to cope with this for very long.

The chance of travelling this horrific, and relatively long, road to death is increased if the patient is co-infected with HIV, and increased if their access to medicine and enough food to strengthen their struggling bodies is hampered. Unfortunately, this is the case in many areas around the world.

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Beth Roberts Dispatches from Mali: Communities embracing the importance of vaccines

Today we have the first in what we hope will become a regular posting from Beth Roberts. Beth is currently serving in the Peace Corps in Mali, West Africa.  She is a small enterprise development volunteer whose primary project is advising a small women’s cooperative that produces high quality shea butter and shea soaps.

As secondary projects she works with the English students at the local secondary school and holds small training sessions for women at the local health center.  Her two-year term ends in August 2012.  You can follow her experiences in Mali on her blog at bethroberts13.wordpress.com.”

Bolo ci nafa kan bon, de!

At the health centre

About four months into my service as a Peace Corps volunteer in Mali, West Africa, I started visiting the Centre de Santé Communautaire (CSCOM), or local health center.  Before joining the Peace Corps, my work in Washington, DC was primarily focused on health care issues – chronic disease prevention, domestic health care reform, HIV/AIDS prevention and treatment locally and abroad.  Although I had not been placed as a health care volunteer, I was curious about the Malian health care system and it seemed that the easiest place to get a read on it was at the ground level.

I met with the resident doctor at the center and he suggested that I come in on one of three days a week women bring their babies to the health center to get vaccines.  I agreed and anxiously awaited the visit.

When I arrived, I sat in the corner of the waiting area. My shaky Bambara skills prevented me from having very long conversations with people, so I took the opportunity to simply observe.

Women awaiting vaccines for their children at the CSCOM

The CSCOM was packed with Malian women, dressed to impress, with babies tied to their backs.  Although there were many things about the health center that didn’t impress me – including, but not limited to, the chickens who seemed to call the health center home – I was impressed with the sheer number of women who were taking advantage of the vaccination services.

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