Spread of Chikungunya throughout the Americas Eclipsed by Ebola Coverage

Posted Novembro 25, 2014

The debilitating mosquito-borne Chikungunya virus has infected almost one million people since it first emerged in South America and the Caribbean less than a year ago, but it is getting much less attention due to the Ebola outbreak in West Africa. From the Guardian:

The Dominican Republic, the most popular Caribbean island for tourists last year with 4.7 million visitors, has recorded 500,000 cases. A third of the population lives on 80 pence ($1.25) a day. Central America has also been affected, with 123,000 cases in El Salvador.

The epidemic has failed to attract international media attention amid the Ebola crisis, as deaths from Chikungunya are relatively rare: . About 150 people have died among nearly 931,000 cases in the Americas – the US has had more than 1,830 cases.

But Chikungunya causes painful and debilitating symptoms in more than 80% of those infected, and can exacerbate poverty due to missed work and medical expenses (pdf).

Patients most commonly suffer painful and swollen joints, fever, headache, fatigue and a rash within three to seven days after an infected bite. The symptoms usually disappear within three weeks. However, arthritis, especially in the wrists and hands, can last for months, or years in some people, causing long-term disabilities. “Chikungunya” means “bent over” in the Makonde language of Tanzania, where the virus was first detected in 1952, and describes the stooped appearance of those with joint pain.

The virus can also cause diarrhoea and vomiting, mouth ulcers, visual problems and meningitis, which pose the greatest threat to vulnerable groups including elderly people, babies, pregnant women and those with existing conditions such as high blood pressure or diabetes, according to the Pan American Health Organisation, which is monitoring the epidemic. There is no treatment or vaccine and the first human clinical trials are at least several years away.

“[Chikungunya] has clearly become a global virus,” said Dr Alain Kohl, head of the University of Glasgow Centre for Virus Research, where scientists recently made an important breakthrough in preventing transmission.

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Global Health and Development Beat

An Indian laboratory has confirmed that drugs used as part of mass sterilizations at a government-run health camp, which killed at least 13 women and made dozens ill, were tainted.

A Reuters photo essay provides a look into the practice of female genital mutilation in Kenya.

Rwandan men are increasingly turning to the vasectomy for family planning purposes, reports the New Times.

Afghan women are excluded from efforts to negotiate peace with the Taliban and hard-won rights could be bargained away unless more is done to include them in the process, aid agency Oxfam said in a report.

Some of Africa’s top musicians launched an alternative Ebola appeal song to Band Aid’s new recording of “Do they know it’s Christmas’ with proceeds also going to fight the virus that has killed more than 5,000 people in West Africa this year.

Doctors in Sierra Leone are to start their own clinical trial, using the blood of Ebola survivors, to speed up the search for a cure for the disease, which has so far killed more than 5,000 people in west Africa.

A new Band Aid single featuring stars One Direction, Bono and Chris Martin stormed to the top of the UK singles chart after its release.

NewLink Genetics, said it has made a deal with drugmaker Merck, to research, develop, manufacture and distribute the experimental Ebola vaccine. That move will put the two leading Ebola vaccine programs on more equal footing.

As Jamaica struggles under the burden of an ongoing drought, experts say ensuring food security for the most vulnerable groups in society is becoming one of the leading challenges posed by climate change.

NPR reports how organization called City Health Works is trying to bring an African model of health care delivery to the United States. Usually it works the other way around. If City Health Works’ approach is successful, it could help change the way chronic diseases are managed in poverty-stricken communities, where people suffer disproportionately from HIV/AIDS, obesity and diabetes.

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Spotlight on PSI

Four ideas on how NGOs can be a part of local solutions from PSI CEO Karl Hofmann in Devex. An excerpt:

3. Push the evolution strategy, not an exit strategy.

At the end of the day, no one really wants to work themselves out of a job. Is this the best way to recruit talent and build a robust institution? Like the private sector, development organizations need to evolve, shift with the market and respond to stakeholder demands.

Flexible sustainability is a better course than predetermined sunsetting. Donor funding streams can frustrate this reality by assuming that the definitive solutions are a three- or five-year funding cycle and the disappearance of the institution that has brought about change.

Long-term commitment is required to understand the needs of the environment and to meet the challenges that yield inequity or injustice or misery or sickness. And long-term commitment often means a lasting institution, not a time-bound project.

4. Capitalizing is better than cannibalizing.

A nationally based NGO with sufficient financial reserves or diversity of funding sources is far more likely to achieve sustainable impact than a structure that’s established for an artificially limited purpose and then dismantled when funding ends.

Donor agencies should care a lot about not just the programmatic capabilities of an implementing partner, but also its balance sheet. Will the institution survive a break in funding that too often happens when donors change strategies or shift geographies … or Congress decides to shut down?

Fund programs and institutions — not projects — so the entrenched challenges of development can really be addressed.

Oh, and one more suggestion: Let’s stop talking about “local” solutions, when what we really mean are national solutions. Local is good for organic produce and community composting. National is the transition in ownership that development demands. PSI’s network members aren’t aiming for local solutions; their ambitions for impact are bigger, and the language we use should afford them that respect.

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Buzzing in the Blogs

The Gates Foundation’s blog describes how increasing impact in global health involves the sharing of information and why it is opening up access to the research it funds. An excerpt:

Given the Gates Foundation’s focus on improving health for the world’s poorest people, we put a high priority not only on the research necessary to deliver the next important drug or vaccine, but also on the collection and sharing of data so other scientists and health experts can benefit from this knowledge.

For example, we have been a longtime funder of the Institute for Health Metrics & Evaluation (IHME), which generates high-quality, up-to-date information on dozens of diseases worldwide, by country, age, and gender. This data equips government policymakers and others with crucial information that helps ensure health systems are aligned with evolving patterns of disease.

We also believe strongly in the value of post-market safety surveillance to ensure that new drugs and vaccines are safe and effective. By collecting data on new health solutions once they hit the market, doctors and public health officials can better understand the real-world benefits and risks.

But there is more we can and should do – particularly when it comes to sharing the research the foundation funds. That is why we are adopting anOpen Access (OA) policy to enable the unrestricted access and reuse of all peer-reviewed published research funded by the foundation, including any underlying data sets. This change will take place over a two-year period, and effective January 1, 2017, will require that all publications resulting from foundation funding, and all data underlying the published research, be available immediately upon publication. This will enable other researchers to access the latest evidence and draw on it to advance their own research. The policy applies not only to global health and development, but to our work across the foundation, including our efforts to improve education in the U.S.

In adopting this policy, we are joining a growing open access movement that includes the World Health Organization, the National Institutes of Health, the Wellcome Trust, and the Research Councils UK. Many prestigious peer-reviewed journals have also started adopting services that support open access.

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