Discriminatory laws repealed in India

The Nippon Foundation, Japan’s largest private philanthropic foundation, which campaigns for an end to worldwide stigma and discrimination against leprosy-affected people, has offered its support and congratulations to the Orissa State Cabinet on the removal of discriminatory clauses involving people affected by leprosy and tuberculosis in the Orissa State Municipality Act of 1950 and the Gram Panchayat Act.

In a statement given by the Orissa State House on 12 December, the offending clauses which stated that “a person shall not be eligible to stand for election…if he is a deaf-mute or is suffering from leprosy or tuberculosis”, were struck from the statute book.

“This is a landmark development”, commented Mr Yohei Sasakawa, Chairman of The Nippon Foundation, “and shows what can be achieved when leprosy-affected people are confronted by discriminatory and unfair legislation.”

Mr Sasakawa is the WHO Goodwill Ambassador for Leprosy Elimination and Japanese Government Goodwill Ambassador for the Human Rights of People Affected by Leprosy.

Mr Sasakawa originally wrote to the Chief Justice of the Supreme Court of India in September 2008 concerning a case whereby the elected position of a leprosy-affected person in Orissa State was disqualified. The petition, submitted by representatives of people affected by leprosy and other NGOs, with the support of lobbying by Mr Sasakawa, led to a report from the Rajya Sabha (Upper House) Committee on Petitions which recommended the removal of the discriminatory law. This report, which included action taken by relevant government ministries and recommendations, was released in November 2010.

In January 2013, Mr Sasakawa will announce the launch of an alliance between The Nippon Foundation and the International Bar Association (IBA), the global voice of the legal profession, at the 2013 Global Appeal to end stigma and discrimination against people affected by leprosy. The collaboration with the IBA will target the discriminatory laws and regulations against leprosy-affected people still on the statute book of a number of countries.

A major breakthrough was achieved in 2010 when the United Nations General Assembly unanimously adopted a resolution calling for the elimination of discrimination against persons affected by leprosy and their families.

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This press release is reprinted by Alanna Shaikh out of an obscure sense of guilt. It does not represent the opinions of Alanna Shaikh or any of her employers.

MCC Board Selects Countries Eligible for Compacts and Threshold Programs

Washington, D.C. — At its quarterly meeting today, the U.S. Government’s Millennium Challenge Corporation (MCC) Board of Directors selected Liberia, Niger, Sierra Leone, Morocco, and Tanzania as eligible to develop proposals for new compacts, and Guatemala as eligible for a Threshold Program.

“This year’s selection decisions are a testament to the ‘MCC Effect,’ the ability of MCC to provide incentives for countries to adopt policy reforms and strengthen institutions in order to become eligible for an MCC compact,” said Daniel W. Yohannes, MCC’s Chief Executive Officer. “Liberia, Niger and Sierra Leone have worked hard for several years to meet MCC’s rigorous eligibility standards, and the Board is pleased to recognize these efforts by selecting them as eligible to develop compact proposals.” 

 

Examples of the types of reforms pursued by these countries range from new asset-disclosure requirements in an effort to combat corruption in Liberia to the introduction of free access to maternal and child health care in Sierra Leone to a dramatic increase in environmental protection in Niger. 

 

Two current MCC compact countries—Morocco and Tanzania—were selected as eligible to develop second compact proposals. Both Morocco and Tanzania have continued to perform well on the MCC scorecard and have been good development partners during first compact implementation. Second compact eligibility is contingent on successful implementation of the first compact, continued good policy performance and development of proposals that have significant potential to promote economic growth and reduce poverty.

 

“MCC is pleased to have five countries selected as compact eligible this year," Mr. Yohannes stated. “These countries, like others selected as compact eligible, will need to compete for scarce budget resources by maintaining a strong commitment to democratic and economic governance and by developing high-quality, timely compact proposals to promote growth and reduce poverty.”

 

The Board also chose Guatemala as eligible for a new Threshold Program. Guatemala is extremely close to meeting the MCC scorecard criteria, passing 10 indicators, including the Democratic Rights hurdle, and performing exactly on the median for Control of Corruption.

 

In addition to the new selections, the Board re-selected Benin, El Salvador, Georgia, and Ghana as eligible to continue developing compact proposals and Honduras and Nepal as eligible to continue developing Threshold Programs in Fiscal Year 2013. No eligibility determinations were made for countries that already have signed compacts since these countries do not require annual re-selection.

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This press release is reprinted by Alanna Shaikh out of an obscure sense of guilt. It does not represent the opinions of Alanna Shaikh or any of her employers.

Analysis of health R&D pipeline of the last decade

Medical 'breakthroughs' against neglected diseases: Analysis of health R&D pipeline of the last decade

Analysis of health R&D pipeline shows important progress, but significant gaps in innovation remain

New York, NY, December 13, 2012—  Despite important progress in research and development (R&D) for global health over the past decade, only a small fraction of new medicines developed between 2000 and 2011 were for the treatment of neglected diseases, highlighting the ‘fatal imbalance’ between global disease burden and drug development for some of the world most devastating illnesses, said Doctors Without Borders/Médecins Sans Frontières (MSF) and the Drugs for Neglected Diseases initiative (DNDi), in an analysis to be presented today at an international conference aimed at spurring medical innovations for these diseases. 

DNDi and MSF found that between 2000 and 2011, 3.8 percent of newly approved drugs (excluding vaccines) were for tropical diseases, TB, and other neglected infections, which together account for 10.5 percent of the global disease burden. Much of the progress in the treatment of neglected diseases and important patient benefit during this time came about through drug reformulations and repurposing of existing drugs against these illnesses.  However, only four of the 336 brand-new medicines (new chemical entities) developed between 2000 and 2011 were for the treatment of neglected diseases.

“We have to ask ourselves, how much progress have we really made over the past decade?” said Dr. Unni Karunakara, MSF International President. “People are still dying of archaic diseases. Doctors and nurses are still handcuffed by the shortcomings of available medicines, forced to treat their patients with decades-old, often brutal drugs. As we speak, there are drug-resistant TB patients enduring two years on an absolutely horrific course of treatment—debilitating nausea and pain, depression, social isolation, hearing loss, and even psychosis, are just some of the few side effects they can have while on these medicines. Our patients are still waiting for real scientific breakthroughs.”

The two-day conference, Lives in the Balance: Delivering Medical Innovations for Neglected Patients and Populations, also hosted by the Mount Sinai School of Medicine’s Global Health Program, will look at the progress and shortcomings of the last decade of medical R&D to fight neglected diseases—a period during which there has been an increase in new neglected disease R&D initiatives and funders— and will focus in particular on the need to accelerate development and delivery of new health technologies to fight Chagas disease and drug-resistant tuberculosis (DR-TB). It will also examine the need for field-adapted vaccines to reach the 22.4 million children who are still not receiving even the most basic package of immunizations every year.

According to the DNDi and MSF analysis, three of the four brand-new medicines approved for neglected diseases in the past decade were for malaria, with none for the 17 neglected tropical diseases (NTDs) defined by the World Health Organization (WHO), nor TB. Furthermore, as of December 2011, only 1.4 percent of a total of nearly 150,000 registered clinical trials were focused on neglected diseases.

The conference is taking place 10 years after MSF hosted a major conference in New York to examine the crisis in R&D for neglected diseases and lay the groundwork for the creation of DNDi in 2003. In a 2001 study carried out by MSF and the Drugs for Neglected Diseases Working Group, the precursor to DNDi, only 1.1 percent of new drugs approved between 1975 and 1999 were for neglected diseases, including NTDs, malaria, and TB, though they accounted for 12 percent of the global disease burden.

Some individual successes have emerged from the proliferation of global R&D actors over the last decade. For example, product development partnerships (PDPs) were responsible for over 40 percent of neglected disease products registered between 2000 and 2011, including new TB diagnostics and malaria combination treatments. 

“There have been advances, but for many diseases we have yet to see the kind of ‘game-changers’ that are truly needed,” said Dr. Bernard Pécoul, Executive Director of DNDi. “Product development partnerships and ad hoc R&D initiatives cannot be ‘the’ solution to the systemic lack of innovation. We must make patient needs the driving force for R&D.This is the only way to build on the successes we have seen in the past ten years and overcome the fatal imbalance that still exists between drug R&D and global health needs.  Governments must put in place a R&D framework to sustainably coordinate, finance, and stimulate medical innovation for new drugs, diagnostics and vaccines for the people who need them most.”

The conference comes on the heels of a recent decision by governments to further delay a WHO-led, 10-year effort to develop a global framework to strengthen priority-setting, coordination, and financing of R&D for diseases that affect millions worldwide. Today’s system for medical R&D is flawed in that it is predominantly driven by commercial rewards rather than global health priorities. This means that research is steered towards areas that are the most profitable, leaving fundamental medical needs—particularly those that disproportionately affect developing countries like NTDs or TB—unaddressed. 

The conference, which will bring together a broad range of researchers, medical professionals, global health experts, policymakers, pharmaceutical and biotechnology experts, donors, activists, patient advocates, and journalists, will feature a keynote address from Dr. Anthony S. Fauci, director of the National Institute of Allergy and Infectious Diseases at the US National Institutes of Health, and a video address by World Bank President Dr. Jim Yong Kim.

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This press release is reprinted by Alanna Shaikh out of an obscure sense of guilt. It does not represent the opinions of Alanna Shaikh or any of her employers.

Child Pneumonia Risks in Rural Kenyan Homes Not Significantly Lowered By Use of Ceramic Indoor Cookstoves

DEERFIELD, Il. (December 11, 2012)—Inexpensive, locally-produced ceramic cookstoves may produce less smoke than traditional indoor 3-stone firepits, but they don’t significantly reduce indoor air pollution or the risk of pneumonia in young children, according to results from a small, year-long observational study by researchers working in rural Kenya.

The findings, published online today in the American Journal of Tropical Medicine and Hygiene, are the first to examine the health impacts of ceramic cookstoves that do not vent smoke to the outside of the house, said Robert Quick, MD, MPH, a researcher in the Division of Waterborne, Foodborne, and Enteric Diseases at the U.S. Centers for Disease Control and Prevention.

Women who used the ceramic stoves (called “upesi jiko,” which is Swahili for “quick stove”) reported less smoke in their homes, along with fewer stinging eyes and runny noses. However, the study found that even though there were fewer respiratory symptoms, these stoves only reduced air pollution by 13 percent and there was no significant difference in pneumonia among children under 3 years of age in these homes when compared to those in homes with 3-stone firepits.

Women and their young children bear the brunt of health problems caused by cooking indoors, in inadequately vented spaces, over open fires fueled by unprocessed wood, charcoal or other biomass.

“Despite requiring less fuel, these stoves may not be efficient enough,” Quick said. “The belief is that you need much more efficiency, maybe a reduction of 50 percent or more, to really observe the health benefits,” he added.

Pneumonia is the leading cause of death for children under 5 years of age in developing countries, with nearly 70 percent of these 1.2 million deaths occurring in Southeast Asia and sub-Saharan Africa. Research has found household air pollution can increase the risk of pneumonia—a 2008 study found that exposure to this type of pollution from burning solid fuel nearly doubled the risk of pneumonia in young children. Very small particles and toxic gases in indoor smoke can inflame the airways and lungs.

Methodology

For one year, Quick and his colleagues followed the health of children under 3 years of age in 20 villages in the Nyando District of Kenya’s Nyanza Province, which were already participating in a water quality study.

Since 2008, households in the district have been able to purchase locally produced upesi jiko stoves, sold at a cost of about 150–300 Kenya shillings or US $2-3. The researchers looked at how rates of cough, pneumonia, and severe pneumonia differed among the infants, and whether these differences were related to upesi jiko or traditional firepit cooking. The cases of pneumonia were diagnosed by fieldworkers trained to recognize familiar signs of the illness, such as a cough combined with a specific rapid breathing rate, but the cases were not confirmed by x-rays or other objective tests.

The stoves study also was not a randomized controlled trial, Quick noted. The number of homes in the study was relatively small. Also, he and his colleagues found there were lower rates of coughing and pneumonia in households with cell phones, a pattern that is consistent with other studies showing that wealthier households—perhaps due to factors such as better access to health care—have a lower risk of the disease. Future randomized studies that include more households and stoves that burn more cleanly, he said, will help clarify whether improved stoves can really make a difference in children’s respiratory health.

Building a Cleaner Cooking Stove

The Global Alliance for Clean Cookstoves and the World Health Organization are also evaluating six other cookstove technologies in a separate study, to find out which designs produce the least pollution, Quick said. “Even though a stove might appear to be burning efficiently, you don't necessarily remove the key exposures associated with pneumonia.”

The locally-made ceramic cookstoves in the Kenyan study are built into a matrix of mud and sand in the homes and draw air in through a small hole in the side to deliver heat up to a burner surface. The upesi jiko stoves are somewhat more efficient than 3-stone firepits and require less wood or other fuel for cooking.

Better Health Through Home Improvement?

“There is a real demand for upesi jiko stoves and I think that just reflects that the reality of using a three-stone firepit is not very pleasant,” said Quick. “If you've ever been in any of these huts while people are cooking, there’s this choking smoke in the household.”

Along with reducing smoke, the upesi jiko cooked faster and gave women more space for food preparation. Quick said that health researchers and global partnerships should pay more attention to these kinds of details as they strive to find ways to reduce household air pollution. “The more we’re meeting the actual demands of these mothers, the better we’ll do.”

“This research on cookstoves illustrates that the approach to improving children's health must employ strategies that take a holistic view of the child, one that includes the home,” said David H. Walker, MD, the new president of the American Society of Tropical Medicine and Hygiene and chair of the department of pathology at the University of Texas Medical Branch in Galveston. “Data from this and further studies will help aid programs make evidence-based decisions as they determine where to allocate their increasingly scarce funds.”

In the end, cost may be still a significant factor in adopting cleaner cookstoves. The upesi jiko stoves “are relatively cheap, around $3, but even this small cost is beyond the reach of many people who typically earn US $1-2 per day,” Quick explained. According to the study, despite the active marketing and availability of this stove, most households didn’t have one.

“Based on our findings in Kenya, the Global Alliance for Clean Cookstoves may want to explore various options—including subsidies—for improving access to clean burning, safe cookstoves by the poorest households where children are at greatest risk of pneumonia,” Quick added.

This study was supported by grants from the U.S. National Institutes of Health, the Infectious Disease Society of America, Emory University’s Global Health Institute, and the United States Agency for International Development.

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This press release is reprinted by Alanna Shaikh out of an obscure sense of guilt. It does not represent the opinions of Alanna Shaikh or any of her employers.

Working to end discrimination

The International Bar Association (IBA) and The Nippon Foundation, Japan’s largest private philanthropic foundation, have formed an alliance to combat the stigma and discrimination against leprosy-affected people which are still prevalent in the world and sustained in some countries by out-of-date and discriminatory legislation.

The launch of this collaboration will be the occasion of the annual Global Appeal to end stigma and discrimination against people affected by leprosy and their families, organised by The Nippon Foundation, which will be held at the Law Society in London on 24 January next year – three days before the 60th World Leprosy Day. The Global Appeal is led by The Nippon Foundation Chairman, Yohei Sasakawa, who is the WHO Goodwill Ambassador for Leprosy Elimination and the Japanese Government Goodwill Ambassador for the Human Rights of People Affected by Leprosy.

Mr Sasakawa describes the fight against leprosy and the discrimination it causes as his life’s work. A major breakthrough was achieved in 2010 when the United Nations General Assembly unanimously adopted a resolution calling for the elimination of discrimination against persons affected by leprosy and their family members.

Over the years, the Global Appeal has been supported by influential groups to emphasise the anti-discrimination message. These groups have varied from world leaders, faith groups, human rights NGOs and leprosy-affected people themselves.

Endorsing the latest appeal is the IBA, the world’s leading organisation of international legal practitioners, bar associations and law societies. Moreover, the Co-Chair of the IBA’S Human Rights Institute (IBAHRI), Baroness Helena Kennedy QC, will be giving the keynote address at the Global Appeal event. The IBAHRI works to promote, protect and enforce human rights under a just rule of law.

The target is the list of discriminatory laws and regulations against leprosy-affected people still on the statute books of a number of countries. These include Singapore, Nepal, Malta, Thailand and India – where discriminatory laws still apply in the areas of contesting elections, marriage and divorce, residential eligibility, and employment.  On immigration, the U.S., China and many other countries still refer to leprosy as a reason for declining entry.

Comments Yohei Sasakawa: “Leprosy is easily curable today by multi-drug therapy. There are no grounds to discriminate against someone with the disease. We now need to ensure that the UN resolution is fully implemented. I would also like to propose, as the 60^th anniversary of World Leprosy Day approaches, that it be made an International Day designated by the UN agencies so that people can more seriously consider this issue.”

Says Akira Kawamura, President of the IBA: “Put simply, as the global voice of the legal profession, the IBA will work to eliminate discriminatory laws, and to ensure that the human rights of people affected by leprosy are upheld in accordance with the principles enshrined in the United Nations Universal Declaration of Human Rights.”

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This press release is reprinted by Alanna Shaikh out of an obscure sense of guilt. It does not represent the opinions of Alanna Shaikh or any of her employers.