Category Archives: International

Emergence of extensively drug-resistant tuberculosis holds unsettling consequences

By Ava Torjani

A recent study found that a rare form of multi-drug resistant tuberculosis (MDR TB), called extensively drug-resistant tuberculosis (XDR TB), has been spreading across regions of South Africa and currently has no effective treatment for or prevention against it. Although in much smaller numbers, cases of XDR TB have also been reported in countries including the U.S., Russia, and Brazil.

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The War on Disease: The Creation of a Global Vaccine-Development Fund

By Moses Im

Just recently, the Ebola outbreak lead to over 11,000 deaths. Yet, the pandemic also exposed the constant looming threats that affect global health due to the lack of necessary medicines and vaccines. Thus, as the world shook in fear, WHO (World Health Organization) and other supporting countries rushed in to control and stop the disease.

Coincidentally, before the outbreak occurred there were at least seven different vaccines that passed animal testing with promising results. Out of those only one went through further clinical trials before being abandoned due to costs and difficulties in the licensing process. Here, bureaucracy took precedence over safety and health. Due to the pandemic, however, the governments and organizations pushed the research further. Eventually the right vaccine was licensed but it came thousands of lives too late.

Out of those only one went through further clinical trials before being abandoned due to costs and difficulties in the licensing process. Here, bureaucracy took precedence over safety and health.

This pattern of pharmaceutical profit and insufficient government funding is seen in many diseases considered under the term of the “the valley of death.” For example, Ebola, West Nile, and the SARS virus are all included on this deathly list of diseases. If this reluctance for action continues many people around the globe will become vulnerable to death.

Yet, there is a new hope.

In July 2015 three prominent physicians, Stanley Plotkin, M.D., emeritus professor of pediatrics at the University of Pennsylvania, Adel Mahmoud, M.D., Ph.D, professor in the Molecular Biology Department and Woodrow Wilson School of International and Public Affairs at Princeton University, and Jeremy Farrar, M.D., Ph.D, director of the Wellcome Trust, in a published article called for a “global vaccine-development fund.” Their plan requires a $2 billion investment in vaccine research which will target “the valley of death.”Thus, the funds are meant to help vaccines and projects get past preliminary rounds of research and simplify the licensing process. Therefore, the ideology relies on paying large sums upfront and decreasing the costs later down the road. For context, the Ebola crisis alone costed the world about $8 billion. Overall, through their article, Plotkin, Mahmoud, and Farrar called the world to learn to adapt to “the lesson we [can] take from the Ebola crisis.” And it appears the world indeed learned.

The science community responded positively to the article, and, just as the authors hoped, great discussion grew out of this call to action. As a direct result, under the leadership of Director Jeremy Farrar, the Coalition of Epidemic Preparedness Innovations (CEPI) was formed and launched on January 18, 2017. The global company is backed by the European Commission, the Bill and Melinda Gates Foundation, the Wellcome Trust, World Economic Forum, and the governments of Norway, Japan, Germany, and India. Organizations like Pfizer, Johnson & Johnson, Johns Hopkins Vaccine Initiative, and many more have joined as well. CEPI have decided to start by targeting Lassa, Nipah and MERS as advised by their scientific advisory board. While CEPI may have been launched with a little less than $500 million, they hope to finish fundraising by the end of this year. Thus, CEPI has created a feeling of hopefulness for the creation of solutions to diseases. The world may soon be rest assured that another crisis like Ebola will not erupt.

Vaccine Delivery: Reaching New Heights

By Tiffany Pham

Whether used as high-tech toys, weapons of war, or eyes in the sky for videography, drones have demonstrated much versatility and potential. These aerial machines have expanded the limits of technology and the parameters of industrial science. It comes as no surprise, then, that drones have extended their influence to the field of healthcare.

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Is Surgery the Stepchild of Global Public Health?

By Nina Rodriguez

Surgery is a medical service typically not on the agenda for global healthcare advocates.  However, inadequate surgical care and scarce access to anesthesia is a serious issue in low-income and middle-income countries, such as Uganda.  It is a matter that is severely overshadowed by other more discussed crises.  In fact, Paul E. Farmer and Jim U. Kim even went so far as to name surgery the neglected stepchild of global public health in their 2008 article “Surgery and Global Health: A View from beyond the OR.”

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The Food Paradox: An Augmenting Connection Between Obesity and Malnutrition in Developing Countries

By Mimi Chung

Obesity, a growing problem in industrial and post-industrial countries, is in many areas intertwined with malnutrition. Though many industrial nations have seen a sharp increase in the number of people facing problems stemming from obesity, such as heart disease and diabetes, hunger and undernutrition still persist in wide swaths of the same nation. In China, 100 million citizens faced obesity in 2009, while 200 million suffered from undernutrition. Increasingly, developing countries face the double threat of the food paradox: confronting over and undernutrition at the same time.

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Exorbitant Drug Prices in the US: Why They Don’t Exist in Other Countries?

By Moses Im

From the scandal filled US elections to Michael Phelps’ record breaking twenty-third Olympic gold medal, 2016 has been full of big and unexpected news. Unfortunately, included in all this is the steep price hike of the Epipen (auto-injecting medicine for allergy emergencies). A set which cost $103.50 in 2009 now cost $608.61 this past May. The Epipen situation is hardly the first time when drug prices have risen to ridiculous levels in America. The alarming fact about the issue of drug prices is that it is unique to the US; most other European nations and Canada have established systems and regulations that allow the government to maintain moderate drug prices.

The alarming fact about the issue of drug prices is that it is unique to the U.S.

According to Wall Street Journal, 93% of the 40 branded drugs shared in both America and Norway are more expensive in the U.S. A vial of Rituxan, a cancer drug, costs $1,527 with Norway’s tax-funded healthcare while it costs $3,678 with America’s Medicare program. In countries such as Norway, governments are able to negotiate pricing and therefore maintain low drug prices. Often times, government established health services purchase the country’s supply of drugs and thus have enormous bargaining power. They can set their own drug prices and refuse to buy drugs from companies if they do not meet their standard or pricing. Many countries often have an NGO or government agency that reviews the cost effectiveness of drugs. Canada, for instance, has a drug review board that according to CNN, gives recommendation that helps providers determine a price they are willing to pay for the drug.” With massive negotiating power through bulk buying and drug efficacy reviews, the governments in other nations can effectively limit prices, and forcing pharmaceutical companies to oblige.

America’s health care systems, on the other hand, does not work this way. In America, pharmaceutical companies sell to numerous different consumers such as  Medicare, private insurance companies, and hospitals. As a result, each consumer has little bargaining power and thus the range of drug prices can fluctuate at the ease of the companies. In fact, Medicare is the largest consumer of pharmaceutical drugs in America, yet by law it cannot negotiate prices or gauge effectiveness of drugs. The U.S. also lacks an NGO or agency that does drug reviews like other countries. Consequently, pharmaceutical companies can set their own prices, resulting in branded drugs  being 300% more expensive in the US than in other countries.

Some argue that international price comparisons are inaccurate because they do not factor potential discounts American consumers receive when purchasing drugs. However, Bloomberg News did an analysis of drug prices accounting for these discounts, and the U.S. still constantly had the more expensive prices for top selling drugs. Pharmaceutical companies justify their dramatic price hikes as necessary to fund research and development.  Despite these justifications, Director Dr. Peter B. Bach from Memorial Sloan Kettering’s Center for Health Policy and Outcomes says that Americans are charged high prices for drugs because the companies simply can and that “we have no rational system in the U.S. for managing prices of drugs.”  

The current drug pricing situation may seem bleak in America, but to address these issues Democrats Hillary Clinton and Bernie Sanders have proposed to give Medicare the ability to negotiate drug prices much like its counterparts in other nations. This policy alone may be able to reduce about 16 billion dollars a year in spending. Perhaps it may prove to be beneficial to take inspiration or learn more from other nations’ policies as we continue our debate over healthcare and health policy here in America.



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Why Expectant Mothers Shouldn’t be the Only People Concerned About Zika


Recent news headlines regarding Zika parade photos of mothers with microcephalic babies, demonstrating the visible consequences of Zika infection during pregnancy. Because of these detrimental deficits, most Zika prevention campaigns have been aimed at preventing infection via sexual transmission as well as during pregnancy. With women in the spotlight, men generally feel that they are free from Zika’s most severe prognoses; Zika fever is typically mild and limited to a fever, perhaps rashes, joint pain, and red eyes. However, a recent discovery has provided evidence that Zika virus can cause harmful outcomes for everyone—not just women and their unborn children.

Zika virus can cause harmful outcomes for everyone—not just women and their unborn children.

Said evidence points to Guillain-Barré syndrome as a side-effect of the virus. Cases of Guillain-Barré syndrome more than tripled in areas struck with Zika epidemics. Health officials, including members of the Pan American Health Organization in Washington D.C. and the Brazilian Ministry of Health, outlined their concerns in a letter to The New England Journal of Medicine.

According to these officials, “During the weeks of Zika virus transmission, there were significant increases in the incidence of the Guillain-Barré syndrome, as compared with the pre-Zika virus baseline incidence, in (Brazil’s) Bahia State (an increase of 172 percent), Colombia (211 percent), the Dominican Republic (150 percent), El Salvador (100 percent), Honduras (144 percent), Suriname (400 percent), and Venezuela (877 percent).” “When the incidence of Zika virus disease increased, so did the incidence of the Guillain-Barré syndrome”—a markedly strong case for causality.

Doctors are confident that Zika virus triggers the onset of Guillain-Barré syndrome, a condition characterized by “a little understood reaction in which the immune system attacks the nerves” that results in severe paralysis, although temporary. Paralysis is potentially fatal; epidemiologist Brenda Rivera reported that a Costa Rican man died from a Zika-related Guillain-Barré case. “What does this tell us? That all of us are susceptible,” Rivera preaches as she advises that Puerto Ricans take precautionary measures to avoid the mosquito-borne virus.

A World Health Organization report published on November 3rd states that no countries or territories reported “Guillain-Barré syndrome (GBS) cases associated with Zika virus infection for the first time in the past week.” This should not discredit the fact that “nineteen countries and territories have reported an increased incidence of GBS and/or laboratory confirmation of a Zika virus infection among GBS cases. Guatemala, which has previously reported GBS cases with confirmed Zika virus infections, has reported an increase in incidence of GBS cases in the last week.”

Currently, there are no available treatments to prevent Zika-induced Guillain-Barré syndrome. However, health officials advise “watching for Guillain-Barré cases might be one way to spot Zika outbreaks.” While there have been no reported instances of Zika-induced Guillain-Barré in the United States, people must be aware of this risk and take the necessary precautions.