POVERTY: UK aid budget refocuses 'on areas of greatest need'

 Nicholas Watt, chief political correspondent guardian.co.uk,  27 February 2011
UK aid budget refocuses 'on areas of greatest need', including YemenEnd of aid to Russia, Serbia, China, Cambodia, Vietnam and Moldova, as poorer or failing nations prioritised

Britain is to stop sending aid to a series of relatively affluent developing countries as the government focuses resources on countries with the highest levels of poverty, and failing states that have become havens for Islamist fundamentalists.
A review of Britain's £8.4bn international development budget will herald the end of aid to Russia, Serbia, China, Cambodia, Vietnam and Moldova.
Aid to Yemen, regarded by Britain as a failing state whose lack of economic development provides a fertile recruiting ground for al-Qaida, will instead be doubled from £46.7m this year to £90m by 2015.
The changes will be announced by Andrew Mitchell, the international development secretary, who established separate reviews into Britain's bilateral and multilateral aid budgets after the general election.
The UN Educational, Scientific and Cultural Organisation (Unesco) could be a victim of the review of Britain's support for multilateral organisations. Unesco, which was boycotted by Britain for 12 years between 1985 and 1997 on the grounds that it was "pro-Soviet", will have to meet a series of targets to justify its aid after the review found that it wasted the £12m it receives from Britain each year.
Mitchell told the BBC Politics Show that the reviews would lead to Britain's aid budget being "much better focused" on areas of greatest need. "People who live in conflict states are very much part of that," he said.
The reviews are designed to answer opponents on the right and left who have criticised the government's approach to aid from different angles.
A focus on developing countries in greatest need, with a hard-headed payments by results system, is meant to show sceptical Tories that the aid budget is being spent in a sensible way. Many Tories believe it was wrong of David Cameron to ringfence the aid budget, after the prime minister pledged to maintain Britain's commitment to meet the UN target of spending 0.7% of gross national income on aid by 2013.
Targeting resources at a country such as Yemen, some of whose territory is used by al-Qaida as a training ground, is also designed to show that concerns on the left about the securitisation of Britain's aid budget are unfounded.
Charities have warned that aligning aid priorities with Britain's overall foreign and trade policy could lead to a return to the 1990s when the Pergau dam in Indonesia was funded with British aid money. Harriet Harman, the shadow international development secretary, voiced these fears when she warned of "subsuming aid activities into military activities".
Mitchell said it was in Britain's interests to help countries which present a threat. "It's very much in our national interest to tackle these effects of dysfunctionality and poverty, such as piracy, migration, terrorism and disease in Somalia," he told the Sunday Times. "Tackling the causes of poverty upstream is much less expensive than sending in troops."
Mitchell also tackled one of the main criticisms from the right, that it is wrong to provide aid to India, whose economy is growing at such a fast pace that Delhi can afford a space programme. "The fact is that if you want to reach these [UN] millennium development goals, which we are also keen to do by 2015, you have to operate where poverty is greatest," he told the Politics Show. "In India there are more poor people in three states than there are in the whole of sub-Saharan Africa. Operating there in the way that we do is extremely effective in poverty alleviation."

The reviews, which have been subject to independent peer review, will have four main themes:
• A complete overhaul of the way in which Britain distributes aid. Mitchell believes that Gordon Brown announced an overall figure for a grant to a particular country without working out what exactly that would deliver. "Now it is going to be payment by results, so money will only be granted if it is clear how many more children will be educated in a given country and how much clean water will be supplied, for example," one source said.
• Independent evaluation. A four-strong independent panel, including the Kenyan anti-corruption expert John Githongo, will monitor aid spending. The panel will report to parliament.
• Britain has a moral duty to help those in need in line with its values. Mitchell frequently quotes the anti-slavery campaigner William Wilberforce to support the aid cause. "You may choose to look the other way but you can never say again you did not know," Wilberforce said.
• It is in Britain's own national interests to help countries which present a threat, however indirectly.
http://www.guardian.co.uk/global-development/2011/feb/27/uk-aid-budget-andrew-mitchell

POVERTY: Soaring Food Prices Hit Poor Countries, Spur Farmers

John Ydstie : February 27, 2011

 Seth Perlman/AP
A farmer harvests a corn crop near Monticello, Ill., last September. The price of wheat and corn jumped 70 percent in the second half of 2010.


Sharp increases in food prices helped spark the political upheaval gripping northern Africa and the Middle East. Bad weather in key growing regions was among a confluence of factors driving prices to record levels, a U.N. analyst says. But the price spikes are giving U.S. farmers an incentive to boost production.
Underlying the food inflation is a more than 70 percent increase in the price of wheat and corn in the second half of last year.
Elevated food prices are hitting hardest in poor countries such as Haiti, Bolivia and Mozambique, where people spend more than half their income on food.
"People who are already undernourished may have to forgo a meal. It does add to the number of hungry people," says Abdolreza Abbassian, a senior economist for the U.N.'s Food and Agriculture Organization.
He says the situation is alarming, but not yet a food crisis like the one the world faced three years ago.

Demand, Diversion And Drought
He says many factors have contributed to the upward pressure on food prices. There's demand for more varied diets in emerging economies such as China. And crops are being diverted for use in biofuels such as ethanol.
But the primary cause of the big spike in fuel prices is last year's bad weather: Russia's drought; rains in Pakistan, norther Europe and the U.S.; rains and floods in Australia; and dry conditions in Latin America.
"It looked like Mother Nature picked up the worst months to behave very bad," Abbassian says.
Russia's wheat-growing region was hit by the worst drought in 100 years. The huge wheat exporter halted shipments to foreign customers, including Egypt. Last week, Russian officials said they may extend the ban.
U.N. Food And Agriculture Organization's Food Price Index Hits Record Level

Annual, adjusted for inflation



Source: U.N. Food and Agriculture Organization: Credit: NPR
The ruined harvest left global wheat stocks very low and pushed prices up sharply.

Investment Lags
A decade ago, that might not have happened because government crop subsidies in the U.S. and Europe produced huge stockpiles. But a change in world trade rules ended those subsidies and the stockpiles disappeared. It was hoped investment in Third World farmers would take up the slack. But Abbassian says governments, including the U.S., have invested just a fraction of what was pledged.
"In spite of the declarations and statements made, really the investment in agriculture is lagging behind," he says.
Smaller stockpiles have led to more volatile prices. That volatility has attracted speculators who profit from rapid price changes. But, so far, there's little evidence that speculators are significantly boosting overall prices.
Bad weather may have set the stage for this spike in grain prices, but Greg Page, president of the global food giant Cargill, says that while supplies are tight, prices have risen more than was necessary. He says that's partly because of instantaneous global communication.

A Hoarding Instinct
"People read stories about food prices going up and/or food being short and there's a natural hoarding instinct, I think, wired into all of us and people buy that extra 5-pound bag of flour or 2-liter bottle of vegetable oil," Page says.
OrganizationMultiply that by 100 million households, he says, and concern about a food shortage becomes a self-fulfilling prophecy. Governments got into the hoarding act, too, he says.
"The Saudis have made a public announcement about their intention to double their strategic reserve," he says. "The Algerians have made a similar statement in the last several weeks."
Other nations are buying up grain stocks, too. All of this has pushed prices higher. Luckily, Page says, those high prices are a signal for farmers.

An Incentive To Boost Production
Greg Westland produces hard red spring wheat and soybeans on about 5,600 acres in Cando, N.D. The snow is still deep in North Dakota, but Westland is preparing for planting, spending days in his shop with his sons, prepping equipment. The high prices have convinced him to try to boost the number of bushels he produces per acre.
"We're adding more fertilizer, shooting for a 60-bushel hard red spring wheat crop up here and a 42-to-45-bushel soybean crop," Westland says.
Those yields would be about 20 percent above average. Cargill's Page says brisk fertilizer and seed sales indicate that farmers are responding.
"If nature gives them any collaboration at all I think we are clearly in a position to feed the world handsomely and actually to build some stocks this year based on the number of acres we would predict will be planted," he says.
As long as the weather cooperates. The U.N.'s Abbassian agrees. Both also acknowledge that climate change adds another level of uncertainty. Another wild card: the recent run up in the price of oil, which, if it persists, could boost already high food prices.

http://www.npr.org/2011/02/27/134069431/soaring-food-prices-hit-poor-countries-spur-farmers

POVERTY: Five Causes of Rising Food Prices

February 16, 2011: Jacob Goldstein

  trimmer741/Flickr

Global wheat prices more than doubled in the second half of last year, according to a new report from the World Bank. The price of corn, sugar and cooking oil also soared.
Why are global food prices skyrocketing? Who is going to go hungry as a result? And what does it mean for the U.S.?
I recently put these questions to Abdolreza Abbassian, a food economist at the UN's Food and Agriculture Organization. Here's what he told me.



 FAO

Skyrocketing Prices
Abbassian attributed the price rise to several factors — some familiar to me (and probably to you), some less familiar.
1. The rise of biofuels, like ethanol made from corn. This market, driven largely by government subsidies, has created demand that is what economists call "price inelastic" — demand stays strong even as prices rise.
2. More demand from the developing world, particularly for meat. Livestock eat grain, so increasing demand for meat means increasing demand for grain. This source of demand has also been price inelastic, Abbassian said.
3. Disappearing stockpiles.
Because of WTO rules, the U.S. and Europe have been moving away from subsidies that led to vast reserves of wheat and corn.
Subsidies still exist in the U.S. and Europe, but they've taken a different form. Governments used to buy and stockpile surplus food from farmers. Now it's more common for governments to give farmers subsidy payments without actually buying any of the food they produce, Abbassian told me.
This sounds super wonky, but it has a huge impact on the price of food.
Big stockpiles mean that the supply of food remains relatively constant, even when there are disasters like the vast fires that destroyed last summer's Russian wheat crop.
But in the absence of stockpiles, unexpected shocks like those fires in Russia last summer have a huge impact on supply. That, in turn, contributes to huge price spikes.
"What you get is a world market that is increasingly tight, without much of a buffer," Abbassian told me. "Without a buffer, you have volatility. It's as simple as that."
4. Speculation
The volatility created by declining stocks is in turn compounded by speculation — traders betting on the rise or fall of prices.
Abbassian argued that bringing more transparency to commodities futures markets might mitigate this issue.
"If we know who is buying it and what are they buying it for, that may get those who are just there to gamble to be more cautious about their positions," he said.
Who is going to go hungry?
At any given moment, there are about a billion people in the world who don't have enough food to eat. When food prices go up, more people do go hungry — but the increase isn't as dramatic as you might think.
That's partly because many of the world's poorest people simply have no money and no access to food. Many live in countries where wars and other crises make it hard to get food to people. They would be hungry even if the price of food had not spiked.
What's more, in many poor countries, the local harvest is a more important factor than the price of global commodities. And many countries in Africa have had strong harvests of staples such as white corn and cassava.
One often overlooked region likely to be hit hard by the price increases is Central Asia, Abbassian said. This recent FAO report has lots of region-by-region detail.
What does all this mean for the U.S.?
Despite the fact that the price of staples like wheat, corn and sugar have risen by more than 50 percent in recent months, the price of food in the U.S. has barely budged — food prices here rose only 1.5 percent over the past year.
That's because the price of food in the U.S. is driven largely by labor costs and other factors, rather than by the price of the ingredients.
"If you eat a loaf of bread in the West, 2 percent of the price may be the wheat-flour price," Abbassian said. "In the developing world, it's 70 percent."
What's more, Americans only spend about 10 percent of their income on food — a far lower percentage than what people in the developing world typically spend. So even when food prices do rise in the U.S., it takes a smaller bite out of the average household's budget.
http://www.npr.org/blogs/money/2011/02/16/133744524/why-are-food-prices-going-crazy

BIOTERRORISM: Smallpox virus: crunch time for the fate of a global killer

Smallpox has long been eradicated but the virus still exists at two high-security labs. Should these stocks now be destroyed?

Robin McKie and Gabriel Stargardter The Observer, Sunday 13 February 2011


 Scientists at Russia’s high-security Vector lab carry out an experiment with a deadly virus. Photograph: ITAR-TASS/Vladimir Zinin

Twenty miles south-east of Novosibirsk, in Siberia, several dozen concrete buildings have been erected outside the town of Koltsovo. The settlement is ringed with triple rows of barbed wire fences. Video cameras and motion sensors monitor any activity near the wires while soldiers from an elite Russian army unit patrol its perimeter.
This is Russia's State Research Centre of Virology and Biotechnology – or Vector, as it is usually known. Frozen in winter, when temperatures plunge below -30C, and then scorched in summer, when the heat routinely rises above 30C, the place is as unwelcoming as you could imagine. Given its name, location and a high-security protection, Vector would make an ideal setting for a James Bond film.
This would be a fitting accolade, for Vector contains a number of unsettling scientific secrets, with the most sinister being housed in bio-containment laboratory P-4, in Building 6. Here a small storage plant, chilled by liquid nitrogen, holds phials of one of the deadliest pathogens known to medical science: the smallpox virus.
Smallpox killed the Egyptian pharoah Ramses V in 1145 BC and Tsar Peter II of Russia in 1730 and was responsible for an estimated 300–500 million deaths in the 20th century alone; only in 1980 was it declared eradicated by the World Health Organisation following a series of global vaccination programmes. But smallpox – with its once dreaded symptoms of blistered skin, lesions, delirium and fever – does survive in two places on Earth: at Vector and at another high-security laboratory, at the Centre for Disease Control in Atlanta, USA.
At the Russian and American units, scientists have continued to study the smallpox virus for the past decade. However, these last repositories are now under threat. In May, the World Health Assembly – the decision-making body of the WHO – will be asked to set a date by which these collections should be destroyed. If agreed, the move would result in the extinction of one of the deadliest ailments to have afflicted our species.
Previous assemblies have delayed moves to have these last smallpox stocks destroyed. Nevertheless, it is expected that a decision will be taken this time: either to eradicate the virus or to save it.
The issue may seem straightforward: why should humanity keep phials of a deadly virus that it went to such pains to eradicate and which could trigger a horrific epidemic in the event of an accidental release? This point is stressed by the many doctors and scientists who back the call for the phials' destruction. It is time to wipe this scourge from our planet, they say.
Such views are not shared by all scientists, however. An opposing group claims that disposal of the CDC and Vector's smallpox stocks would be a disaster, arguing that the world needs these samples in order to develop new drugs against the disease should it one day reappear, either accidentally or intentionally. Those stocks could be our saviour, they claim. The World Health Assembly vote is going to trigger an intense scientific battle.
A detailed look at both sides is illuminating, starting with those researchers – including many senior scientists and defence officials in Russia and the US – who say it would be a calamity if the smallpox pathogen was destroyed. These virus supporters, who are known as "retentionists", argue there is a strong prospect that smallpox samples may already have been obtained by terrorist groups and that the Vector and CDC stocks will therefore be needed to help defend the world from bio-terror attacks. To back this point, the Russians say Iran made several attempts in the 1990s to recruit some of their Vector scientists – efforts that may have been successful in a couple of instances.
American scientists and officials take a similar view. Before 9/11, the US supported the destruction of smallpox stocks, but it now takes the risk of an attack seriously. Last month, an unnamed US scientist – who was also a former UN inspector – told the Wall Street Journal that inspections in Iraq in 2003 and 2004 provided some "credible intelligence that suggests it [the virus] was there". Hence the need to retain smallpox samples and to continue testing drugs and vaccines that could counter the disease if a release occurred.
This argument has powerful supporters. Last month, an editorial in the science journal Nature argued that the danger posed by the use of smallpox as a terrorist weapon should not be ignored. The vaccination programmes of the last century, although saving countless lives, has – paradoxically – left the world's population dangerously exposed. "Smallpox would be an effective weapon – it spreads easily and kills almost one-third of the people it infects," the editorial states. "Furthermore, the triumph of smallpox eradication after widespread vaccination in the 1960s and 1970s means that some 40% of the world's population has no immunity today." In short, we're vulnerable and care is needed to ensure the protection of billions of individuals now defenceless against a new smallpox epidemic.
There is a further argument, put forward by retentionists. The smallpox virus is such a deadly pathogen, it acts as a Rosetta stone for understanding the immune system, they say. This point is stressed by Dr Inger Damon, head of the CDC's poxvirus section. She is one of only 10 scientists who has access to the centre's smallpox samples – housed in a high-security laboratory that can only be reached using electronic security cards and retinal scanners – which she uses to study diagnostic tests, anti-virus therapies and new vaccines against the virus. "There is considerable uncertainty about possible undisclosed virus stocks that might exist – about what might be out there and about the dangers of smallpox being used as an agent of terrorism," she says. "That is why we need to keep these stocks and to keep studying them."
However, other scientists disagree and argue the virus should be wiped out completely. This camp – known as the "destructionists" – argue that there is little new information to be gained from continued research on the smallpox virus. Experiments on pathogens have yielded all the information that can be gleaned. At the same time, keeping samples alive maintains a constant risk of an accidental release that could have disastrous consequences.
An example is provided by the accidental release of the variola virus, which causes smallpox, from a research laboratory at Birmingham university in 1978. Janet Parker, a medical photographer, was infected and subsequently died, though not before transmitting the disease to her mother. In the end, the outbreak was contained, although the head of the microbiology unit, Professor Henry Bedson, subsequently killed himself, leaving a note apologising for his role in the incident.
However, there is another, more important reason for eradicating the world's last smallpox stocks, argues DA Henderson, head of the WHO's eradication campaign and a former leading US expert on bioterrorism. Once virus stocks are destroyed, "any lab, scientist or country found to have the virus after the date of destruction is de facto guilty of very serious crimes against humanity," he says.
This argument is backed by security expert Jonathan Tucker of Darmstadt University. "If the authorised stocks of the virus were eliminated, it would become possible to draw a clear red line and brand any possession, synthesis or hostile use of the variola virus as a crime against humanity, punishable with the most severe economic, political and military sanctions," he states.
How these arguments will influence the World Health Assembly is difficult to assess. It is possible it may vote for destruction but for the US and Russia to refuse. Another scenario might see an agreement to destroy most samples, but retain a handful as last resorts. (CDC has 451 samples at present, Vector 120.) Or it may simply agree to the status quo.
In any case, eradication of the US and Russian samples would not necessarily wipe out smallpox for eternity. Its genome is known and scientists, using the latest in DNA technology, could recreate the virus from scratch, a point stressed by Dr Inger Damon. "Biology has now advanced to the stage where it is no longer inconceivable that one could put together a virus as large as the smallpox variola using synthesised nucleic acids," she says. "This is all the more reason, I believe, for keeping the natural variety in safe containment for future study."
http://www.guardian.co.uk/society/2011/feb/13/smallpox-virus-vector-health-terror

TUBERCULOSIS: Partners In Health -- Russia

  Laboratory in Tomsk


  Doctor with TB patient

Partners In Health's work in Russia has a narrower medical focus over a vastly wider geographical area than any of our other projects. From a base in the region of Tomsk Oblast, Siberia, PIH has been working since 1998, in collaboration with the Russian Ministry of Health, to combat one of the world's worst epidemics of drug-resistant tuberculosis (MDR-TB). In partnership with the Division of Social Medicine and Health Inequalities (DSMHI) at the Brigham and Women’s Hospital, PIH has focused on improving clinical services for MDR-TB patients in Tomsk while undertaking training and research to catalyze change in treatment of MDR-TB across the entire Russian Federation.
Partners in Health began working with local clinicians to improve treatment of MDR-TB in Tomsk in 1998. Our joint effort got a major boost in 2004, when we assisted our partners in Tomsk in securing a five-year $10.8 million grant from the Global Fund to Fight AIDS, Tuberculosis and Malaria for efforts to improve prevention, diagnosis and treatment of TB and MDR-TB. Key components of our clinical effort include improving diagnostics in order to detect cases earlier, developing a comprehensive strategy to promote adherence among patients, improving infection control in hospitals and clinics and decreasing transmission of TB to HIV-positive patients. Our work in Tomsk also encompasses health education for the public and clinical and program management training for medical personnel in Tomsk.
Even before receiving the Global Fund grant, PIH had expanded its responsibilities to provide training for healthcare professionals and to advocate for institutional change at the federal level. Drawing on financial support from the Eli Lilly and Co. Foundation, PIH’s training program for MDR-TB program managers and physicians has played an integral role in catalyzing change within the Russian TB services. To date, PIH has led training sessions for 215 physicians, representing three quarters of the territory of the Russian Federation. By 2008, PIH and DSMHI are on course to train 325 physicians and program managers, covering the entire territory of Russia, from the Baltic to the Pacific.
PIH has also organized an exchange program at the Harvard School of Public Health’s Program in Clinical Effectiveness that enrolls several promising Russian medical professionals every year. The first two students earned their Masters degrees in Public Health in 2006, and are now spreading their knowledge as lecturers at Moscow Medical Academy, where they hope to establish a permanent faculty for epidemiology and biostatistics.
Research carried out with data collected from the first two cohorts of MDR-TB patients treated in Tomsk has had a significant impact on discussions and decisions about MDR-TB treatment throughout Russia, other parts of the former Soviet Union and beyond. One study showed that very high rates of treatment success could be achieved in Russia using the WHO's pilot DOTS-Plus strategy that adds treatment for MDR-TB to the standard Directly Observed Therapy Short-course (DOTS) regiment for non-resistant TB. Another demonstrated that providing DOTS-Plus treatment for MDR-TB patients did not undermine treatment of drug-susceptible TB, as some experts had feared. In fact, the results suggested that integrating DOTS-Plus treatment for MDR-TB may strengthen the standard DOTS program. A third study showed that the greatest risk factor by far for development of MDR-TB was hospitalization, not failure to adhere to treatment. These findings are likely to lead to a reevaluation of the role of hospitalization versus community-based TB treatment in Russia.
The Tomsk research and the Russian-language edition of PIH's guide to treatment of MDR-TB treatment guide have had a significant influence on a High Level Working Group convened by WHO and the Russian Ministry of Health that has helped shape the MDR-TB portion of Russia's national TB treatment guidelines. And research findings from Tomsk also helped inform new global guidelines for treatment of MDR-TB that were released in May 2006, backed by the WHO, the US Centers for Disease Control and Prevention, PIH and other leading agencies in efforts to stop TB. The new guidelines were accompanied by a call to scale up treatment rapidly worldwide, from 16,000 patients in 2006 to more than 800,000 a decade later.

http://www.pih.org/pages/russia/

TUBERCULOSIS: Locating people most at-risk for developing tuberculosis in Siberia.

01/20/11




Laboratory in Strezhevoy tests for HIV and MDR-TB.










Recently, PIH-Russia (Partnwers in Health) strengthened its proactive tuberculosis program in Strezhevoy, a town of 45,000 people located about 400 miles north of PIH’s first Russian program in Tomsk City. Isolated by hundreds of miles of tundra, the town is defined by its Siberian culture, the large oil-based production companies that employ much of the city’s workforce, and one of highest incidence rate for HIV and co-infection of tuberculosis HIV and tuberculosis (TB) in that region of Russia. Making matters worse, a disproportionate number of people are developing multidrug-resistant TB (MDR-TB).
Nationwide, Russia reports 85.1 cases of TB for every 100,000 people, compared to only five per 100,000 in the United States. In Tomsk Oblast, where Strezhevoy is located, the number tops 101.5 new cases per 100,000. Additionally, about 13 percent of new TB cases are MDR-TB in Tomsk Oblast. Moreover, curbing the rate of TB in regions like Strezhevoy has been difficult, due in part a high rate of intravenous drug use and its isolation.
In order to reverse these trends, PIH-Russia refined an algorithm used to identify HIV patients who are most at risk of contracting TB. A preventive strike against TB and MDR-TB.
The team used information collected and analyzed over the past decade to create the algorithm. The formula relies on the results of the TB testing, patients’ CD4 count, their exposure to TB, and other factors.
Once identified using the formula, the patients are put on an intense anti-TB drug regimen called Latent TB Infection (LTBI) chemoprophylaxis. They will take the drugs for four months, three times a week, under the direct observation of medical staff. To encourage patients to take care of themselves while on the regimen, they receive food packages during the course of treatment.
If a patient is not able to visit the nearest treatment facility, PIH medical workers will visit the patient in their home as part of the organization’s “Hospital at Home” project.
The goal: prevent people from contracting a disease that is often painful, and for people living with HIV, deadly.
Preventing the spread of TB not only spares the patient, but also reduces the threat of transmitting the disease within the larger community.
http://www.pih.org/news/entry/locating-people-most-at-risk-for-developing-tuberculosis/

BIOTERRORISM: CDC Defends Smallpox Retention

Monday, Jan. 24, 2011
The U.S. Centers for Disease Control and Prevention is defending its retention of smallpox stocks. The United States and Russia are the only countries known to possess live strains of the highly virulent variola virus that was declared eradicated from nature in 1980. The two superpowers have justified their continued retention of the potential bioterrorism material on the grounds that further study is needed for the production of improved vaccines and other countermeasures.
"More work has to be done on the vaccine," CDC spokesman David Daigle said. "We want to make a better vaccine without side effects, and we have much more work to be done (with developing) antivirals."
Last week, the executive body of the World Health Organization supported retaining the smallpox cultures. The full World Health Assembly in May could make a final decision on whether to establish a cutoff date for the smallpox strains to be destroyed.
A significant number of countries want to see the material eliminated, according to the newspaper.
"I think there is probably quite a bit of geopolitical posturing in this," said Inger Damon, who heads the CDC Poxvirus and Rabies Branch.
No more than than 10 scientists at the federal public health agency have access to the Atlanta-based organization's 451 smallpox specimens, which are surrounded by tighter safeguards than those employed for dangerous pathogens such as anthrax, Damon said. Safeguards for the smallpox virus are on par with those used to protect cultures of the Ebola and Marburg viruses.
Washington and Moscow have argued they should be allowed to keep their smallpox strains as it is not definitively known that all other states have destroyed theirs -- thus not closing the door on an inadvertent or deliberate release of the disease or its acquisition by terrorists for a biological weapons attack.
"(Handing over the virus) was a voluntary effort," Damon said. "There was no extensive checking of freezers and checking of vials."
Other nations, particularly developing states, contend that these fears are overstated and that the real danger lies in the accidental release of a U.S. or Russian variola specimen.
"The logic of deterrence doesn't hold in this area," said biological weapons expert Jonathan Tucker, who in a recent article offered a strategy for resolving the impasse (see GSN, Jan. 13). "If we were attacked with smallpox, we wouldn't retaliate with smallpox. That would be morally repugnant."
"At some point, the U.S. has to show more flexibility," Tucker said.
Observers including Tucker believe the United States has developed enough medical countermeasures to fend off an outbreak of the virus. However, a 2010 study by a WHO advisory panel concluded that smallpox strains were still necessary for the development of antiviral medicines in addition to a safer vaccine (see GSN, Jan. 18).
One-time CDC chief Jeffrey Koplan said he thought it unlikely the United States would agree to eliminate its variola cultures, regardless of whether the World Health Assembly votes this spring to establish a deadline for such a project.
"The overriding factor is that politically it would be difficult for any administration to order the destruction of the virus while the Soviet Union still kept it in their fridge," Koplan said (Katie Leslie, Atlanta Journal-Constitution/Apria Healthcare, Jan. 24).
http://www.globalsecuritynewswire.org/gsn/nw_20110124_1055.php

BIOTERRORISM: Expert says US should agree to destroy smallpox virus stocks

Robert Roos News Editor Jan 11, 2011 (CIDRAP News) – Given the potential for a bitter diplomatic battle at the World Health Assembly (WHA) in May, an expert on smallpox-related policy is recommending that the United States agree to the destruction of the remaining stocks of smallpox virus—or at least be prepared to destroy all but a remnant of them.
Smallpox was eradicated in the late 1970s, but the United States and Russia, citing concern that some countries may have kept hidden caches of the virus for biological warfare purposes, have maintained stocks of the virus for research on medical countermeasures.
The WHA, the annual gathering of World Health Organization (WHO) member states, agreed in the 1990s and again in 2002 to permit retention of virus stocks for continued research, notes Jonathan Tucker, PhD, in a lengthy article in Biosecurity and Bioterrorism. The WHA is scheduled to address the issue at its May meeting, and pressure to destroy the supply is building, Tucker writes. This could lead to "a diplomatic train wreck," he adds.
"In order to avoid an international confrontation at the 2011 World Health Assembly that would be harmful to all concerned, the US should accept a firm deadline (eg, by the end of 2012) for ending the smallpox research program and destroying the WHO-authorized stocks of variola virus," states Tucker, who is Georg Zundel Professor of Science and Technology for Peace and Security at Darmstadt University of Technology in Germany and author of Scourge: The Once and Future Threat of Smallpox.
If this option won't work because of opposition from Russia or other WHO members, the United States should stand ready to negotiate a compromise calling for destruction of most of the remaining stockpile while taking steps to share the results of smallpox research among WHO members, Tucker recommends.
In his view, Russia clearly opposes destroying its variola virus stocks, but if the United States dropped its opposition to destruction, Russia would probably not stand alone against a united WHA. Many developing countries in Africa and Asia want the virus caches destroyed, he says.
Tucker writes that US preparedness for a deliberate release of smallpox virus is far better now than when the research program began in 1999, reducing the need for continued countermeasure research. The nation has enough doses of smallpox vaccine to protect the whole population and a supply of a third-generation vaccine that's considered safer than earlier versions, he notes. Also, two promising antiviral drugs, ST-246 and CMX001, "are in advanced development and could be given under an Emergency Use Authorization."
Tucker proposes three elements for a compromise on the fate of the variola stocks, if complete destruction is not an option.
First, the United States and Russia would agree to reduce the WHO-authorized stocks in their possession to fewer than 10 representative strains in each country. Though this step would leave many unsatisfied, it would be "a major step toward reconciliation," he argues.
Second, the WHA would take steps to prevent the synthesis of variola virus from scratch. This would involve reaffirming the WHO's 2008 guidelines on the handling of variola virus DNA and incorporating them into national laws and regulations.
Third, the United States and Russia would take steps to share the benefits of smallpox research among WHO member countries. That would mean providing royalty-free licenses to any countries that want to produce drugs or vaccines developed under the program, setting up a WHO-controlled stockpile of antiviral drugs for victims of a smallpox attack anywhere in the world, and increasing the two countries' contributions to the WHO's global smallpox vaccine reserve.
Tucker JB. Breaking the deadlock over the destruction of the smallpox virus stocks. (Commentary) Biosecur Bioterror 2011 (published online Jan 10) [First page]
http://www.cidrap.umn.edu/cidrap/content/bt/smallpox/news/jan1111smallpox.html

TUBERCULOSIS: USAID in Russia

Russia ranks 11th on the list of 22 high-burden tuberculosis (TB) countries in the world.


After years of gradual decline, TB incidence doubled during the 1990s, but since 2000, the annual growth in the number of new cases has been smaller. According to the World Health Organization’s (WHO’s) Global Tuberculosis Control Report 2009, the TB incidence rate in 2007 was an estimated 110 new cases per 100,000 population, and an estimated one in five people have latent TB in Russia. Around 282,850 people died from TB between 1998 and 2007. Russia initiated DOTS (the internationally recommended strategy for TB control) in 1995, and population coverage has increased annually, reaching 45 percent by 2004 and 100 in 2007. Case detection remains low, particularly for sputum smear-positive (SS+) cases, though it increased from 15 percent in 2004 to 49 percent in 2007. Death, treatment failure, and default rates all continue to be high and contribute to low treatment success rate. Globally, Russia had the third largest number of multidrug-resistant (MDR) TB cases in 2007, with close to 43,000. Extensively drug-resistant (XDR) TB is a serious problem and may account for 6 percent of MDR-TB cases.1 The incidence of HIV, which complicates TB treatment, has also been growing again in recent years. In 2007, HIV co-infection among new TB cases was 16.3 percent.
Russia’s TB indicators reflect the slow progress following the collapse of the health care system after the breakup of the Soviet Union in the early 1990s. Russia was not able to sustain the previous TB infrastructure and this facilitated the spread of TB and MDR-TB. The country needed new approaches to TB control and although TB specialists and political officials (who favored the Soviet approach to TB control) initially resisted the DOTS approach, their acceptance progressed and continues to grow as the government looks for new solutions. Yet problems still remain. The case notification rate, which directly measures the capacity to detect cases of infectious TB, has revealed a very high proportion of SS - notifications among new cases. Support for supervision at the regional level is needed in order to ensure accurate implementation of the approved recommendations on TB control, particularly on MDR-TB treatment.
The approach to TB in prisons is improving, but remains complicated. MDR-TB and XDR-TB rates are high among prison inmates relative to other populations. The TB notification rate in the penitentiary system is approximately 17 times higher than in the civilian sector. DOTS is implemented in all prison health facilities, as most cases are diagnosed when inmates arrive at pre-trial detention facilities, and TB incidence, prevalence, and mortality in prisons are notably decreasing.

USAID Approach and Key Activities
USAID assistance in Russia began in 1998 with the objective of helping the government implement DOTS, reduce TB mortality, morbidity, and disease transmission. Through its partners, USAID has expanded DOTS, helped the Ministry of Health and Social Development (MOHSD) incorporate routine TB control into the health system, and provided training on internationally recognized TB diagnostics. USAID funding for TB programming in Russia totaled $7.1 million in fiscal year (FY) 2008. While this is a small percent of the total TB control program funding, it supports important interventions in target areas. Technical assistance (TA) focuses on nine target territories recommended by the MOHSD: Orel, Vladimir, Pskov, Belgorod, oblasts, Chuvashia Republic, Khakasia Republic, Republic of Adygeya (the North Caucasus region), Jewish Autonomous oblast and Khabarovsk kray (the Russian Far East). Two other territories recently started to receive limited TA (Orenburg and Mariy El). USAID activities have focused on the following:

Developing regional models for DOTS activities for MDR-TB and TB-HIV/AIDS
Increasing access to diagnosis and treatment for vulnerable populations
Strengthening TB control and disease surveillance in the general population, with interventions extending into the prison system; and establishing links between the civilian and prison health systems
Increasing civil society involvement in TB control efforts
Developing national- and provincial-level policies and training health care providers to understand DOTS
Strengthening laboratories as well as capacity building for program monitoring and supervision
Providing TA for improving infection control
Developing social and psychological support schemes for patients to improve adherence to treatment
Conducting operations research on TB control programs
USAID Program Achievements
USAID has played a major role in building political commitment in Russia for TB control and prevention based on the DOTS strategy. In partnership with WHO and others, USAID helped establish and support the High-Level Working Group on TB. At the program level, USAID support has expanded DOTS coverage to all of Russia’s territories. Achievements also include:
Implemented modern TB control systems in nine provinces, resulting in improved treatment success rates of up to 75 to 80 percent
Provided training in TB laboratory diagnostics, including smear microscopy, culture, and drug sensitivity testing (more than 700 laboratory personnel, including prison staff)
Supported and helped the Khakasia Republic TB laboratory become the highest ranked TB laboratory in proficiency testing nationwide
Improved infection control in six central province laboratories and provided equipment for 12 microbiological laboratories
Trained 2,297 health professionals in TB-related issues in FY 2007
Assisted the MOHSD in issuing new executive orders on TB diagnosis and treatment, recording and reporting systems, and prevention and treatment of HIV/AIDS-associated TB
Provided TA for the preparation of a proposal to the Global Fund to Fight AIDS, Tuberculosis and Malaria for TB control that was approved for $88 million
Provided treatment to 200 new MDR-TB patients in the Orel region in FY 2005–2007
Assisted five regions to obtain approval from WHO’s Green Light Committee (GLC) for DOTS-Plus treatment for MDR-TB for more than 5,400 patients in 2007
Established a Center of Excellence for TB and MDR-TB in FY 2007
Developed guidelines and training materials on the provision of TB care to people living with HIV/AIDS
Supported HIV testing for more than 90 percent of TB patients in USAID-assisted regions in FY 2007
Supported increased involvement of civil society in the fight against TB, including the more than 1,000 new Red Cross volunteers involved in TB control efforts in FY 2007
http://www.usaid.gov/our_work/global_health/id/tuberculosis/countries/eande/russia_profile.html

TUBERCULOSIS: Treating MDRTB in Siberian Prisons

The PHRI/Soros Russian TB Program ... Treating MDRTB in Siberian Prisons
The tuberculosis epidemic in Russia, particularly in the Russian prisons, had reached alarming proportions by the mid 1990s. Virtually every prisoner in Russia was exposed to tuberculosis, many became sick, and many died, and tens of thousands of infected individuals were being released into the general population.
At the initiation of PHRI's Dr. Alexander Goldfarb, who became the Project Director, the Soros Foundation/Open Society Institute provided several grants, ultimately totaling $13 million, for PHRI to develop demonstration tuberculosis control projects which could become a model for replication throughout Russia.
Accomplishing this aim required the establishment of collaborative working relationships with a variety of partners in Russia, building a laboratory infrastructure virtually from scratch, training laboratory and medical personnel, implementation of TB control procedures, provision of appropriate first and second line drugs, advocacy to convince TB and governmental leaders to proceed with the program, and a myriad of additional tasks, all taking place in a highly charged political atmosphere.
Beginning in 1997, PHRI succeeded in establishing effective TB control systems in several Russian regions, in both civilian and prison populations, and successfully managed the treatment of thousands of patients with drug susceptible tuberculosis. In addition, PHRI established, in the oblast of Tomsk in western Siberia, the first, largest, and still (to our knowledge) the only large scale functioning program in Russia to treat multiple drug-resistant tuberculosis (MDRTB) in both prison and civilian settings.
Once the program was implemented, it required an ongoing medical presence, and PHRI invited the Partners-in-Health (PIH) organization, headed by Drs. Paul Farmer and Jim Kim of Harvard, into the project, first as consultants and then to assume medical management of the project. Ultimately, over the course of 2001-2002, PHRI transferred the entire Tomsk program to PIH.
http://www.phri.org/programs/program_russiantb.asp

TUBERCULOSIS: Russia Bracing for Spread of Dangerous TB Strains

Sarah Schafer

 August 24, 2009
MOSCOW -- Russia's severe tuberculosis problem is about to get much worse, increasing the risk that the dangerous drug-resistant strains that are common here will spread, causing outbreaks elsewhere, local health officials and other experts warn.
Preliminary surveys have recorded an uptick in infections, which experts say could be the start of a surge fueled by declining living standards and deteriorating medical care resulting from the country's worst economic slowdown in a decade.
But Russian officials and health specialists also blame the government's failure to order supplies of key medicines last year, a blunder that could strengthen antibiotic-resistant forms of TB and threaten wealthier countries that have all but eradicated the disease.
Russia already has one of the highest rates of TB in the world. In parts of its Far East, the infection rate is three times what the World Health Organization considers epidemic levels. The government has made progress in recent years, with infection rates falling from a peak in 2000, but health officials are worried that those gains are now in jeopardy.
Preliminary state statistics show the rate of infection growing from 83.2 cases per 100,000 people in 2007 to 85.2 in 100,000 last year, and anecdotal evidence from hospitals and clinics around the country suggests that the numbers are still climbing.
By comparison, the infection rate in the United States is about 8 in 100,000, with about 0.2 percent of American TB cases ending in death. In Russia, about 18 percent of TB patients die of the disease, according to WHO figures.
"Because people are poorer and life is worse, the disease is progressing much faster now," said Veronika Agapova, a tuberculosis specialist with the Russian Red Cross. "The Ministry of Health didn't pay a lot of attention to this problem last year," she added.
Although the increase reported was small, officials are worried because the number of TB cases soared the last time Russia suffered a severe economic downturn, rising from 74 cases per 100,000 people before the 1998 financial crisis to 90.4 two years later.
"What was bad in 2008 will continue to be seen in 2009 and 2010," said Mikhail Perelman, Russia's most prominent TB specialist. "I am pessimistic. . . . The WHO set a goal to eradicate tuberculosis, but this task seems quite fantastic to us at this point."
A spike in infections in Russia could have consequences well beyond its borders because about a fifth of all TB patients here suffer from drug-resistant strains -- more than almost anywhere else in the world.
In 2006, a Russian-born man infected with a strain of drug-resistant TB was jailed after moving to Arizona and ignoring a judge's order to wear a mask outdoors. A year later, an American lawyer with drug-resistant TB set off an international panic and was quarantined after traveling across Europe and returning to the United States.
"Like air pollution, it doesn't see a border," said Murray Feshbach, an expert on Russian public health at the Woodrow Wilson International Center for Scholars who argues that Russia understates its TB rate by as much as 50 percent.
http://www.washingtonpost.com/wp-dyn/content/article/2009/08/23/AR2009082302208.html

POVERTY: Faith and poverty in the world

2010, September 8
Using data from a recent Gallup report showing a correlation between wealth and faith, Charles M. Blow reports in graphic form. Each sphere, sized by population, represents a country. Spheres are colored by dominant religion in that country.
The United States is an outlier among the relatively richer countries. While the United States is the richest country by GDP per capita, 67% of Americans say that religion is important in their daily lives. Compare that to France, Britain, and Japan who report 30% or less.
On the flip side of that, it looks like there's a cluster of countries with both low GDP and low religiosity, such as Vietnam and Russia.
Many scientists believe "religion plays a more functional role in the world's poorest countries, helping many residents cope with a daily struggle to provide for themselves and their families."
Does this suggest that outliers might use other ways to cope with struggle?
http://flowingdata.com/2010/09/08/faith-and-poverty-in-the-world/

POVERTY: The backlash begins against the world landgrab

Ambrose Evans-Pritchard
12 Sep 2010
The backlash begins against the world landgrabThe neo-colonial rush for global farmland has gone exponential since the food scare of 2007-2008.
"Madagascar's land is neither for sale nor for rent," said its new president
Last week's long-delayed report by the World Bank suggests that purchases in developing countries rose to 45m hectares in 2009, a ten-fold jump from levels of the last decade. Two thirds have been in Africa, where institutions offer weak defence.
As is by now well-known, sovereign wealth funds from the Mid-East, as well as state-entities from China, the Pacific Rim, and even India are trying to lock up chunks of the world's future food supply. Western agribusiness is trying to beat them to it. Western funds - many listed on London's AIM exchange - are in turn trying to beat them. The NGO GRAIN, and farmlandgrab.com, have both documented the stampede in detail.
Hedge funds that struck rich 'shorting' US sub-prime have rotated into the next great play of our era: 'long’ soil. "Productive agricultural land with water on site, will be very valuable in the future. And I've put a good amount of money into that," said Michael Burry, star of 'The Big Short'.
Needless to say, this has set off a fierce backlash. Brazil has passed a decree limiting acreage held by foreign-owned companies, the latest evidence that our half-century era of globalisation may be drawing to a close.
Authorities are probing whether firms are using local fronts to disguise investment in Mato Grosso and Amazonia. "Brazilian land must stay in the hands of Brazilians," said the farm development minister, Guilherme Cassel. It is starting to feel like the early 1970s when the military regime more or less froze out foreign buyers.
Where will this leave the plans of SinoLatin Capital, Goldman Sachs, Harvest Capital, or Berkshire Hathaway? Warren Buffett, wisely, is exploring his $400m venture in soya and sugar with a Brazilian partner.
Argentina is drawing up its own law, pressed by the country's bishops. More than 7pc of national territory is owned by foreigners. The Benetton brothers have 900,000 hectares of Patagonia, some on disputed Mapuche tribal land. George Soros has holdings, so does CNN's Ted Turner, and currency trader Joe Lewis, who made himself a public enemy by blocking public access to the majestic Hidden Lake.
"There are many foreigners who don’t buy to produce, but rather to position themselves in places with water, mineral resources and hydrocarbons," said Pablo Orsolini, a sponsor of the legislation.
In Madasgascar, a deal with Korea's Daiwoo Logistics to plant corn on territory half the size of Belgium led to the downfall of the government in 2008. The lease was revoked. "Madagascar's land is neither for sale nor for rent," said the new president. Even Australia's senate has called for an audit of foreign-owned land and water projects.
The allure of global land is obvious. The World Bank says industrial and “transition” countries are losing 2.9m hectares of cultivated farmland each year. China is paving over its fertile belt on the Eastern seabord, and depleting the water basin of the North China Plain for crop irrigation.
Cheng Siwei, head of China's green energy drive, told me last week that eco-damage of 13.5pc of GDP each year outstrips China’s growth rate of 10pc. National wealth is contracting. "We have an intangible environmental debt that we are leaving to our children," he said. So does India. Much of the globe is stealing food from the future.
The World Bank said we must lift production 70pc by 2050 to meet a triad of converging demands: extra mouths; rising use of animal feed from grains as Asia moves up the affluence ladder to meat-based diets; and the biofuel drive.
This will not be easy. The great leap forward in crop yields is fading. The Bank said rises in wheat and soya yields have declined from 2pc a year to zero since the 1970s in the West. Yield growth for rice and soya in emerging economies has fallen from 3pc to 1pc.
"With few break-through technologies on the horizon, the scope for yield gains seems lower than in the past. Irrigation has contributed to past growth in crop yields, but water scarcity in many regions is now a major constraint," it said. The Green Revolution is "exhausted".
There is plenty of land in the former Soviet Union, where crop planting has fallen by 30m hectares since the sovkhoz collectives of the Khruschev era. Yields are still barely half Western levels on many Russian farms.
Untapped hinterlands lie in Africa (Congo and Sudan) and Latin America. Developing countries are freeing up 5.5m hectares a year. There is a theoretical reservoir of 445m hectares of unforested cropland in the world, on top of the 1.5bn hectares in production.
Rich countries do not face a Malthusian crisis. They face a shift in the terms of trade between country and city, a reversal of urban dominance since the industrial revolution. We are on a thinner margin of food security, just as we are on a thinner margin of oil security.
But those who live in poor countries that rely on food imports most certainly did have a Malthusian moment in 2008 when bread riots swept Egypt, Indonesia, and a string of states in Africa.
Last week, 10 people died in riots in Mozambique, set off by Russia's grain export ban. Wheat prices have doubled since June. The World Bank said the number of people who go to bed hungry each night has risen from 830m to more than 1bn over the past three years.
The morality of the global land rush is finely balanced. Good projects are exactly what we need to solve the food crisis. They bring investment, know-how, and transport links. They create jobs. Peru's auction scheme on the Pacific Coast has been a success.
Yet the World Bank appears deeply torn. While the report endorses the Bank's open-door globalisation agenda, the sub-text dissents on every page. "Large land acquisitions come at a high cost. The veil of secrecy that often surrounds these deals must be lifted," it said.
It warns of a "resource curse" that may enrich a small elite, leaving wreckage behind. Proposals are not properly screened. Peasants are forcibly displaced. Communal grazing lands are closed off. Some investors manipulate opinion with a media blitz of false promises. Nothing has been produced so far on almost 80pc of the land purchased. Benefits are often minimal, "even non-existent". In Africa, the land rush is diverting effort from the core task of helping small farmers raise yields.
The Bank implicitly questions whether it is wise to divert half of the world's increased output of maize and wheat over the next decade into biofuels to meet government “mandates". It will be another decade before the stalks and other inedible parts of plants can be used in bulk.
Personally, I am coming to the conclusion that the biofuel drive is misguided, given that mass solar power and throrium-based nuclear reactors – coupled with electric cars - could step into the energy breach with less destructive effects. All it takes is global leadership. As Friends of the Earth reproaches us, every time we make a frivolous journey in an over-powered car we are hurting somebody.
Land is not a commodity. It has an atavistic pull in most cultures, and is semi-sacred everywhere. Absentee landlords who amass chunks of the earth – however well-intentioned - will be expropriated. Politics always prevails.
http://www.telegraph.co.uk/finance/comment/ambroseevans_pritchard/7997910/The-backlash-begins-against-the-world-landgrab.html

MALNUTRITION: UN calls meeting on food price concerns

The United Nations' food agency has called a special meeting of policy makers to discuss the recent rise in global food prices.
The announcement came after Russian Prime Minister Vladimir Putin extended the country's ban on grain exports on Thursday.
This added to fears that prices of food staples would continue to rise.
The meeting will take place on 24 September, probably in Rome, the UN Food and Agriculture Organization said.
"In the past few weeks, global cereal markets experienced a sudden surge in international wheat prices on concerns over wheat shortages," the agency said.
"The purpose of holding the meeting is for exporting and importing countries to engage in constructive discussions on appropriate reactions to the current market situation."
Mr Putin did not say when exactly the Russian grain export ban, originally to run from 15 August to 31 December, would be lifted, but said that it would not be before next year's harvest had been reaped.
Russia is one of the world's biggest producers of wheat, barley and rye and was hit hard by a drought this summer.
The heatwave destroyed crops in many parts of the country, pushing food prices up.
This year's crop could be as low as 60 million tonnes, but Russia needs almost 80 million just to cover domestic consumption, analysts say.
Other key grain producers have also reported shortages, causing the price of wheat to rise more than 50% since the beginning of July.
http://www.bbc.co.uk/news/business-11177346

TUBERCULOSIS: MSF in Chechnya

MSF video of treatment of tuberculosis in Chechnya
http://www.msf.ca/news-media/photo-gallery/medical-programs-in-chechnya/

MALNUTRITION: Less wheat

The Food and Agriculture Organization (FAO) has lowered its global wheat production forecast for 2010 due to unfavorable weather. From 676 million tons in June, the forecast is now set at 651 million tons. Despite the decrease in wheat production, FAO says that the world market is still better than during the world food crisis in 2007/08.
The Russian Federation is still coping with drought and countries such as Kazakhstan and Ukraine anticipate lower yields. Canada is also expecting a decline in its production. These countries are major exporters of wheat to the rest of the world. Wheat prices have increased by over 50 percent since June but world inventories are adequate to cover anticipated production shortfall.
http://www.fao.org/news/story/en/item/44570/icode/

BIOTERRORISM: New smallpox vaccine

The United States government has started stockpiling both a newer and safer version of smallpox vaccine. The vaccine, Denmark-based Bavarian Nordic's Imvamune, is made with modified vaccinia ankara. This is a much safer alternative to the cowpox vaccines that have been used for generations.
Company officials say the first shipments of the new and improved smallpox vaccine arrived in the U.S. Strategic National Stockpile last week, within hours of a World Health Organization ceremony marking eradication of the disease. This is widely regarded as one of the greatest public health achievements of all time. Of course with the threat of bioterrorism, and the fact that the virus still lives, there is still considerable risk to the public if enough of the vaccine isn't stockpiled.
For example, the virus lives in freezers at the Centers for Disease Control and Prevention in Atlanta and possibly in Russia, where Soviet scientists are believed to have created tons of weaponized smallpox. The breakup of the Soviet Union and the rise of global terrorism led the United States about ten years ago to begin stockpiling vaccine.
If Russia has smallpox; who else does? That's likely the larger question that no one is coming out and directly asking. Today, however, Randall Larsen, CEO of the non-profit Weapons of Mass Destruction Center, said that the national stockpile now contains 300 million doses of the vaccine.
http://news.gather.com/viewArticle.action?articleId=281474978256665

TUBERCULOSIS: Increasing resistance to known drugs

In a series of studies into TB, scientists said "superbug" strains of the disease were already gaining ground in some countries and called for greater investment into research and development of new drugs and possible vaccines.
Multidrug-resistant tuberculosis, known as MDR-TB, has much lower cure rates, higher death rates, and costs far more to treat than normal TB, they warned.
An estimated 440,000 MDR-TB infections occurred around the world in 2008, accounting for 3.6 percent of known cases.
Neel Gandhi of New York's Yeshiva University and Paul Nunn of the World Health Organization in Geneva, who conducted one of the studies, found that India and China had around 50 percent of the global MDR-TB burden, followed by Russia with 9 percent.
"Unless countries invest substantially in management of MDR TB, the possibility remains that MDR strains could become the dominant form," they wrote.
"The future possibility of strains that are totally resistant to all anti-tuberculosis drugs is not inconceivable."
TB -- which causes around 1.8 million deaths worldwide every year, or nearly 5,000 people a day -- is often associated with poverty and is one of the leading causes of death among people in economically productive age-groups in developing nations.
Of a 11 million active cases of TB recording in 2008, 95 percent of cases were in low- and middle-income countries.
It is caused by the Mycobacterium tuberculosis bacteria and can be cured with antibiotics, but they must be taken daily for months to be effective and public health funding cuts in some countries may mean fewer drugs are available.
Because people do not always take the drugs properly, MDR-TB strains are starting to take hold and the WHO says there is an urgent need for countries to set up laboratories to fight it.
Gandhi and Nunn said MDR-TB treatment is less effective, requiring 24 months of treatment rather than the usual 6 months, and far more expensive -- costing an average of $3,500 in drugs per patient versus around $20 per patient for normal cases.
"Even though there are fewer cases of drug-resistant TB, the cost and complexity of their management place a significantly greater burden on the health system," they said.
In other studies in the series, which was published by The Lancet on Wednesday, scientists said the combined impact of new drugs, vaccines, and diagnostic tests could cut worldwide incidence of TB by 94 percent by 2050, but the investment needed to bring this about it falling way too short.
Only around a quarter of the funding needed is being put into TB drug research and development, they said, and called for new ways of encouraging pharmaceutical firms into the field.
"Development of new drugs for TB is lengthy, expensive, and risky, and the expected revenues are too small to justify commercial investment," wrote Zhenkun Ma of the Global Alliance for TB Drug Development. "New financing and market incentive mechanisms are needed."
According to the studies, there are 11 potential TB vaccines being tested in human trials and up to 10 experimental medicines in the TB drug "pipeline." Since many drugs fail in late-stage trials, this handful of possibilities is unlikely to be enough.
"To eliminate TB as a public health concern by 2050, all responsible parties need to work together to strengthen the global anti-tuberculosis drug pipeline," the scientists said.
http://www.reuters.com/article/idUSTRE64H6RP20100518