Showing posts with label gates foundation. Show all posts
Showing posts with label gates foundation. Show all posts

Saturday, February 18, 2017

Pandemic Could Kill 30 Million Bill Gates Warns via Terroism or Nature




BILL GATES: A new kind of terrorism could wipe out 30 million people in less than a year — and we are not prepared

Bill Gates Mike Nudelman/Business Insider
The following op-ed was exclusively provided to Business Insider to coincide with a speech Bill Gates is giving for the Munich Security Conference. The following is an abridged version of his remarks.
When I decided 20 years ago to make global health the focus of my philanthropic work, I didn’t imagine that I’d be speaking at a conference on international security policy. But I’m speaking here at the Munich Security Conference because I believe our worlds are more tightly linked than most people realize.
War zones and other fragile state settings are the most difficult places to eliminate epidemics. They’re also some of the most likely places for them to begin—as we’ve seen with Ebola in Sierra Leone and Liberia, and with cholera in the Congo Basin and the Horn of Africa.
It’s also true that the next epidemic could originate on the computer screen of a terrorist intent on using genetic engineering to create a synthetic version of the smallpox virus . . . or a super contagious and deadly strain of the flu.
The point is, we ignore the link between health security and international security at our peril. Whether it occurs by a quirk of nature or at the hand of a terrorist, epidemiologists say a fast-moving airborne pathogen could kill more than 30 million people in less than a year. And they say there is a reasonable probability the world will experience such an outbreak in the next 10-15 years.
bill gates quote Business Insider/Skye Gould
It’s hard to get your mind around a catastrophe of that scale, but it happened not that long ago. In 1918, a particularly virulent and deadly strain of flu killed between 50 million and 100 million people.
You might be wondering how likely these doomsday scenarios really are. The fact that a deadly global pandemic has not occurred in recent history shouldn’t be mistaken for evidence that a deadly pandemic will not occur in the future.
And even if the next pandemic isn’t on the scale of the 1918 flu, we would be wise to consider the social and economic turmoil that might ensue if something like Ebola made its way into a lot of major urban centers.
The good news is that with advances in biotechnology, new vaccines and drugs can help prevent epidemics from spreading out of control. And, most of the things we need to do to protect against a naturally occurring pandemic are the same things we must prepare for an intentional biological attack.

We need to invest in vaccine innovation

First and most importantly, we have to build an arsenal of new weapons—vaccines, drugs, and diagnostics.
Vaccines can be especially important in containing epidemics. But today, it typically takes up to 10 years to develop and license a new vaccine. To significantly curb deaths from a fast-moving airborne pathogen, we would have to get that down considerably—to 90 days or less.
We took an important step last month with the launch of a new public-private partnership called the Coalition for Epidemic Preparedness Innovations. The hope is that CEPI will enable the world to produce safe, effective vaccines as quickly as new threats emerge.
The really big breakthrough potential is in emerging technology platforms that leverage recent advances in genomics to dramatically reduce the time needed to develop vaccines. Basically, they create a delivery vehicle for synthetic genetic material that instructs your cells to make a vaccine inside your own body. And the great thing is that once you’ve built a vaccine platform for one pathogen, you can use it again for other pathogens—which means we could also apply it to other hard-to-treat diseases like HIV, malaria, and tuberculosis.
Of course, the preventive capacity of a vaccine won’t help if a pathogen has already spread out of control. Because epidemics can quickly take root in the places least equipped to fight them, we also need to improve surveillance.
That starts with strengthening basic public health systems in the most vulnerable countries. We also have to ensure that every country is conducting routine surveillance to gather and verify disease outbreak intelligence.
Bill Gates Bill Gates Dave Thompson - WPA Pool /Getty Images
And we must ensure that countries share information in a timely way, and that there are adequate laboratory resources to identify and monitor suspect pathogens.
The third thing we need to do is prepare for epidemics the way the military prepares for war. This includes germ games and other preparedness exercises so we can better understand how diseases will spread, how people will respond in a panic, and how to deal with things like overloaded highways and communications systems.
We also need trained medical personnel ready to contain an epidemic quickly, and better coordination with the military to help with logistics and to secure areas.
It is encouraging that global alliances like the G7 and the G20 are beginning to focus on pandemic preparedness, and that leaders like Chancellor Merkel and Prime Minister Solberg are championing health security.
But there isn’t enough money to help the poorest countries with epidemic preparation. The irony is that the cost of ensuring adequate pandemic preparedness worldwide is estimated at $3.4 billion a year—yet the projected annual loss from a pandemic could run as high as $570 billion.

The pandemic is one of the 3 biggest threats the world faces 

Climate change protest Bill Gates believes climate change, nuclear war and pandemics are the three biggest world threats. Andrew Burton/Getty
When I was a kid, there was really only one existential threat the world faced. The threat of a nuclear war. By the late 1990s, most reasonable people had come to accept that climate changed represented another major threat to humankind.
I view the threat of deadly pandemics right up there with nuclear war and climate change. Innovation, cooperation, and careful planning can dramatically mitigate the risks presented by each of these threats.
I’m optimistic that a decade from now, we can be much better prepared for a lethal epidemic—if we’re willing to put a fraction of what we spend on defense budgets and new weapons systems into epidemic readiness.
When the next pandemic strikes, it could be another catastrophe in the annals of the human race. Or it could be something else altogether. An extraordinary triumph of human will. A moment when we prove yet again that, together, we are capable of taking on the world’s biggest challenges to create a safer, healthier, more stable world.
This is an opinion column. The thoughts expressed are those of the author.
More: Bill Gates Op-Ed Opinion Pandemic

Monday, May 19, 2014

Curbing Newborn Deaths(MelindaGates)/Dying Need Experimental Therapies




Wall Street Journal, Monday, May 19, 2014:





AFRICA NEWS

Melinda Gates Works to Curb Newborn Deaths

Inexpensive, Low-Tech Solutions Urged, Such as Breast-Feeding, 'Kangaroo Care'

May 18, 2014 7:56 p.m. ET

Challenges to the effort include cultural barriers, such as delaying breast-feeding, Ms. Gates said. Agence France-Presse/Getty Images
SEATTLE— Melinda Gates champions high-tech solutions to some of the world's most intractable health problems.
She also says that holding and feeding a newborn the proper way can make the difference between whether it lives or dies.
The co-chair of the Bill & Melinda Gates Foundation is promoting some low-tech approaches as part of a push to improve the survival of newborns, a problem she said has been neglected. In a speech Tuesday at the World Health Assembly in Geneva, she plans to urge global health officials as well as national governments to implement practices that will make deliveries safer and keep newborns alive.
That will require competing for the attention of health ministers deluged with other pressing matters, from expanding HIV services to addressing a growing prevalence of noncommunicable diseases such as cancer and heart disease.
Many newborn deaths, Ms. Gates said in a recent interview, can be prevented by simple, inexpensive measures—such as teaching women to breast-feed, which immediately gives a baby nutrients and hydration, and guards against infection, one of the biggest killers of newborns. Or "kangaroo care"—a technique in which the infant, particularly a preterm baby, is held against the mother's skin to keep it warm and regulate the heartbeat. Or applying chlorhexidine, an antiseptic, to the stump where an umbilical cord has been cut, to prevent infection.
"You could get newborn deaths down substantially in the first couple of years," she said.
Naimot Alabi holds her baby son in 2013 in Lagos, Nigeria. All three of Ms. Alabi's other children have died and even in a country where Unicef reports one in seven perish before turning 5, the 36-year-old mother's case is out of the ordinary. Associated Press
Every year, 2.9 million infants die in their first 28 days of life, while 2.6 million die in the last three months of pregnancy or during childbirth, according to United Nations data. Newborn deaths account for 44% of all deaths in children under 5 years old—a proportion that has grown since 1990 because vaccines, malaria bed nets, and other interventions have helped keep older children alive. The number of children under 5 who died dropped 47% between 1990 and 2012, to 6.6 million.
"It's because we focused on it as a world," Ms. Gates said of the overall reduction in child mortality. "We decided to do certain things in vaccines, malaria and other areas. The piece that to me has always been interesting and that has been left out of that is looking at that first month of life."
Ms. Gates, a 49-year-old mother of three, sees her attention to newborns as an extension of her pledge to help women in the developing world obtain better access to family planning services—an effort for which she has corralled donors but also has been criticized by Roman Catholic groups that oppose using global health and development funds for contraceptives.
"For me it's a continuum of care for women and for babies," she said. "It's the women who are in charge of the health of the children. So if we can keep her healthy, and keep the newborns healthy, you keep the whole family more healthy."
A "newborn action plan" drawn up by Unicef, the World Health Organization, the Gates Foundation, and other organizations calls for training birth attendants who can teach new mothers the methods Ms. Gates describes, ensure supplies of injectable antibiotics and equipment for safer deliveries of babies, and other measures.
The goal, according to Mariam Claeson, director of the maternal, newborn and child health team at the Gates Foundation, is to cut newborn deaths to fewer than 10 per 1,000 live births by 2035. In 2012, there were 21 newborn deaths per 1,000 live births, according to the U.N.
But bringing about change is challenging, Ms. Gates acknowledges. On a visit to a clinic in Senegal, "They were doing all the right things in terms of the checklist of things to do during the birth," she said. "They had two great birth attendants."
But she also saw a woman who wouldn't breast-feed her newborn. It turned out the woman was waiting "for the person to come in from the village who's the religious leader to tell her what's her auspicious date that she can begin to breast-feed," Ms. Gates recalls. "So that's the type of cultural barrier you're often still trying to overcome."
Still, bringing down newborn deaths is "very possible and very doable," said Nosa Orobaton, head of a program that has been working at it for three years in two northern Nigerian states. Nigeria accounts for about a 10th of all newborn deaths annually, according to the U.N.
The program, partly funded by the Gates Foundation in addition to the U.S. Agency for International Development, has trained thousands of counselors to educate communities about safe birthing and newborn practices. It also has helped organize distribution of chlorhexidine gel that helps avert infections when umbilical cords are cut, particularly during home births, where most babies are born, Dr. Orobaton said. The antiseptic used to have to be ordered from Nepal and delivering it would take three months, but recently Nigerian officials arranged domestic production to make supplies cheaper and easier to deliver, he said.
"Once you have community trust, then we are well on our way to making things happen," he said. Then again, "procuring the medicines in a timely manner and getting them to those places in hard to reach areas on time are much more important in determining the success of the program than anything cultural."

Write to Betsy McKay at betsy.mckay@wsj.com



POLITICS AND POLICY

States Open to Drug Options

Expanding Experimental Therapies to the Dying Gains Traction Among Lawmakers

May 18, 2014 10:22 p.m. ET

Mikaela Knapp, of California, died in April at 25 after she failed to qualify for clinical trials because her kidney cancer had spread to her brain. The Knapp Family/We Got This
A push to widen access to experimental drugs for people with terminal illness is gaining traction among lawmakers in several states, highlighting a growing clamor from patients for promising therapies that haven't been approved for sale.
The so-called right-to-try bills, the first of which was signed into law in Colorado on Saturday by Gov. John W. Hickenlooper, may not make a big difference in practice because they generally don't require companies to provide access to the unapproved drugs outside of clinical trials.
The U.S. Food and Drug Administration already grants requests for early access to experimental drugs when companies are willing to provide them, but can't force companies to do so. The FDA approves the "vast majority" of these types of requests, a spokesman said.
Right-to-try supporters hope the movement will sway companies to expand access, and lead to broader changes in a drug-approval process they say takes too long, often several years.
Providing early access to experimental drugs poses a dilemma for companies and federal regulators who don't want to jeopardize patient safety or the integrity of clinical trials needed to get new drugs on the market.
Colorado's right-to-try act would allow people with terminal illnesses who have exhausted other treatment options to take experimental drugs that have cleared early-stage safety trials in humans, as long as the drugs' manufacturer agrees to provide them. Access wouldn't require FDA approval, as it does now.
The Colorado bill received unanimous support from state lawmakers. "If a person has been diagnosed with something terminal, and they don't have any hope, and there is something out there they want to try that might work for them, I am supportive of people being able to do that," said state Sen. Irene Aguilar, a Denver Democrat and physician who co-sponsored the bill.
The Colorado Medical Society didn't take a position on the legislation, saying it hadn't developed a policy on the issue and that the measure was likely to pass without its support. John L. Bender, the group's president, said in a statement Sunday that the law was "unlikely to cause harm, and potentially may help patients on a case-by-case basis."
Arizona residents will vote on a right-to-try referendum this fall, while similar bills have been passed by legislatures in Missouri and Louisiana, but haven't been signed by the governors.
The Goldwater Institute, a Phoenix-based conservative nonprofit advocacy group that designed the proposed state laws, plans to push the measures in legislatures nationwide, said President Darcy Olsen.
The legislation comes on the heels of some high-profile patient campaigns for early access, amplified through social media and online petitions.
At the same time, medical advances have raised hopes for new treatments. For instance, companies including Merck MRK +0.72% & Co., Bristol-Myers Squibb Co.BMY +0.23% and Roche Holding AG ROG.VX -0.45% are developing so-called cancer immunotherapies, which work by unleashing the body's immune system to fight tumors. The drugs, which some companies provide for free, have shown promise in early clinical trials to significantly shrink tumors and extend survival in certain cases.
Keith Knapp of Folsom, Calif., started an online petition earlier this year asking for Merck's immunotherapy MK-3475 for his wife, Mikaela, who was diagnosed with kidney cancer last fall. The petition on change.org got more than 476,000 signatures.
Ms. Knapp didn't qualify for clinical trials of immunotherapies because she had a rare subtype of kidney cancer and it had spread to her brain, said Mr. Knapp. She was unable to receive MK-3475 through an early-access program started by Merck in March because it is only for patients with advanced melanoma, a form of skin cancer. She died in April at the age of 25.
Mr. Knapp said he favors right-to-try laws. "The current way we have this set up, it just doesn't work," he said. The proliferation of online petitions for early access is "a symptom there is some underlying flaw in our current system."
A Merck spokesman said he couldn't discuss specific patient requests, but said the company's first priority is to conduct clinical trials of new drugs. He said Merck allows early access outside of clinical trials when the benefits are likely to outweigh risks. Merck has applied for FDA approval of MK-3475 for melanoma and expects a decision by late October, he added.
A spokeswoman for Roche's Genentech unit said the company has received many requests for access to its experimental cancer immunotherapy, but doesn't have a compassionate-use program in place. The company will continue to evaluate a potential program, she said.
Bristol-Myers is in the process of starting an expanded-access program to allow certain patients with advanced melanoma to take its immunotherapy, nivolumab, a spokeswoman said.
Drug makers and the FDA have expressed concerns about the state proposals. The Pharmaceutical Research and Manufacturers of America, a trade group, said efforts to provide access to experimental medicines that bypass FDA oversight aren't in the best interest of public health.
"Successful completion of the clinical trial process is necessary to demonstrate that an investigational medicine is safe and effective, which is required to obtain FDA approval, so that companies may make the medicine available to a broader patient population when clinically appropriate," said Sascha Haverfield, vice president of scientific and regulatory affairs at PhRMA.
The FDA spokesman said the agency is concerned about "efforts that would be inconsistent with its congressionally mandated authority and agency mission to protect the public from therapies that aren't safe and effective." The FDA said it works with companies to provide access to experimental drugs by helping patients enroll in clinical trials or through expanded access, but it is up to companies to provide them.
Write to Peter Loftus at peter.loftus@wsj.com