Showing posts with label dengue. Show all posts
Showing posts with label dengue. Show all posts

Thursday, June 23, 2016

Climate Tricks 54, Forcing the linkage between climate change and dengue

A friend from UP, Oggie Arcenas, wrote this discussion note at the UPSE website. In  his concluding notes, he  wrote,

"La Niña phenomenon is positively (and significantly) associated with dengue cases. La Niña, as widely known, is “cooling” of surface water temperature, inducing an abnormal cycle and intensity of dryness and wetness in different parts of the world. Although La Niña does happen naturally, its increasing frequency is attributed to general global warming."

Some brief comments here.

1. "La Niña, as widely known, is “cooling” of surface water temperature" Vague. La Nina (and El Nino) is cooling (and warming) of Pacific Ocean's Nino Region 3.4 only. Nino Regions 1, 2 not included, Atlantic Ocean or Arctic or Indian Oceans not included. So it is not just any "surface water temp."


2. "La Nina... increasing frequency", Wrong. La Nina and El Nino happen in cycles, each occur every 5-6 years on average.


3. "general global warming." If you mean "unprecedented, unequivocal warming", Wrong. Global warming-global cooling happen in cycles, natural climate cycles, with or without humanity's SUVs or bicycles. The medieval warm period, Roman warm period, Minoan warm period, produced a planet that was much warmer than the modern (or past century's) warm period.


4. "government action, in this regard, would have to be in the form of climate change-proofing the country." ????
Government, the UN, environmentalists, etc. can prevent or control less rain or no rain or more rain? They can control and fight less flood, no flood or more flood, that happen naturally in cycles since millions or even that past 4.6 billion years ago? weird.


A good reminder but many militant environmentalists and planet saviors oppose until now. From WUWT, Zika and Climate

"A good start to controlling mosquito borne diseases, might be to remove the pointless bureaucratic obstacles to spraying DDT, one of the most effective anti-mosquito chemicals ever developed.

Use of DDT was almost outlawed after vigorous scare campaigns by green groups, but this much maligned chemical is harmless to humans. Professor Kenneth Mellanby, who campaigned for the use of DDT in the 1940s, used to eat a substantial pinch of concentrated DDT as part of his demonstration. Mellanby did not suffer any health problems from his massive consumption of DDT – he died in 1993, at the age of 85 years." 

An economics study on malaria, Average Household Size and the Eradication of Malaria by  Lena Huldén, Ross McKitrick and Larry Huldén, Journal of the Royal Statistical Society Series A, October 2013. 

The paper's findings can apply to dengue, other mosquito-borne diseases. With 4 charts and 2 tables.

I can understand the "climate leaning" of studies from UP and many other colleges and universities. These are mostly USAID, UN, ADB, WHO-funded research projects and all of these institutions peddle the "man-made" CC only. Do not insist the natural or cyclical nature of CC, the "nature-made"CC, there is zero funding from these institutions. So peer-review process will be very limited.

I do not blame Oggie or many other UP economists. The mother of all corruption in the planet is the UN, at least on the climate and energy policies. The corruption and political science aka as UN climate science permeates down to all multilateral and foreign aid agencies, from the WB and IMF down to ADB and regional banks; from UNEP and FCCC to WHO, UNDP, etc.

Paano ba naman, sabihin nila, no nature-made CC, only man-made CC. No global cooling, only global warming. Since it is "man-made" problem, then there are lots of "man-made solutions", doon na papasok sila UN with their global ecological central planning.

Everything in this planet is about natural cycles: day-night cycle, wet-dry cycle, El Nino-La Nina cycle, winter-spring-summer-fall cycle, hydrologic cycle, carbon cycle, nitrogen cycle, solar cycle, lunar cycle,... Tapos walang climate cycle, only "unprecedented, unequivocal man-made warming", 100% political science na.
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See also:

Tuesday, December 04, 2012

Drug Innovation 7: IFPMA, Superbugs and Tropical Diseases

People's lifestyle and communities evolve and continuously change. Their expectations, patience or impatience for more modern lifestyle, including more modern treatment in case they get sick, also evolve and changes. That is how modern medical science, pharmaceutical R&D, diagnostic tests and other aspects of the healthcare industry evolve.

I am reposting below three nice articles by the Executive Director of the Pharmaceutical and Healthcare Association of the Philippines (PHAP), Mr. Reiner Gloor. These are about the role of drug innovation and how to better encourage it, not demonize it. These appeared in his weekly column in BusinessWorld.

Protecting intellectual property rights (IPR) like drug patents is an important policy measure by governments to encourage innovation. Policy reversals like promoting compulsory licensing (CL) and other variants of IPR confiscation can only discourage innovation. After spending 10 to 14 years in various clinical trials and drugs R&D, and some $1 B or more per candidate drug molecule, it is not wise for governments to simply coerce the innovator companies to give away those efforts to other companies which did not spend equal amount of time and money to develop more revolutionary and more disease-killer medicines.

I have argued it over and over in this blog and other papers, that the main function of government is to promulgate the rule of law, protect private property rights, and the citizens' liberty, freedom of expression and freedom from aggression by bullies. Protecting IPR is consistent with this government role.

The three papers are entitled "Impact of innovation", "Protecting innovation", and "Encouraging innovation". Enjoy reading.



(1) Impact of innovation




Posted on 05:03 PM, November 08, 2012

Medicine Cabinet -- Reiner W. Gloor



http://www.bworldonline.com/weekender/content.php?id=61108

THERE was a time when infectious diseases such as pneumonia, typhoid fever and tuberculosis ravaged people around the world with no medicines available to treat or prevent them.

Alexander Fleming’s discovery of penicillin and subsequent research yielded new antibiotics that continue to protect the people from simple to complex infections. Since the 1920s, scientists also had their eyes on prevention, management and even cure for non-communicable diseases. Now, thousands of medicines have been produced to treat or prevent diseases, thanks to pharmaceutical innovation.

During the biennial conference of the International Federation of Pharmaceutical Manufacturers and Associations (IFPMA) in Geneva last week, the global research-based medicines industry called for a shared commitment to promote global health through the promotion of further innovation.

These medical innovations, along with other health interventions, have, after all, helped in beating polio on a global scale, and prevented measles, mumps, rubella and other ailments.

IFPMA President Dr. John Lechleiter said that in the past decade alone, vaccines for measles, polio, and diphtheria-tentanus-pertusis have saved the lives of an estimated 21.2 million children under the age of five each year.

He added that between 2000 and 2006, immunization campaigns reduced the number of deaths caused by measles by 68% worldwide and 91% in Africa. Furthermore, immunizations provided to nearly 300 million children in 72 developing countries have saved over five million lives. Reports also showed that global infant mortality fell from 77 deaths per 1,000 births to 62 or a reduction of 20% between 2000 and 2009.

Innovations in medicine have also helped increase cancer survival rates, and dramatically reduce deaths due to HIV/AIDS.

Biopharmaceutical research is likewise being focused on non-communicable diseases such as cardiovascular diseases, diabetes, chronic respiratory diseases, and cancers that have grown to become the world’s biggest killers.

The biopharmaceutical sector has similarly invested heavily on understanding so-called rare diseases or those which affect fewer than 200,000 people. A deeper look at an individual’s genetic make-up is putting personalized medicine in the forefront of today’s innovation so that detection, treatment and prevention of the disease will be more tailored to the needs of each patient (For more information on personalized medicine, go to 
www.innovation.org.)

People are also living longer due to medical innovations. In illustrating this, a child born in 1955 had an average life expectancy at birth of only 48 years. In 2000, a child could expect to live 66 years. Life expectancy will increase to 73 years in 2025, it is said. Dr. Lechleiter commented that developing countries are seeing the most rapid gains.

Professor Frank Lichtenberg of Columbia University disclosed “new medicines accounted for 40% of the increase in life expectancy during the 1980s and 1990s in 52 developed and developing countries.”

Apart from the impact to life and health, biopharmaceutical innovations also resulted in economic gains by way of years of productive work, economic value added, consumer spending, and taxes paid.

No less than the World Health Organization (WHO) said that a nation needs a healthy population to achieve economic development. In fact, the 2001 report by the WHO Commission on Macroeconomics and Health stated that “health is a creator and pre-requisite of development.” It emphasized that increasing the coverage of health services and a small number of critical interventions to include the world’s poor could “save millions of lives, reduce poverty, spur economic development, and promote global security.”

The IFPMA Assembly also pointed out that there is strong evidence that innovative medicines are the most cost-effective part of health care. In another study, Mr. Lichtenberg found that for every $1 spent on new medicines for cardiovascular diseases in Organization for Economic Cooperation and Development (OECD) countries, close to $4 were saved in hospitalization and other healthcare costs.

More than economic gains are the social impact of medical innovations on patients who may be our children, siblings, parents and friends.

These days, a diagnosis of a disease does not necessarily mean an end to ties with families and friends.

These gains and the processes that these innovations go through must not be taken for granted. As Mr. Lechleiter said, we must build upon and not rest upon the contributions of the past. For despite our tremendous progress, much more remains to be done.

Saturday, November 05, 2011

IPR and Medicines 15: New Vaccines and Public Health

Preventive healthcare is oftentimes more effective than curative healthcare. Have healthy or at least non-abusive lifestyle, get certain vaccines against some known dangerous infectious diseases, while one is not yet sick.

I saw these news reports recently, they are giving hope to humanity who want early protection against certain communicable diseases.

Above news is about vaccine vs. malaria. I thought that there are already existing vaccines against this mosquito-born disease.

Lower news report is about the Patent Pool to discover new drugs against AIDS. These are voluntary schemes, no coercion like compulsory licensing is involved, to develop treatment for patients suffering from, or being exposed to, AIDS.

Here's another news from Partnership for Safe Medicines (PSM) where physician-researchers have tried the drug that they are developing yet on themselves. For these physicians to do this, they must have high confidence on the efficacy and safety of their new drug and vaccine.

News above is definitely good news for patients suffering from certain type/s of cancer, also the family members and friends of the cancer patient. I'm particularly keen on new drugs to curtail or kill cancer. My elder brother, my sister in law, two of our wedding Godmothers, my mother's two cousins, have all died of cancer. If someday, more powerful drugs will be invented against various types of cancer, I shall be even happier. People should live long and productive lives whenever possible, that is why keeping a healthy lifestyle is important.

New drugs against infection, or other anti-biotics treatment, should be another welcome news for many people around the world.

Finally, the much-awaited vaccine against dengue. It is expected to be commercially available by 2014. Some 2,000 Filipino children and 4,000 Thai children were among those who participated in the clinical tests and the results have been generally positive.

It is to be expected that the initial price will be high to allow the innovator company to recoup its high costs of developing the vaccine, compensate for failed or unsuccessful molecules and drugs that did not pass the stringent approval process. But with high volume procurement by both private and government agencies in many countries, evem the initial price can be further brought down. When other innovator companies will also commercially produce their own dengue vaccines, or when the patent by Sanofi will expire after a few years and generic drugs can be introduced and sold, the price should drastically go down, benefitting more patients from more provinces and countries.

I am hopeful that the populist belief that government coercive policies should be imposed against new drug innovation as often as possible, will soon taper off, if not die down. What the Philippines and other developing countries need, is less politics and more scientific discoveries, more competition among many players, in health and other sectors. Competition among innovator companies, competition among generic manufacturers, competition among drugstores and other healthcare providers.
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See also IPR and Medicines 14: Compulsory Licensing in developing countries, October 04, 2011.

Friday, October 14, 2011

Lifestyle Diseases 6: Personal Care against NCDs

One of my friends in facebook, Dr. Erwin Abueva, has been posting a HEALTH INFO series in his wall. I find them useful, tips for personal care against certain diseases, infectious and non-infectious alike. But since most diseases afflicting the people now are lifestyle-related or the non-communicable diseases (NCDs), these tips apply more to NCDs prevention.

* NSAID means non-steroidal anti-inflammatory drug

HEALTH INFO 1: Not all dengue fever patients should be admitted in the hospital. But hydration of patients with intravenous fluids is important in the management of dengue fever.

2. Not all patients who had head trauma require to undergo cranial CT scan. Some of the important considerations in deciding whether to have it done or not are (1) loss of consciousness, (2) vomiting episodes, (3) decrease in sensorium, (4) persistent headache and dizziness, (5) incoherence, (6) blood or clear fluids dripping from nose or ears, (7) convulsions...

3. NSAIDs should not be used for pains associated with Dengue, as these pain relievers may decrease further the ability of the blood to clot.

4. The most common type of headache is related to stress or tension headache. The second most common is migraine headache. Headache secondary to brain tumors is rare. So before thinking of Cranial CT scan, ask yourself many times if it is really necessary...

5. Antibiotics have no role in the management of flu or "trangkaso". Paracetamol for fever and pains, decongestants for clogged nose, and plenty of fluids will be ok for you...

6. If you're a known hypertensive, avoid not only fatty foods but also the salty ones.

7. If you're hypertensive and a cigarette smoker, you have 5x more risk of succumbing to stroke than your friends who are also smokers but with normal BP.

8. If you're blood type is "O" and your wife's blood type is "B", your child's blood type must be either "O" or "B". If its "A", that child is not your offspring (napaltan sa ospital) or that child's father is not you (napindeho ka)!

9. One NSAID advertisement has its tagline "relieves ALL kinds of pain". It is not true and is MISLEADING! For NSAIDs (mefenamic acid, naproxen, ibuprofen, --coxibs, aspirin, meloxicam, diclofenac, etc.) are not used for abdominal pains in general. Instead of relieving, it will worsen the stomach ache and may cause gastritis and GI ulcers.

10. We all have tonsils normally. If your tonsils got inflammed, mostly due to infection, you're likely to experience sorethroat, pain upon swallowing, and usually fever. That is TONSILLITIS. So if you have sorethroat, better say "May tonsillitis yata ako", NOT "may tonsils yata ako"!

11. Inadequate calcium in the body can lead to osteoporosis. So intake of calcium-rich foods such as milk, sardines, cheese, yogurt, soybeans and its products is encouraged. But remember to also have Vitamin D rich diet (egg yolks, saltwater fishes, liver, milk) since calcium is poorly absorbed by our body if without enough Vitamin D.

12. As per guidelines, if you are bitten by a dog or cat, have yourself injected with anti-rabies vaccines immediately. Even if you know that those animals had been vaccinated against rabies, you should still go to a physician for proper advice and management. And DON'T forget to ask for anti-tetanus shots also!

13. No need to have antirabies vaccination if you're bitten by a rat. Only anti-tetanus and antibiotics for your protection.

14. There are many causes of hypertension. It may be due to stress, pain, fatty and high cholesterol diet, kidney disease, other metabolic problems, and many more. But the most common type of hypertension, affecting about more than 90% of hypertensive individuals, has no known clear cause. It tends to be familial and hereditary. That is also called "ESSENTIAL HYPERTENSION". So don't wonder much if your BP is still high even if you're practicing right diet and exercises. Maybe what you have is the "essential" type.

* Hindi mo kasalanan na mahirap ka. Ang kasalanan mo e tamad ka.
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A related note I wrote nearly two years ago:

Health is a Right, Health is Personal Responsibility

(This is my article for "Brigada News", a Pasay city-based tabloid, last February 19, 2010)

The concept of “Health is a basic human right” is popularly supported by many people. Both for its emotional appeal and for some international agreements, like the International Covenant on Economic, Social and Cultural Rights.

A sub-set or sub-topic then are the formulations, “Access to medicines is a basic right”, “Access to hospitals and healthcare is a basic right”, and so on.

Thus, others would extend them further and say, “Education is a basic human right”, “Decent housing is a basic human right”, “Cheap and abundant food is a basic human right”, and so on.

The term “right” implies and connotes entitlement. That is, regardless of the circumstances why one person or household or community has/have become sickly, they should be entitled to decent healthcare to be provided at a low cost if not free by the government, local or national.

This can be a big source of public debate between those who demand entitlement and those who question it. For the latter, for every “right” there is a concomitant “responsibility.” Thus, while people can demand that health care is their basic right, they are also expected to assume certain responsibilities about their bodies and their lifestyles

I personally believe that healthcare is first and foremost, a personal and parental responsibility. People should not over-drink, over-smoke, over-eat, over-fight, over-sit in sedentary lifestyle. People should not live in dirty places and should observe basic personal hygiene like washing hands carefully before eating.

Health inequity results not just because of income and social inequity, but also because of people’s unequal inputs in taking care of their body. A person may be poor but if he does not over-drink and over-smoke and observe personal hygiene in his daily life, he will have a better health outcome than a rich person who over-drinks, over-smokes, over-eats and over-sits. The former, even without a private health insurance, all other things being equal, will less likely develop lifestyle-related diseases like hypertension, high cholesterol and obesity.

These topics are timely as the drug price control policy of the government is now more than six months old, and there is no formal assessment made by the Department of Health yet, on whether it has achieved its goal or not – to make essential but deemed expensive medicines become more affordable to the poor.

In the absence of such formal study and assessment by the DOH, some sectors and industry players – drugstore operators, pharma companies, some NGO leaders – have already produced their own findings: the answer is No. The policy, supposed to help the poor, did not benefit the poor.

The main reason is that there was a relatively healthy competition among pharma companies in the country already, among innovator companies and among generic producers. So while the rich and middle class were looking at a branded amlodipine, for instance, at P44 per tablet, there were cheap amlodipine generics already, sold as low as P8 per tablet. When price control was imposed, the P44 became P22. But the poor did not buy the P22 a tablet, because it is still high compared to what they are buying at P8 a tablet. So the poor did not benefit, the rich and middle class did.

Instead of forcing private companies to give the discounts, the government should force itself to procure essential medicines at no-corruption price and dispense these for free to the really poor, especially children of poor households who have been exposed to dirty environment for several years, who now have weaker lungs and other internal organs. This is where government can possibly put its limited resources – giving essential medicines for free to these patients.

The best form of healthcare is preventive, not curative. People should not abuse their body simply because alcohol, tobacco and fatty foods are more available and more affordable compared to several decades ago. But should they abuse their body, then they should suffer some consequences later.

Meanwhile, the damage to the country’s investment environment as a result of no-time table drug price control policy should be big by now. Many revolutionary drugs, new disease-killer drugs that are available in other countries around the world, may no longer be introduced and sold in the Philippines. The most adversely affected then will be the poor and some middle class patients. The rich, the politicians and government administrators who pushed the price confiscation policy, will have the means and network to buy such drugs from abroad.

That is one example of the “law of unintended consequences.”
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See also
Part 5: NCDs Global Picture, September 30, 2011, and
Part 4: The UN on NCDs, September 25, 2011.