💉 Malaria resurgent once again; Dengue climbs upward too; If four of your friends don't have genital herpes, you do
#546 | 2024 is super-super-hot; Making drug discovery faster in Africa; Don't breathe Indian air
Hello, and welcome back to The Kable this most auspicious of Fridays. Before we move on to the news, just a quick reminder that next week's issue will be our last one for the year before we head into our annual break.
And with that out of the way, on with the news, where many a mystery will hopefully be unfolded. Except the one of the mystery disease in Democratic Republic of Congo (DRC) that first came to light last week. The illness hasn't been diagnosed yet. However, in what should be no surprise to anybody, the WHO says children and malnourished people are more at risk. The agency is also sending experts to the epicentre of the outbreak to help with relief measures and also try and ascertain the cause of this so-far-unexplained illness. Also sending in experts on an investigatory mission is the Africa CDC. Rapid tests at the outbreak site found many positive malaria cases. However, samples taken for testing last week were not usable. Elsewhere, in Italy, reports indicate that a person who travelled from DRC last month was hospitalised with similar symptoms and was treated successfully. Samples from that person are still being tested. The one grouse we have around this whole situation is that this illness, for want of a diagnosis so far, has been dubbed Disease X, and we have missed any word from CEPI, which has otherwise spoken so much about Disease X in times past.
In good news from Africa, Senegal and Rwanda have become the newest countries to achieve WHO Maturity Level 3 in medicines regulation, bringing the total count of African countries at this level to 8.
In more encouraging developments, the Africa CDC has listed its priorities to enhance access to diagnostics for epidemic-prone diseases across Africa. The initial focus is on mpox, dengue, cholera, bacterial meningitis, and measles.
In what has been a relentlessly busy week for the WHO, the agency sought expressions of interest from institutions to join its global network of Regional Biomanufacturing Training Centers under the WHO Biomanufacturing Workforce Training Initiative. These facilities will provide comprehensive training in biomanufacturing, prioritizing workforce development in low- and middle-income countries (LMICs) through hands-on courses, innovative learning methods, and collaboration with universities and biotech companies while operating independently and ensuring financial sustainability. The WHO also expanded its partnership with the Global Health Innovative Technology (GHIT) Fund to improve access to drugs, vaccines, and diagnostics for neglected tropical diseases (NTDs). The agreement focuses on four key areas: advancing research and development, mobilising resources, raising awareness, and engaging GHIT in WHO-led NTD initiatives as observers. The WHO also approved a new packaging and shipping site in Nigeria for the WHO-prequalified STANDARD Q HIV 1/2 Ab 3-Line Test, developed by SD Biosensor. This is quite the milestone in advancing regional production of HIV diagnostics in Africa. And in the last bit of WHO news in this section, the agency unveiled a new report outlining government spending around the world on health, and it makes for distressing reading.
In the US, kiss-the-ring season is in full swing, and Big Pharma has officially joined the celebrations with bigwigs from Pfizer, Eli Lilly and PhRMA cosying up to The Orange One.
Also in the US, bird flu. In a, well, positive development, officials have issued orders mandating nationwide testing of milk for bird flu. Not that it is doing much to deter raw milk contrarians from thulping down raw milk by the gallonful... and falling ill.
And finally, in extraordinarily good news, a giant new study says drinking coffee can give you nearly two more years of life. And everybody knows coffee tastes best black.
Stories Of The Week
The return of the mosquito. Malaria cases surged by 11 million in 2023 compared to 2022, reaching an estimated 263 million, with 597,000 deaths - most among African children under five - highlighting stalled progress against the disease, according to a WHO report. While malaria cases and deaths fell significantly from 2000 to 2015, progress has since reversed, with mortality spiking during the (ongoing) pandemic. Case numbers now exceed 60 per 1,000 people at risk, nearly three times the WHO target, and deaths remain double the goal. Despite the promise of new tools like vaccines and next-generation bed nets, challenges such as climate change, resistance, funding shortfalls, and conflict hamper progress, with only $4 billion available in 2023 against the $8.3 billion needed. But we're sure, absolutely certain, that 2024 numbers will be different.
(WHO)
In more ways than one. Because if it is malaria elsewhere, in the Americas, mosquitoes are making dengue prosper. Dengue cases in the region have surged to a record-breaking 12.6 million this year, with over 21,000 severe cases and 7,700 deaths, making it the largest outbreak since tracking began in 1980, according to PAHO. Brazil, Argentina, Colombia, and Mexico have been hit hardest, accounting for 90% of cases and 88% of deaths, while children remain particularly vulnerable, with 70% of dengue-related deaths in Guatemala and a third of severe cases in Mexico, Costa Rica, and Paraguay involving those under 15. PAHO attributes this alarming rise to climate events, poor waste management, and stagnant water, all of which facilitate mosquito breeding, highlighting the urgent need for more substantial mitigation efforts in a region where dengue continues to thrive.
(PAHO)
One out of five adults... has a gift that keeps on giving. What gift, you ask? Genital herpes. According to new estimates, genital herpes has been confirmed as the most common incurable sexually transmitted infection (STI) worldwide, affecting nearly 900 million people as of 2020. This represents approximately 24% of individuals under 50, with 520 million cases attributed to herpes simplex virus type 2 (HSV-2) and 376 million linked to HSV-1, traditionally associated with cold sores but increasingly causing genital infections through sexual transmission. Unlike chlamydia, which is treatable, herpes remains lifelong, with periodic flare-ups affecting over 200 million people annually. Despite its significant global health burden - including increased risks for HIV transmission and potential neurological complications - progress in prevention and treatment remains limited due to stigma and underinvestment.
(WHO)
Breakthroughs
New diseases, new drugs. In a groundbreaking development, researchers at Rockefeller University's Tuschl lab have identified a novel antiviral approach targeting methyltransferase enzymes, essential for the survival of many RNA and DNA viruses, including SARS-CoV-2, Ebola, and dengue. Unlike existing drugs like Paxlovid that inhibit proteases, this new method disrupts viral RNA caps, a key mechanism viruses use to evade immune defenses. Early tests of their compound in mice show it to be as effective as Paxlovid, with the added benefit of reducing the likelihood of drug resistance. While not yet ready for human trials, this innovation holds promise for combating a wide range of pathogens and enhancing pandemic preparedness.
(Nature)
Bottom line
Climate change: dengue's hype man. A new study reveals that nearly one-fifth of dengue cases in Latin America and the Caribbean - about 45 million infections annually - can be attributed to climate change. Rising temperatures, urbanisation, and deforestation have created optimal conditions for dengue-transmitting mosquitoes, leading to record-breaking outbreaks in recent years. Researchers also predicted a 61% increase in dengue cases by 2050 under high-emission scenarios, with cooler regions like parts of Mexico, Brazil, and Peru facing the sharpest rises.
(ASTMH)
Can you feel the heat? This year, in case you still had any apprehensions, is set to be the hottest on record, surpassing 2023, with global temperatures averaging over 1.5°C above pre-industrial levels for the first time, according to the EU's Copernicus Climate Change Service. Extreme weather in 2024 has included devastating heatwaves, floods, droughts, and cyclones, all tied to human-caused climate change. Despite global pledges to cut emissions, CO2 levels are set to hit a record high, driving the long-term warming trend. While a potential La Niña in 2025 could temporarily cool temperatures, scientists warn that dangerous climate impacts, such as heatwaves and wildfires, will persist without significant action to reduce emissions. And the UK Met Office chimed in to say that while La Niña might see global temperatures fall back below 1.5°C, the effect won't last for long.
(Copernicus, Met Office)
How clean is my air? In India, not so much. Air pollution isn’t just a seasonal issue; it’s a year-round health crisis across India. A study published in The Lancet: Planetary Health revealed that annual exposure to PM2.5 - fine particles from sources like crop burning, traffic, and industry - contributes to over 1.5 million deaths annually in India. Even districts with pollution levels below national standards face increased mortality risks, highlighting the urgent need for stricter regulations.
(The Lancet Planetary Health)
Long reads
A key for Africa. Ghana's president writes in Project Syndicate on how Africa can actually achieve vaccine independence.
(Project Syndicate)
Gaslighting Pro Max. Bio Pharma Dive writes about the long road for new treatments for endometriosis, that most prolific of diseases to affect women, one that has often resulted in them being labelled hysterical by the larger medical fraternity.
(Bio Pharma Dive)
Make in Africa. A brilliant tete-a-tete in Health Policy Watch detailing the origins and ambitions of Africa's home-grown drug discovery research network.
(Health Policy Watch)
Oh, and Gopal Nair doesn't want you to see this.