EU launches universal flu
vaccine research project
A newly launched European project is set
to take a major step towards the development
of a universal flu vaccine. It aims to
counter the emergence of new strains and
The viral infection usually strikes in
colder months with seasonal influenza
being responsible for around 3 - 5 million
cases of severe illness and 250,000 to
500,000 deaths worldwide.
Due to its rapid spread, particularly
among high-risk population groups, influenza
remains a serious public health
problem. To date, the most effective way
to prevent the disease or severe symptoms
is annual vaccination, but current vaccines
only offer limited protection against
evolving strains of the infection.
To overcome these weaknesses, a publicprivate
partnership comprising seven renowned
organisations from Europe joined
forces under the EDUFLUVAC project
to develop a broad-spectrum, long-lasting
vaccine. EDUFLUVAC aims to take a
novel approach by ‘educating’ the immune
system to cross-recognise common regions
within multiple influenza virus strains.
“Developing a universal flu vaccine has
become a global health priority for preventing
the spread of the virus and the
emergence of new strains, and we are convinced
that EDUFLUVAC will be a major
step towards achieving this goal,” says Othmar Engelhardt, principal
at the National Institute for Biological
Standards and Control, United Kingdom.
The research team expects to achieve
better protection against epidemic
influenza through the development
of a vaccine that
would not only offer the
advantage of eliminating
the need for a seasonal
vaccine every year, but
could also reduce the
need for costly annual vaccination
Odile Leroy, Executive Director
of the European Vaccine
Initiative and co-ordinator of
EDUFLUVAC, says: “Low and middleincome
countries currently have minimal
influenza vaccination programmes.
Thus, the development of a vaccine that
elicits broad long-lasting defence would
facilitate vaccination campaigns and
confer protection against influenza in
hitherto untargeted groups with limited
The four-year project is co-ordinated
by the European Vaccine Initiative headquartered
in Germany and was awarded a
grant of EUR 4.6 million in EU funding.
Pneumonia – the single biggest
cause of child mortality
Pneumonia remains the single biggest killer
of children under five globally, claiming
the lives of more than one million children
To celebrate World Pneumonia Day on
12 November, the GAVI Alliance, UNICEF
and the World Health Organization
(WHO) launched an “Innovate to End
Child Pneumonia” campaign to highlight
essential actions to help end child deaths
from this entirely preventable disease.
“Tackling pneumonia doesn’t necessarily
need complicated solutions,” said Dr
Mickey Chopra, Chief of Health, UNICEF,
proposing five simple but effective
interventions, which will help reduce the
burden of the disease that is responsible for
almost one-fifth of all child deaths around
the world, if implemented properly. These are:
- Exclusive breastfeeding for six months
and continued breastfeeding complemented
by nutritious solid foods up to age 2;
- Vaccination against whooping cough
(pertussis), measles, Haemophilus influenzae
type b (Hib) and pneumococcus;
- Safe drinking water, sanitation and handwashing facilities; Improved cooking
stoves to reduce indoor air pollution;
- Treatment, including amoxicillin dispersible
tablets and oxygen;
Recognizing that child mortality cannot
be addressed in a vacuum, but only through
integrated efforts, in April 2013, WHO and
UNICEF released an Integrated Global Action
Plan for the Prevention and Control of
Pneumonia and Diarrhoea (GAPPD).
The GAPPD presents an innovative
framework bringing together prevention,
protection and control of both pneumonia
and diarrhoea – two of the world’s
leading killers of children under 5 – to
make more efficient and effective use of
scarce health resources.
To mark 5th World Pneumonia Day,
Mauritania and Papua New Guinea introduced
the pneumococcal vaccine, which
protects against one of the leading causes
of pneumonia. With support from the
GAVI Alliance, more than 50 countries
will introduce this vaccine by 2015.
“The GAVI Alliance is helping to accelerate
the fight against pneumonia by
increasing access to pneumococcal vaccines,
thanks to GAVI’s innovative Advance
Market Commitment (AMC), but
also to the five-in-one pentavalent vaccine
which protects against Haemophilus influenzae
type b, another major cause of pneumonia,”
says Dr Seth Berkley, CEO of the
Since the launch of the GAPPD seven
months ago, several countries have taken
this forward. For example, Bangladesh and
Zambia are translating the GAPPD into
local implementation plans in some districts.
Program managers responsible for
immunisation, child health, nutrition and
water and sanitation have joined forces to
accelerate progress and eliminate preventable
deaths from pneumonia and diarrhoea.
In addition, in October 2013, the WHOupdated
guidelines on the treatment of
pneumonia, recommending simpler antibiotic
regimens, and published a handbook on
how to introduce the pneumococcal vaccine
for staff, in line with the GAPPD.
“To achieve the vision and goals of the
integrated plan – to end preventable deaths
from pneumonia and diarrhoea in the next
generation – the children of the world need
to see political will, co-ordinated efforts, and
increased resources at the global and national
levels to fight these stubborn killers,” says
Dr Elizabeth Mason, Director of WHO’s Department
of Maternal, Newborn, Child and
Cancer tumour analysis to be digitized
Philips has announced that it is collaborating
with Institut Curie, in order to digitize
tumour analysis research, with the aim of
speeding up and improving cancer diagnosis
While pathologists today view tissue
sample images manually using a microscope,
by using Philips Digital Pathology
Solution, Institut Curie hopes to increase
workflow efficiency and consolidate its pathology
activities at multiple sites into one
single virtual laboratory.
In addition to the diagnosis of tissue
from patients with cancer indications, the
pathology department at Institut Curie
evaluates thousands of test samples from
experimental cancer research programmes
worldwide to gain a better understanding
of the causes and mechanisms of diseases
at both cellular and molecular level.
new insights may give rise to new diagnostic
approaches and therapeutic treatments.
Currently, Institut Curie produces and
diagnoses more than 200,000 glass pathology
slides every year using a microscope.
Digitization of the pathology workflow
could ease this logistical burden and enable
new ways of working, such as real-time collaboration
with peers and creation of a virtual
network across the globe. Moreover,
in cancer research, digital histopathology
information can now, for example, be added
to biology data and this opens up new
ways to mine information from tumour tissue for further data analysis.
“Digitization of pathology will enable us
to keep momentum going to accelerate cancer
research and, in the end, improve patient
care,” says Xavier Sastre-Garau, director of the
Biopathology Department of Institut Curie.
“Philips’ digital pathology solution is empowering
Institut Curie to realize a single virtual
laboratory that offers new opportunities
for intensive collaboration,” says Guido du
Pree, vice-president of Marketing & Sales for
Philips Digital Pathology Solutions.
To support its cancer research, Insitut
Curie has completed installation of the fully
integrated Philips Digital Pathology Solution
with ultra-fast scanners at its locations
in Paris and St. Cloud, which are connected
on-line through an image management system
that provides an interface to communicate
with commercially available Laboratory
Information Systems (LIS).
Developing world faces
breast cancer surge
Rising breast cancer incidence and mortality
represent a significant and growing
threat for the developing world, according
to a new global study commissioned
by GE Healthcare.
Report co-author Bengt J?nsson, Professor
in Health Economics at the Stockholm
School of Economics, explained: “Breast
cancer is on the rise across developing nations,
mainly due to the increase in life
expectancy and lifestyle changes such as
women having fewer children, as well as
hormonal intervention such as post-menopausal
hormonal therapy. In these regions,
mortality rates are compounded by the later
stage at which the disease is diagnosed, as
well as limited access to treatment, presenting
a ‘ticking time bomb’ which health systems
and policymakers in these countries
need to work hard to defuse.”
The report on “the prevention, early
detection and economic burden of breast
cancer” suggests that consumer understanding
about breast cancer and screening
methods is putting lives at risk in the
developing world. For example, a recent
survey in Mexico City indicated many
women feel uncomfortable or worried about having a mammogram.
“It is of great concern that women in
newly industrialized countries are reluctant
to get checked out until it is too late.
This is why GE is working with a number
of governments and health ministries in
these regions to expand access to screening
and improve consumer awareness. Some
of these initiatives are making excellent
progress,” said Claire Goodliffe, Global
Oncology Director for GE Healthcare.
The study draws some interesting conclusions
about the impact of breast cancer
on sufferers’ lives.
According to the most
recent published data, 15 million years of
‘healthy life’ were lost worldwide in 2008
due to women dying early or being ill with
the disease. ‘Healthy life lost’ is defined
by years lost due to premature death and
incapacitation due to the effects of breast
cancer. Women in Africa, China and the
USA lost the most years of healthy life.
Furthermore, of the 15 million years lost
globally, more than three times as many
years were lost due to dying than being
ill with the disease. For women in Africa,
Russia, Mexico, Turkey and Saudi Arabia,
the number of healthy years lost due to
death were up to seven times greater than
elsewhere in the world.
Jonsson said: “The report findings suggest
that a worryingly high proportion of women
are still dying from breast cancer across the
world and this seems to correlate strongly
with access to breast screening programmes
and expenditure on healthcare.”
He highlighted the distinct lack of accurate
and current data in areas like breast
cancer incidence and mortality, the economic
burden of the disease, and detailed
patient-linked data on outcomes in relation
to treatment patterns and stage of diagnosis.
“This limits analyses of how changes
in clinical practice affect patient outcomes
and needs to be addressed,” he said.
As breast cancer incidence rates have
steadily increased in developed countries
over the last 50 years, it is no surprise that
the main focus of treatment has been survival.
However, as more women are now living
with the disease, the report suggests that
quality of life is becoming a growing issue as survival rates improve. As a
are urged to focus on measuring the impact of
diagnosis and treatment on survivors’ quality
of life to identify what problems patients may
have and how these can be mitigated.
Goodliffe said: “This report finds a direct
link between survival rates in countries and
the stage at which breast cancer is diagnosed.
It provides further evidence of the need for
early detection and treatment which we
welcome, given current controversies about
the relative harms, benefits and cost-effectiveness
of breast cancer screening.”
EU funds new research for strategies
to prevent neurodegenerative diseases
The EU Joint Programme - Neurodegenerative
Disease Research (JPND) - is
launching two calls for proposals aimed at
encouraging research teams across Europe
to investigate the cross-disease pathways
in neurodegenerative diseases such as Alzheimer’s
and Parkinson’s, and to identify
new, innovative preventative strategies for
these debilitating conditions.
“Neurodegenerative Diseases such as
Alzheimer’s and Parkinson’s are a global
health, economic and social emergency
with numbers affected expected to double by
2030 and more than triple by 2050,” according
to Professor Philippe Amouyel, Chair of
the JPND Management Board. “With this
in mind, JPND-participating countries have
identified two further areas of greatest need
for targeted investment in order to improve
understanding of the underlying links between
different diseases, and to encourage
new ideas on preventative strategies.”
Professor Amouyel added: “This investment
is part of a series of JPND funding
initiatives, aimed at addressing priority
areas identified in our European Research
Strategy. This year’s calls will see over 23
million euro made available to applicants
from 18 different countries.”
According to Professor Thomas Gasser,
University of Tübingen and Chair of the
JPND Scientific Advisory Board, “Neurodegenerative
diseases currently cannot
be cured, prevented, or even substantially
In order to tackle these diseases
together, we need greater thinking across
traditional clinical boundaries and new, innovative ideas aimed at preventing
development and progression in healthy,
at-risk and early-stage populations. These
calls aim to harness the necessary expertise
across Europe and globally to address these
needs in the fight against these diseases.”
The following neurodegenerative diseases
are included for both calls:
l Alzheimer’s disease and other dementias
l Parkinson’s disease and PD?related
l Prion disease
l Motor neurone diseases
l Huntington’s disease
l Spinocerebellar ataxia (SCA)
l Spinal muscular atrophy (SMA)
New HIV strain leads to
faster AIDS development
A recently discovered HIV strain leads to significantly
faster development of AIDS than
currently prevalent forms, according to new
research from Lund University in Sweden.
The period from infection to the development
of AIDS was the shortest reported
among HIV-1 types, at around five years.
There are over 60 different epidemic
strains of HIV-1 in the world, and geographic
regions are often dominated by
one or two of these. If a person becomes
infected with two different strains, they
can fuse and a recombined form can occur.
“Recombinants seem to be more vigorous
and more aggressive than the strains from
which they developed”, explained Angelica
Palm, a doctoral student at Lund University.
The recombinant studied is called
A3/02 and is a cross between the two most
common strains in Guinea-Bissau, West
Africa - 02AG and A3. It has previously
been described by Joakim Esbjörnsson, a
post-doctoral fellow at the University of
Oxford, who is a co-author of the study.
So far, the new strain has only been
identified in West Africa, but other studies
have shown that the global spread of different
recombinants is increasing.
In countries and regions with high levels of
such as the US and Europe, the
trend is towards an increasingly mixed and
complex HIV flora, unlike in the beginning
of the epidemic when a small number
of non-recombinant variants of the virus
There is, therefore, reason to
be wary of HIV recombinants in general.
“HIV is an extremely dynamic and variable
virus. New subtypes and recombinant
forms of HIV-1 have been introduced to
our part of the world, and it is highly likely
that there are a large number of circulating
recombinants of which we know little
or nothing. We therefore need to be aware
of how the HIV-1 epidemic changes over
time”, said Patrik Medstrand, Professor of
Clinical Virology at Lund University.
The research is based on a unique longterm
follow-up of HIV-infected individuals
in Guinea-Bissau, a project run by Lund
University. In future research, Angelica
Palm and her colleagues hope to be able
to continue researching the characteristics
of recombinant viruses and the presence of
these among HIV carriers in Europe.
For health services, the new research results
mean a need to be aware that certain
HIV-1 types can be more aggressive than
others, according to the research team.
Frost & Sullivan issues predictions
for global healthcare market
Frost & Sullivan has released its three big
predictions for the global healthcare market
for 2014 and beyond: mHealth, Cloud in
Healthcare and Regulatory Environments.
“Insights from a ‘2013 Search for
Growth’ survey which involved 1835 executives
in more than 40 countries worldwide
has also been essential in unveiling
the business outlook for Pharmaceuticals,
Biotechnology, Clinical Diagnostics and
Medical Devices, as well as to provide a
global perspective on the industry’s geographical
hot spots,” explains Frost & Sullivan
Partner, Dorman Followwill.
mHealth expansion has been fuelled by an
unprecedented spread of mobile technologies,
as well as advancements in their innovative
application to address health priorities.
It is largely supported by mobile phones,
patient monitoring devices, personal digital assistants (PDAs) and other
The penetration prospects of mHealth
technologies are significant in the following
areas: wireless vital signs monitoring, location-
aware telemonitoring systems and Bluetooth
wireless technology-enabled health
It is an exciting area of opportunity
for healthcare growth and will provide innovative
solutions for healthcare providers and
patients alike, across the board.
In addition, as more healthcare IT and patient
monitoring tools are integrated, every
hospital facility will eventually have to acquire
a full-enterprise wireless solution.
most innovative mobile healthcare solutions
that best meet pressing healthcare needs will
be adopted as the gold standard.
Enterprise-wide healthcare informatics
will also improve the quality of medical
services and efficiency of operations while
reducing expenditure. Implementing cloud
computing technologies appropriately will
help healthcare providers improve the
quality of medical services and the efficiency
of operations, share information worldwide
and manage budgets.
can be applied in a variety of ways, including
data storage and data loss prevention,
maintaining patient information records
and authorized sharing of information.
As for Regulatory Environment, recent
healthcare reforms and policy initiatives in
many countries have emphasised the importance
of quality of care over quantity. In the
absence of sufficient proof of clinical benefit,
reimbursements may pose a major hurdle.
Overall, three big predictions may be
formulated based on the survey’s results:
– As healthcare is geared towards a personalized
medicine model, companion diagnostics
will alter drug development and
the commercialization process of drug candidates.
Combining biomarkers and drugs
will make for safer, more efficient therapy.
– The healthcare and life sciences industry
will consolidate further in this decade,
with many big pharma companies seeking
alternatives to the blockbuster model.
– The rise of new technologies capable
of integrating medical devices into a connected
platform will improve function of
devices, reduce the manpower burden and
World lung organisations call
for better lung health policies
Experts from the world’s leading lung organizations
have come together for the
first time to call for a worldwide effort to
improve healthcare policies and systems
to make a positive difference for the lung
health of the world.
Produced by the Forum of International
Respiratory Societies (FIRS), the report was
launched on 20 November, COPD (Chronic
Obstructive Lung Disease) Day. Entitled
Respiratory Diseases in the World: Realities
of Today – Opportunities for Tomorrow, the
report features five major disease areas that
are of immediate and greatest concern, including
COPD, which is the fourth-leading
cause of death worldwide.
“This report aims to heighten awareness
of lung disease throughout the world. We
hope that this collaboration will help to shed
light on the pervasiveness of these conditions
and diseases and will be a call to action for
health-care professionals, policy makers, patients,
and advocates,” said Michael H. Baumann,
MD, MS, FCCP, President, American
College of Chest Physicians.
Some of the key issues highlighted in
this publication include the following:
l COPD affects more than 200 million
people and is the fourth-leading cause of
death in the world.
l Asthma affects about 235 million
people worldwide, is one of the most frequent
reasons for hospital admissions
among children, and leads to approximately
180 000 deaths each year.
l Respiratory infections account for
over 4 million deaths annually, disproportionately
in children, and are the leading
cause of death in low-income or middleincome
l TB kills around 1.4 million people with
about 8.7 million new cases of TB annually.
l Lung cancer is the most commonly
diagnosed cancer in the world, accounting for 13% of the total reported cancers
affecting over 1.6 million people annually.
Tapping into spinal cord injury
As many as 500,000 people suffer a spinal
cord injury each year, and are two to five
times more likely to die prematurely, with
worse survival rates in low- and middleincome
countries, according to the WHO.
A new WHO report, International Perspectives
on Spinal Cord Injuries, summarizes
the best available evidence on the causes,
prevention, care and lived experience of
people with spinal cord injury.
Males are most at risk of spinal cord injury
between the ages of 20-29 years and
70 years and older, while females are most
at risk between the ages of 15-19 years and
60 years and older. Studies report male to
female ratios of at least 2:1 among adults.
Up to 90% of spinal cord injury cases
are due to traumatic causes like road traffic
crashes, falls and violence. Variations exist
across regions. For example, road traffic
crashes are the main contributor to spinal
cord injury in the African Region (nearly
70% of cases) and the Western Pacific Region
(55% of cases) and falls the leading
cause in the South-East Asia and Eastern
Mediterranean Regions (40% of cases).
Non-traumatic spinal cord injury results
from conditions such as tumours, spina
bifida, and tuberculosis. A third of nontraumatic
spinal cord injury is linked to
tuberculosis in sub-Saharan Africa.
Most people with spinal cord injury experience
chronic pain, and an estimated
20-30% show clinically significant signs of
People with spinal cord injury
also risk developing secondary conditions
that can be debilitating and even lifethreatening,
such as deep vein thrombosis,
urinary tract infections, pressure ulcers and
Spinal cord injury is associated with lower
rates of school enrolment and economic participation.
Children with spinal cord injury
are less likely than their peers to start school,
and once enrolled, less likely to advance.
Adults with spinal cord injury face similar
barriers to socio-economic participation,
with a global unemployment rate of more
than 60%. Spinal cord injury carries substantial individual and societal costs.
Many of the consequences associated
with spinal cord injury do not result from
the condition itself, but from inadequate
medical care and rehabilitation services,
and from barriers in the physical, social and
policy environments that exclude people
with spinal cord injury from participation.
Full Implementation of the Convention
on the Rights of Persons with Disabilities is
urgently required to address these barriers.
“Spinal cord injury is a medically complex
and life-disrupting condition,” notes
Dr Etienne Krug, Director of the Department
of Violence and Injury Prevention
and Disability, WHO. “However, spinal
cord injury is preventable, survivable, and
need not preclude good health and social
Essential measures for improving the survival,
health and participation of people
with spinal cord injury include:
l Timely, appropriate pre-hospital management:
quick recognition of suspected
spinal cord injury, rapid evaluation and
initiation of injury management, including
immobilization of the spine.
l Acute care appropriate to the level
and severity of injury, degree of instability
and presence of neural compression.
l Access to ongoing health care, health
education and products such as catheters
to reduce risk of secondary conditions and
improve quality of life.
l Access to skilled rehabilitation and
mental health services to maximize functioning,
independence, overall well-being
and community integration.
l Access to appropriate assistive devices
that can enable people to perform
everyday activities, reducing functional
limitations and dependency.
l Specialized knowledge and skills
among providers of medical care and rehabilitation
Essential measures to secure the right to
education and economic participation include
legislation, policy and programmes
l Physically accessible homes, schools,
workplaces, hospitals and transportation.
l Inclusive education.
l Elimination of discrimination in employment and educational settings.
l Vocational rehabilitation to optimize
the chance of employment.
l Micro-finance and other forms of
self-employment benefits to support alternative
forms of economic self-sufficiency.
l Access to social support payments
that do not act as disincentives to return
l Correct understanding of spinal cord
injury and positive attitudes towards people
living with it.
International Perspectives on
Spinal Cord Injuries
New resource expands
access to family planning
A new resource for health program managers
and policy makers released recently
aims to improve access to family planning
for women after childbirth and during the
first 12 months of motherhood.
Closely spaced and unintended pregnancies
are a health risk to both mother
and child: spacing pregnancies at least two
years apart can avert 10% of infant deaths
and about one out of five deaths in children
aged 1 to 4.
Launched in Addis Ababa, the ‘International
Conference on Family Planning for
Postpartum Family Planning Full Access,
Full Choice’ provides interventions at all
levels of health care to expand access to
scientifically-sound family planning methods
for new mothers.
The plan identifies three critical areas
of work for countries to ensure successful
implementation of the strategies:
l Close tracking of post-partum contraceptive
use to ensure a steady supply and
distribution of contraceptives;
l High quality, easy-to-understand informational
materials about family planning
options to help women and families
make informed choices; and
l Health worker training of recommended
practices so services are consistent
with global standards of care.
Programming Strategies is being
launched by the World Health Organization (WHO), the US Agency for International
Development (USAID) and
its implementing partner, the Maternal
and Child Health Integrated Program
“Virtually all women who have just had
a baby are not ready to have another one
right away; but too often they don’t have
access to family planning,” says Dr Marleen
Temmerman, director of the Department
of Reproductive Health and Research at
“Many women are not even aware
that they can become pregnant within 12
months of giving birth.”
Demographic and Health Survey
(DHS) data from 27 developing countries
show that 95% of post-partum women
want to avoid a pregnancy for at least two
years, yet 65% do not use contraception.
In Ethiopia, a similar analysis shows 81%
of post-partum women are not using any
“There are many obvious, although often
missed, opportunities to inform postpartum
women on their options for healthy
birth spacing and offer them an effective
method of contraception,” said Patricia
MacDonald, Senior Technical Advisor,
Office of Population and Reproductive
“Antenatal care givers,
birth attendants, child health providers and
vaccinators should all take the time to ask
a woman whether she is interested in family
planning to protect herself from having
another pregnancy too soon.
window may be the only chance to offer
post-partum women the information they
need for safe and healthy motherhood.”
“This document demonstrates the global
health community’s response to the growing
demand for post-partum family planning,”
according to Koki Agarwal, MCHIP
Director and moderator of the launch
“Today we call on stakeholders
across the spectrum – from health extension
workers to midwives, nurses, medical
doctors and policy makers – to ensure that
every mother, every couple, is better able
to safely plan their families.”
Programming Strategies for
Postpartum Family Planning http://tinyurl.com/p7gjhfh