In 1978 I went to work in The Gambia as a junior doctor at the Medical Research Council (MRC) research unit hospital. With a population of less than one million at the time there was only one government ophthalmologist, Dr Shiona Sowa. I got to know Dr. Sowa well and heard about the work which had brought her to The Gambia - to try out new vaccines for trachoma.
The COVID-19 pandemic has sparked great interest in the mathematical models used to estimate disease transmission in the population. These models have figured prominently in the decisions of many governments, as they can help project the course of the disease, allocate people and resources, and evaluate the impact of policies. But models - though undoubtedly valuable - are not crystal balls; they are only as good as the available information.
Better evidence, more trust – Drug regulators can improve decision-making to reassure public on vaccines
At a record pace, the first new vaccines were developed and entered the market in less than a year since the sequencing of the new SARS-CoV-2 virus. This astonishing achievement was made partially possible due to decades of basic research targeting the underlying biology of similar coronaviruses, and earlier clinical development efforts with the utilised vaccine platform technologies.
Malaria is caused by Plasmodium parasites, the most prevalent and deadly of which is Plasmodium falciparum (accounting for 97% cases worldwide, according to WHO). While there is a vaccine candidate, called RTS,S, it is only 30-40% effective. There are many different ways of designing vaccines. ‘Sub-unit vaccines’ are based on a component of pathogen – the organism that causes the disease. For example, the RTS,S vaccine is based on a pathogen-derived protein, P. falciparum’s circumsporozoite protein (CSP).
The remarkable transition general practitioners have made to predominantly remote and telephone consultations is to be applauded. Yet this has brought its own challenges which may have meant that less serious health conditions have gone untreated. Many patients will have had understandable fears about the risk of infection or burdening the health service. Others may lack the digital access or skills to join a remote appointment.
In the midst of the COVID-19 pandemic we are reminded that infectious diseases are not a thing of the past but a very real threat to millions of people globally. Tuberculosis (TB), caused by the bacterium Mycobacterium tuberculosis, is the biggest killer by a single bacterial pathogen, causing over 10 million people to fall ill and 1.5 million people to die from TB each year.
You have to hand it to the Premier League, their response to the coronavirus pandemic has been outstandingly successful. On 17th June, three months after the start of the UK lockdown in March 2020, they resumed playing and have not stopped since. Many of us are facing ever increasing restrictions to our social and professional lives, but when Tottenham meets Liverpool on Thursday, 11 players plus substitutes and a considerable number of staff will have travelled half the country for what is effectively a close contact mass gathering for our entertainment.
The global community is certainly in a very different place for this year’s World AIDS Day. We are facing the colliding impacts of two of the biggest epidemics of our time: HIV/AIDS and COVID-19.
Hydroxychloroquine use prior to coronavirus infection may not reduce COVID-19 deaths…but clinical trials required
Hydroxychloroquine was quickly thrown into a global spotlight after it garnered simultaneous praise and criticism from a number of high-profile sources. The drug has since been investigated in several randomised clinical trials and observational studies. Most studies to date have shown no evidence of a benefit of hydroxychloroquine as a treatment for patients admitted to hospital who already have COVID-19.
As I left the UN General Assembly High-Level Meeting on Ending TB in New York two years ago, there was renewed hope that this could be a turning point for accelerating progress against tuberculosis (TB). But COVID-19 has shifted global TB control from acceleration into reverse.