Tag Archives: World Health Organization

The WHO and humanitarian crises: an interview with Michel Yao

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Michel Yao (left) and Etienne Minkoulou (right) at the WHO office in Bangui, Central African Republic in March 2014.
{credit}WHO/Christopher Black{/credit}

Armed conflicts and other humanitarian crises are notorious for claiming lives. But any disaster scenario can quickly go from bad to worse when health facilities are abandoned or ransacked. That’s precisely the situation brewing in the Central African Republic, where ongoing political fighting that erupted late in 2012 and intensified last December has plunged the country into chaos and devastated the health system. Many health workers have fled for safety, and looting has damaged health facilities and led to shortages of medicines and other essential supplies.

On 10 April, the United Nations Security Council voted to send peacekeeping forces to the Central African Republic. Meanwhile, the World Health Organization has been collaborating with the country’s Ministry of Health and non-governmental organizations (NGOs) to provide much-needed basic health services in the region. Michel Yao, a physician by training and the senior health security adviser for humanitarian crises at the WHO in Geneva, Switzerland, recently returned from a two-month trip to the Central African Republic. Yao spoke with Nature Medicine about the ongoing medical relief efforts in the beleaguered country.

Can you describe the current situation in the Central African Republic?

There are a huge number of people that are dying—we don’t have an exact number but we’re talking over a thousand people that have lost their lives and several thousand that have been wounded since December. Most of the health facilities have been looted, and health workers also left the health facilities, fleeing to save their own lives. So in this case, the system that is supposed to provide health services to people that are in need cannot work. As an alternative, health care is provided by the humanitarian health workers, but there are few public servants who can still work. The health facilities for the people in the capital city Bangui are more or less covered, but the main challenge remains outside of Bangui. Continue reading →

Neglected diseases see few new drugs despite upped investment

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Over the past decade, neglected diseases have attracted increased attention and larger investments in research. Even often overlooked tropical diseases such as sleeping sickness and leishmaniasis have received more funding. “These Cinderella diseases, long ignored and underappreciated, are a rags-to-riches story,” said Margaret Chan, director-general of the World Health Organization, in an address in May. But these newfound ‘riches’ have given rise to just a few dozen newly approved therapies and only a handful of truly novel drugs. A new analysis by Médecins Sans Frontières (MSF) and the Drugs for Neglected Diseases Initiative (DNDi) finds that the rate of approvals for new compounds over the past decade is roughly the same as it was during the previous two-and-a-half decades, when the diseases received little attention.

“It is still a very depressing picture,” says Manica Balasegaram, head of MSF’s Access Campaign in Geneva. “This is a little bit disheartening considering the huge amount of activity that’s been happening in the global health world.”

The new analysis, presented today at a symposium in New York, shows that of the 850 new therapies and vaccines approved by the US Food and Drug Administration, the European Medicines Agency and other agencies between 2000 and 2011, 37 focused on neglected diseases, and just four of those were new chemical entities. The work builds on a pioneering paper published in 2002 by members of the Drugs for Neglected Diseases Working Group, which counted 1,393 new drug approvals—16 of which focused on neglected diseases—between 1975 and 1999 (Lancet 359, 2188–2194, 2002). According to DNDi, 11 of those 16 drugs could be considered new chemical entities. The numbers suggest that although the rate of approvals for drugs for neglected diseases has gone up, the rate of approvals for new chemical entities seems to have remained relatively flat.

Direct comparisons, however, are difficult, as the new analysis is more comprehensive than the previous one, and tallying drug approvals can prove challenging. Joshua Cohen, a health economist with the Tufts Center for the Study of Drug Development in Boston, reanalyzed the working group’s data a few years ago and came up with a different count—32 new drugs approved for neglected diseases, including 13 new chemical entities (PLoS ONE 5, e10610, 2010).

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Global health leader Kim nominated to lead World Bank

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Dartmouth University/Copyright WHO/P.Virot

Doctor, anthropologist and former leader of the World Health Organization’s HIV/AIDS unit Jim Yong Kim has been nominated by US President Barack Obama to lead the World Bank.

“The leader of the World Bank should have a deep understanding of both the role that development plays in the world, and the importance of creating conditions where assistance is no longer needed. I believe that nobody is more qualified to carry out that mission than Dr. Jim Kim,” Obama said in announcing the nomination today.

Kim is president of Dartmouth College. In the 1990s, he worked with the health-and-human-rights organization Partners in Health to treat multidrug-resistant tuberculosis in Peru. He won a Macarthur Genius Grant in 2003. At the World Health Organization (WHO), whose HIV/AIDS unit he led from 2004–6, Kim launched the “3-by-5” initiative, which aimed to get antiretroviral drugs to 3 million people by 2005. The goal wasn’t met until 2007, but Kim told Nature Medicine in 2008 that the initiative was worthwhile:

“Many analysts have suggested that the momentum that was gained by ‘3 by 5’ really led to the achievement of ‘3 by 7’. Missing by two years is about as well as the WHO has ever done in reaching a global target,” he said. (Read the full Nature Medicine interview here).

Kim was not one of the people widely thought to be in the running for the World Bank post. His nomination has so far drawn mostly positive, but some negative, reviews.

Kim’s background in poor countries and in global health may “partly insulate” him from criticism raised by groups that want to end the tacit agreement by which the United States typically picks the head of World Bank, wrote the New York Times.

One other nominee, Nigerian finance minister and former World Bank Official Ngozi Okonjo-Iweala, has been put forward, and nominations close this evening, reports the Times, which says that Obama’s nomination makes Kim the front-runner for the post.

Follow Erika on Twitter at @Erika_Check.