By Hepeng Jia

BEIJING — China has not always been a world leader when it comes to infectious disease surveillance. Severe acute respiratory syndrome caught the country by surprise in 2003, and, two years later, government officials went into denial after reports surfaced that H5N1 avian influenza had infected people and birds. But since those debacles, China has ramped up its screening efforts, building several infectious-disease institutes and more than 400 labs devoted to flu surveillance and testing, plus adding sentinel equipment to some 550 hospitals. So when H1N1 ‘swine flu’ struck four years later, the world’s most populous country was much better prepared.

“China has set up the world’s largest influenza surveillance network,” Yuelong Shu, director of the National Influenza Center, part of the Chinese Center for Disease Control and Prevention (CDC), told Nature Medicine. And now, China can also boast being the first country in the developing world to host a World Health Organization (WHO) Collaborating Center for Reference and Research on Influenza.

Joining other collaborating centers in Australia, Japan, the UK and the US, the Beijing-based National Influenza Center will serve as a regional hub for monitoring and responding to flu outbreaks. The Chinese center will also host research into new antiviral medicines and help provide pandemic preparedness training for medical personnel from across East Asia.

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Image: H1N1, CDC’s Doug Jordan

By David Cyranoski

Singapore, the fastest growing economy in Asia last year, has enjoyed a decade of free-flowing research funding. Money is still pouring in, but the question remains whether money can buy international-class science, especially after the sudden attachment of strings to grant money starting last fall. Perhaps the best person to answer this question is Sir George Radda (he received his knighthood in 2000). Radda was the chief executive of the UK’s Medical Research Council (MRC) from 1996 to 2003. In his final year at the helm of the MRC, he had his first interaction with Singapore’s budding biomedical program as a member of the A*STAR Biomedical Sciences International Advisory Council. Shortly thereafter, Radda was asked to help with the next five years’ science and technology plan. A pioneer in nuclear magnetic resonance imaging, he became the founding chairman of the Singapore Bioimaging Consortium, traveling to Asia nearly once a month before he moved to Singapore three years ago. In April 2009, he was appointed chairman of the city-state’s Biomedical Research Council (BMRC), which coordinates the country’s biomedical activities and oversees institutes that comprise the Biopolis, a hub of more than 2,000 researchers and staff. Here he talks with David Cyranoski about what’s ahead for Singapore.

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Image: A*STAR

By Alisa Opar

In Kettleman City, California, a town of 1,620 people, 11 babies were born with severe birth defects in the last three years. Meanwhile, at least 60 men who lived on the Camp Lejeune Marine Corps Base in North Carolina from the late 1950s into the 1980s have developed breast cancer. And residents in Wellington, Ohio are three times more likely to develop multiple sclerosis than in the rest of the country.

A new report highlights these and 39 other so-called ‘disease clusters’—defined as unusual aggregations, real or perceived, of health events grouped together in time and space—that have been confirmed or are currently being identified by a local, state or federal agency in 13 US states since 1976. The 28 March report from two nonprofit organizations, the Natural Resources Defense Council (NRDC) and the National Disease Clusters Alliance, calls for expanded federal efforts to identify clusters and their causes.

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By Elie Dolgin

ORLANDO, FLORIDA — Basal cell carcinoma is the most common form of skin cancer, but in people with a hereditary predisposition to this disease, lesions crop up so fast that they can hardly keep pace with their doctor’s appointments. “Surgery can become tedious, and often, because of that, people don’t go as often as they should and the [cancerous] areas grow larger,” says Maria Michalowski, a former board member of the Basal Cell Carcinoma Nevus Syndrome (BCCNS) Life Support Network who herself suffers from the disease.

Yet, judging by trial results reported here last month at the annual meeting of the American Association for Cancer Research (AACR), pharmaceutical options on the horizon may preclude the need for regular surgery. In a phase 2 study of 41 people with BCCNS, a team led by Ervin Epstein from the Children’s Hospital Oakland Research Institute in California found that participants taking an experimental Genentech drug called vismodegib developed only four new tumors on average over the course of a year, compared to 24 in subjects on placebo. Plus, subjects taking the drug saw their existing skin lesions shrink dramatically, whereas those on the dummy pill experienced modest growths. “Indeed, there was a tremendous reduction in new lesions,” says Epstein. “The people on the drug had no surgeries. The difference was dramatic.”

Vismodegib, also commonly referred to as GDC-0449, works by inhibiting signaling in the so-called Hedgehog pathway, which regulates cell growth and differentiation. Mutations in this pathway are responsible for some cases of BCCNS as well as a form of brain cancer known as medulloblastoma. And, indeed, vismodegib has also been shown to benefit a young man with the latter disease (N. Engl. J. Med. 361, 1173–1178, 2009).

But even when no such mutations are present, aberrant Hedgehog signaling can still drive solid tumors, for example by supporting the blood vessels that fuel their growth. That’s why Genentech, a San Francisco–based subsidiary of the Swiss pharma giant Roche, is currently testing its drug for nearly 20 other types of cancer.

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Image: USDA Forest Service

NEW YORK — Ever since scientists first linked an obscure blood-borne virus to chronic fatigue syndrome two years ago, blood centers around the world have been scrambling to determine whether their collections are safe. With memories of previous blood scares still fresh in the minds of blood bank officials, many collection centers have even gone so far as to bar donations from people with the disease. But it’s not just xenotropic murine leukemia virus–related virus (XMRV) that threatens global blood supplies today. Even well-known pathogens such as hepatitis B virus can slip through the cracks of existing screening techniques, leading to contaminated blood products and accidental infections.

Newly implemented technologies might change all that. Speaking at the New York Academy of Sciences here in late March, a panel of blood bank officials and infectious disease experts unveiled plans to make blood supplies safer by introducing DNA-based screening tests to improve disease detection.

“Our blood supply is safer than it’s ever been,” Gail Moskowitz, a healthcare consultant who has directed several blood banks in the New York area, said at the 29 March meeting. “But transfusion is still associated with [a] risk of transmission.”

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Image: iStockphoto

By T V Padma

China and India, in 2001 and 2005, respectively, amended their patent laws to comply with the World Trade Organization’s Trade Related Intellectual Property Rights (TRIPS) agreement, which bans making generic copies of drugs still under patent protection. The move sparked concerns about the affordability of medicines in poor countries. But Bangladesh, categorized among the world’s least developed countries (LDCs) according to the UN, hopes to fill the void—at least for the next five years.

Under the TRIPS agreement, LDCs can make generic versions of patented drugs until 2016. Bangladesh already has an estimated 350 drug companies, from small domestics to large multinationals, which produce 97% of its domestic demand for medicines. However, to make these medicines for domestic use and export, Bangladesh imports 80% of the active pharmaceutical ingredients (APIs), the chemicals responsible for a drug’s action. “That is a weakness, as the imports do not make our pharma industry a fully integrated one,” Abdul Muktadir, secretary general of the Dhaka-based Bangladesh Association of Pharmaceutical Industries, told Nature Medicine.

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Image: Masud Ananda, Flickr

By Branwen Morgan

Japan is the world’s second largest pharmaceutical market after the US on the basis of total revenue. But according to Business Monitor International (BMI), a London-based analyst firm, Japan’s overall pharmaceutical market is stagnating, and the devastating 9.0-magnitude earthquake that struck in March has introduced new uncertainties. In its initial review, published in early March, BMI stated that factors such as the government’s cuts to subsidies for prescription medicines and its pro-generics stance will conspire to lower annual growth rates going forward. Presently, pharmaceutical expenditure is 1.8% of the country’s gross domestic product and BMI predicted that through to 2015 the five-year compound annual growth rate will be 0.7%. However, soon after BMI published these gloomy estimates, they revised them down further. The 11 March earthquake and tsunami that devastated a large part of northeastern Japan led the firm to downgrade its pharmaceutical market forecast to take into account the impending economic slowdown.

“The majority of the report’s content is still applicable, but we have lowered our 2020 sales predictions by 1.5% (from $91.7 billion to $90.3 billion), which reflects a change in the country’s overall macroeconomics now that the full extent of the recent disaster is known,” says Jamie Davies, BMI analyst and report author. “To improve their overall outlook for growth, the country’s pharmaceutical companies need to look more to emerging markets, such as China.”

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Image: VectorPortal

By Gary Peach

Russia’s biomedical industry is woefully underdeveloped, accounting for only 0.2% of the world market. But plans are afoot to change that. Speaking at the opening of a new birth center in Ryazan on 11 March, for example, Prime Minister Vladimir Putin stated that the government wants to boost Russia’s presence on the world biopharma stage to 3–5% in the next decade. And he emphasized that the country already possesses the necessary academic and research institutions to achieve that. “We need to come up with measures to stimulate demand for Russia-made biotechnological products and remove barriers that often prevent businesses from working,” he said.

To that end, Russian leaders announced in March that they have approved 120 billion rubles ($4 billion) for a strategic investment program aimed at developing the country’s massively import-dependent pharmaceutical and medical supplies industries.

Dubbed Pharma-2020, the program—which was adopted two years ago although financing was only approved by the government last month—will attempt to boost output of local medicines, in gross sales terms, from nearly 25% last year to 50% by 2020. In addition, the program calls for ensuring that 90% of vital medicines are domestically produced, retooling some 160 companies to good manufacturing practice standards, establishing ten research and development centers that will focus on creating innovative products and boosting exports to $100 million.

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Image: Astapkovich Vladimir, Newscom