Correction: An Immeasurable Crisis? A Criticism of the Millennium Development Goals and Why They Cannot Be Measured

Correction: An Immeasurable Crisis? A Criticism of the Millennium Development Goals and Why They Cannot Be Measure

Roll Back Malaria? The scarcity of international aid for malaria control

The WHO announced the Roll Back Malaria (RBM) movement in 1998, with the goal of halving malaria deaths by 2010, and halving again by 2015. It is widely agreed that reaching this goal requires a major increase in international aid funding for malaria control, to a budget of perhaps $1.5 –$2.5 billion annually. To ascertain whether progress is being made, we compiled data self-reported by the donors to the Development Assistance Committee of OECD, and also to ourselves directly. We find that, in fact, the total amount of international aid dedicated to malaria control, from the 23 richest donor countries plus the World Bank, remains in the range of $100 million annually – a figure that is virtually unchanged since the start of RBM. This lack of progress toward increasing funding very seriously threatens RBM and demands that WHO regularly audit and report on malaria control funding, with the certainty that RBM will fail to meet its deadline of 2010 if this is not done

Highly sensitive C-reactive protein levels in Iranian patients with pulmonary complication of sulfur mustard poisoning and its correlation with severity of airway diseases

Background: Sulfur mustard (SM) is a chemical warfare agent that can cause serious pulmonary complications. This study was designed to determine serum highly sensitive C-reactive protein (hs-CRP) and evaluate its correlation with lung function parameters in patients with chronic obstructive pulmonary disease (COPD) due to SM poisoning. Methods: Fifty consecutive SM patients with stable COPD and a mean age 46.3 + 9.18 years were enrolled in this cross sectional study. Thirty healthymen were selected as controls. Lung function parameters were evaluated. Serum hs-CRP by immunoturbidometry assay was measured in both the patients and controls. Results: In the case group, the mean forced expiratory volume in one second (FEV1) was 2.14 + 0.76 L (58.98%+17.51% predicted). The mean serum hs-CRP was 9.4+6.78 SD and 3.9+1.92 SDmg/L in the cases and controls, respectively, with significant statistical differences (p < .001). There was negative correlation between the serum hs-CRP and FEV1 levels (p ¼ .01). The serum hs-CRP levels were also correlated with Global Initiative for ChronicObstructive Lung disease (GOLD) stages (r ¼ .45, p < .001). Conclusions:Our findings suggest that the serum hs-CRP level is increased in SM patients with COPD and may have a direct correlation with disease severity. It may then be used as a marker for the severity of COPD in patients with SM poisoning

Pilot Study of Essential Drug Quality in Two Major Cities in India

BACKGROUND: India is an increasingly influential player in the global pharmaceutical market. Key parts of the drug regulatory system are controlled by the states, each of which applies its own standards for enforcement, not always consistent with others. A pilot study was conducted in two major cities in India, Delhi and Chennai, to explore the question/hypothesis/extent of substandard and counterfeit drugs available in the market and to discuss how the Indian state and federal governments could improve drug regulation and more importantly regulatory enforcement to combat these drugs. METHODOLOGY/PRINCIPAL FINDINGS: Random samples of antimalarial, antibiotic, and antimycobacterial drugs were collected from pharmacies in urban and peri-urban areas of Delhi and Chennai, India. Semi-quantitative thin-layer chromatography and disintegration testing were used to measure the concentration of active ingredients against internationally acceptable standards. 12% of all samples tested from Delhi failed either one or both tests, and were substandard. 5% of all samples tested from Chennai failed either one or both tests, and were substandard. Spatial heterogeneity between pharmacies was observed, with some having more or less substandard drugs (30% and 0% respectively), as was product heterogeneity, with some drugs being more or less frequently substandard (12% and 7% respectively). CONCLUSIONS/SIGNIFICANCE: In a study using basic field-deployable techniques of lesser sensitivity rather than the most advanced laboratory-based techniques, the prevalence of substandard drugs in Delhi and Chennai is confirmed to be roughly in accordance with the Indian government's current estimates. However, important spatial and product heterogeneity exists, which suggests that India's substandard drug problem is not ubiquitous, but driven by a subset of manufacturers and pharmacies which thrive in an inadequately regulated environment. It is likely that the drug regulatory system in India needs to be improved for domestic consumption, and because India is an increasingly important exporter of drugs for both developed and developing countries. Some poor countries with high burdens of disease have weak drug regulatory systems and import many HIV/AIDS, tuberculosis and malaria drugs from India

The Synergistic Effect of Cold Atmospheric Plasma Mediated Gold Nanoparticles Conjugated with Indocyanine Green as An Innovative Approach to Cooperation with Radiotherapy

Objective: The multimodality treatment of cancer provides a secure and effective approach to improve the outcomeof treatments. Cold atmospheric plasma (CAP) has got attention because of selectively target and kills cancer cells.Likewise, gold nanoparticles (GNP) have been introduced as a radiosensitizer and drug delivery with high efficacy andlow toxicity in cancer treatment. Conjugating GNP with indocyanine green (ICG) can develop a multifunctional drugto enhance radio and photosensitivity. The purpose of this study is to evaluate the anticancer effects of GNP@ICG inradiotherapy (RT) and CAP on DFW melanoma cancer and HFF fibroblast normal cell lines. Materials and Methods: In this experimental study, the cells were irradiated to RT and CAP, alone and in combinationwith or without GNP@ICG at various time sequences between RT and CAP. Apoptosis Annexin V/PI, MTT, and colonyformation assays evaluated the therapeutic effect. Finally, the index of synergism was calculated to compare the results.Results: Most crucially, the cell viability assay showed that RT was less toxic to tumors and normal cells, but CAPshowed a significant anti-tumor effect on melanoma cells with selective toxicity. In addition, cold plasma sensitizedmelanoma cells to radiotherapy so increasing treatment efficiency. This effect is enhanced with GNP@ICG. Incomparison to RT alone, the data showed that combination treatment greatly decreased monolayer cell colonizationand boosted apoptotic induction. Conclusion: The results provide new insights into the development of better approaches in radiotherapy of melanomacells assisted plasma and nanomedicine

Physical and chemical stability of expired fixed dose combination artemether-lumefantrine in uncontrolled tropical conditions

<p>Abstract</p> <p>Background</p> <p>New artemisinin combination therapies pose difficulties of implementation in developing and tropical settings because they have a short shelf-life (two years) relative to the medicines they replace. This limits the reliability and cost of treatment, and the acceptability of this treatment to health care workers. A multi-pronged investigation was made into the chemical and physical stability of fixed dose combination artemether-lumefantrine (FDC-ALU) stored under heterogeneous, uncontrolled African conditions, to probe if a shelf-life extension might be possible.</p> <p>Methods</p> <p>Seventy samples of expired FDC-ALU were collected from private pharmacies and malaria researchers in seven African countries. The samples were subjected to thin-layer chromatography (TLC), disintegration testing, and near infrared Raman spectrometry for ascertainment of active ingredients, tablet integrity, and chemical degradation of the tablet formulation including both active ingredients and excipients.</p> <p>Results</p> <p>Seventy samples of FDC-ALU were tested in July 2008, between one and 58 months post-expiry. 68 of 70 (97%) samples passed TLC, disintegration and Raman spectrometry testing, including eight samples that were post-expiry by 20 months or longer. A weak linear association (R²= 0.33) was observed between the age of samples and their state of degradation relative to brand-identical samples on Raman spectrometry. Sixty-eight samples were retested in February 2009 using Raman spectrometry, between eight and 65 months post-expiry. 66 of 68 (97%) samples passed Raman spectrometry retesting. An unexpected observation about African drug logistics was made in three batches of FDC-ALU, which had been sold into the public sector at concessional pricing in accordance with a World Health Organization (WHO) agreement, and which were illegally diverted to the private sector where they were sold for profit.</p> <p>Conclusion</p> <p>The data indicate that FDC-ALU is chemically and physically stable well beyond its stated shelf-life in uncontrolled, tropical conditions. While these data are not themselves sufficient, it is strongly suggested that a re-evaluation of the two-year shelf-life by drug regulatory authorities is warranted.</p