Availability, price and affordability of cardiovascular medicines: A comparison across 36 countries using WHO/HAI data

<p>Abstract</p> <p>Background</p> <p>The global burden of cardiovascular disease (CVD) continues to rise. Successful treatment of CVD requires adequate pharmaceutical management. The aim was to examine the availability, pricing and affordability of cardiovascular medicines in developing countries using the standardized data collected according to the World Health Organization/Health Action International methodology.</p> <p>Methods</p> <p>The following medicines were included: atenolol, captopril, hydrochlorothiazide, losartan and nifedipine. Data from 36 countries were analyzed. Outcome measures were percentage availability, price ratios to international reference prices and number of day's wages needed by the lowest-paid unskilled government worker to purchase one month of chronic treatment. Patient prices were adjusted for inflation and purchasing power, procurement prices only for inflation. Data were analyzed for both generic and originator brand products and the public and private sector and summarized by World Bank Income Groups.</p> <p>Results</p> <p>For all measures, there was great variability across surveys. The overall availability of cardiovascular medicines was poor (mean 26.3% in public sector, 57.3% private sector). Procurement prices were very competitive in some countries, whereas others consistently paid high prices. Patient prices were generally substantially higher than international references prices; some countries, however, performed well. Chronic treatment with anti-hypertensive medication cost more than one day's wages in many cases. In particular when monotherapy is insufficient, treatment became unaffordable.</p> <p>Conclusions</p> <p>The results of this study emphasize the need of focusing attention and financing on making chronic disease medicines accessible, in particular in the public sector. Several policy options are suggested to reach this goal.</p

Transmission-Blocking Vaccines: Focus on Anti-Vector Vaccines against Tick-Borne Diseases

Tick-borne diseases are a potential threat that account for significant morbidity and mortality in human population worldwide. Vaccines are not available to treat several of the tick-borne diseases. With the emergence and resurgence of several tick-borne diseases, emphasis on the development of transmission-blocking vaccines remains increasing. In this review, we provide a snap shot on some of the potential candidates for the development of anti-vector vaccines (a form of transmission-blocking vaccines) against wide range of hard and soft ticks that include Ixodes, Haemaphysalis, Dermacentor, Amblyomma, Rhipicephalus and Ornithodoros species

Large animal models of cardiovascular disease

The human cardiovascular system is a complex arrangement of specialized structures with distinct functions. The molecular landscape, including the genome, transcriptome and proteome, is pivotal to the biological complexity of both normal and abnormal mammalian processes. Despite our advancing knowledge and understanding of cardiovascular disease (CVD) through the principal use of rodent models, this continues to be an increasing issue in today's world. For instance, as the ageing population increases, so does the incidence of heart valve dysfunction. This may be because of changes in molecular composition and structure of the extracellular matrix, or from the pathological process of vascular calcification in which bone-formation related factors cause ectopic mineralization. However, significant differences between mice and men exist in terms of cardiovascular anatomy, physiology and pathology. In contrast, large animal models can show considerably greater similarity to humans. Furthermore, precise and efficient genome editing techniques enable the generation of tailored models for translational research. These novel systems provide a huge potential for large animal models to investigate the regulatory factors and molecular pathways that contribute to CVD in vivo. In turn, this will help bridge the gap between basic science and clinical applications by facilitating the refinement of therapies for cardiovascular disease. Copyright (c) 2016 John Wiley & Sons, Ltd

The Water Footprint of Diets: A Global Systematic Review and Meta-analysis.

Agricultural water requirements differ between foods. Population-level dietary preferences are therefore a major determinant of agricultural water use. The "water footprint" (WF) represents the volume of water consumed in the production of food items, separated by water source; blue WF represents ground and surface water use, and green WF represents rain water use. We systematically searched for published studies using the WF to assess the water use of diets. We used the available evidence to quantify the WF of diets in different countries, and grouped diets in patterns according to study definition. "Average" patterns equated to those currently consumed, whereas "healthy" patterns included those recommended in national dietary guidelines. We searched 7 online databases and identified 41 eligible studies that reported the dietary green WF, blue WF, or total WF (green plus blue) (1964 estimates for 176 countries). The available evidence suggests that, on average, European (170 estimates) and Oceanian (18 estimates) dietary patterns have the highest green WFs (median per capita: 2999 L/d and 2924 L/d, respectively), whereas Asian dietary patterns (98 estimates) have the highest blue WFs (median: 382 L/d per capita). Foods of animal origin are major contributors to the green WFs of diets, whereas cereals, fruits, nuts, and oils are major contributors to the blue WF of diets. "Healthy" dietary patterns (425 estimates) had green WFs that were 5.9% (95% CI: -7.7, -4.0) lower than those of "average" dietary patterns, but they did not differ in their blue WFs. Our review suggests that changes toward healthier diets could reduce total water use of agriculture, but would not affect blue water use. Rapid dietary change and increasing water security concerns underscore the need for a better understanding of the amount and type of water used in food production to make informed policy decisions