Navigation Links
Treating HIV in war zones -- Public health emergencies need rapid advice from WHO

HIV treatment can be delivered even in settings of armed conflict, and humanitarian health agencies should not wait until a conflict is over before launching HIV care programs, say a team from Médecins Sans Frontières (MSF) in this week’s PLoS Medicine.

Heather Culbert and colleagues report their results of three years’ experience of providing HIV care, including antiretroviral therapy (ART), to a conflict-affected population in the Democratic Republic of the Congo (DRC). The reported treatment outcomes were similar to those in HIV projects in non-conflict settings.

"Our experience has shown us that one of the keys to successful provision of ART in conflict settings is preparation for disruption," say the authors. Some of the crucial contingency measures include:

  • Providing patients with extra emergency drug supplies that can be taken in case of program interruption.
  • Stockpiling emergency supplies of ART and securing them against vandals and looters
  • Distributing clinics widely throughout the treatment area, thus reducing travel requirements and making it easier and safer for staff and patients to access the clinics in times of insecurity
  • Establishing links with HIV care programs in neighboring regions, allowing displaced patients to continue to receive care
  • Educating patients on the importance of not conserving their pills and trying to take them on time even during periods of instability.

Culbert and colleagues' paper includes powerful testimonies from patients who have been under the care of MSF. One patient, followed in the clinic since May 2003, and on ART since December 2003, says:

"I heard gun fire all through the night. When I had only five pills left I lost my appetite and felt desperate…but despite the uncertainty I continued to take my treatment at the correct hour… When I had only one pill left I had the courage to go out and seek some more treatment. I went to see nu rse who informed me that she would be able to distribute antiretrovirals; with that I had a month’s worth of treatment. If we have to give up this treatment we will return to how we were at the start, sick."

The authors acknowledge that their results have been achieved with the resources of an international nongovernmental organization (MSF), in an urban setting, with the episode of conflict-related disruption occurring early in the programme, and thus similar results in conflict settings may not always be possible. "Nevertheless," they say, "the key elements of contingency planning for care delivery in conflict settings are not resource-intense and we believe they can generally be applied to most care programmes."

Citation: Culbert H, Tu D, O’Brien DP, Ellman T, Mills C, et al. (2007) HIV treatment in a conflict setting: Outcomes and experiences from Bukavu, Democratic Republic of the Congo. PLoS Med 4(5): e129.

IN YOUR ARTICLE, PLEASE LINK TO THIS URL, WHICH WILL PROVIDE ACCESS TO THE PUBLISHED PAPER::"request=get-document&doi=10.1371/journal.pmed.0040129


Related images for press use:’brien-graph.pdf

Daniel O’Brien
Médecins Sans Fron tières (MSF) Holland
Public Health Department
Plantage Middenlaan
Amsterdam, Holland 1001 EA
+31 20 520 8031
+31 20 620 5170 (fax)

Public health emergencies require urgent advice from the WHO

The World Health Organization (WHO) has developed a new mechanism, described in this week's PLoS Medicine, for issuing urgent guidelines to health professionals in a public health emergency such as an infectious disease outbreak.

The first rapidly issued guideline was developed by the WHO in order to advise countries that were dealing with avian influenza A (H5N1) infection.

Typically, the most rigorous clinical practice guidelines take two years or more to develop. The laborious process involves convening experts who search for and appraise all the relevant research literature, and who meet several times before making treatment recommendations. Such a time frame is clearly not practical in an emergency situation.

Holger J. Schünemann and colleagues, authors of the rapidly issued guideline on H5N1 infection, say that it took just one month to convene an expert team, and only five weeks for the team to summarize the evidence and prepare draft guidelines. The guidelines were then discussed at a two-day meeting, after which a draft manuscript for publication was prepared within 10 days.

In a related editorial discussing how WHO is responding to global public health threats, the PLoS Medicine editors comment that while the time scale for developing the H5N1 guideline was "miraculously quick in WHO terms", an even quicker time frame is sometimes going to be needed.

Citation: Schünemann HJ, Hill SR, Kakad M, Vist GE, Bellamy R, et al. (2007) Transparent development of the WHO Rapid Advice Guidelines. PLoS Med 4(5): e119.

IN YOUR ARTICLE, PLEASE LINK TO THIS U RL, WHICH WILL PROVIDE ACCESS TO THE PUBLISHED PAPER::"request=get-document&doi=10.1371/journal.pmed.0040119


Holger J. Schünemann
Italian National Cancer Institute Regina Elena
Department of Epidemiology
Via Elio Chianesi 53
Rome, RM 00144
+39 3460846102

Related PLoS Medicine Editorial:

Citation: The PLoS Medicine Editors (2007) How is WHO responding to global public health threats" PLoS Med 4(5): e197.



Source:Public Library of Science

Related biology news :

1. Potential Drug Target For Treating Cocaine Abuse Found
2. NCI Researchers Confirm the Effectiveness of Immunotherapy Approach to Treating Melanoma
3. Opiates Better Than Sedatives For Treating Newborns In Withdrawal
4. Treating populations infected with HIV and latent TB could speed the emergence of drug-resistant TB
5. Ocean dead zones trigger sex changes in fish, posing extinction threat
6. How to manage forests in hurricane impact zones
7. NIH Calls on Scientists to Speed Public Release of Research Publications
8. AIDS Public Awareness Campaign Expands Following Report Of Rapidly Progressive HIV
9. Public collections of DNA and RNA sequence reach 100 gigabases
10. Public release of pig genomic sequences
11. PLoS ONE is launched by the Public Library of Science

Post Your Comments:

(Date:9/29/2015)... is excited to be named one of the first 100 ... announcement was recently made at an invite-only IBM Watson: ... Francisco , where iDAvatars presented a demo of its ... "It is both an honor and a privilege to be ... the cognitive power of IBM Watson in our product, which ...
(Date:9/28/2015)... 28, 2015 Synaptics Inc. (NASDAQ: SYNA ... announced that Lenovo has selected Synaptics , Natural ... its latest smartphone, the Vibe P1. The new ... the device and provide swift access to applications and ... Natural ID FS4202 sensor solution utilizes AES256-bit encryption of ...
(Date:9/10/2015)... , Sept. 10, 2015 Report Details ... Study Reveals Selling Opportunities and Revenue Prospects to ... future of biologics, especially new drug classes? Get ... stay ahead with exclusive market data and industry ... trends, developments, results, opportunities and sales predictions. ...
Breaking Biology News(10 mins):
... WASHINGTON, DC -- June 2, 2011 -- A ... (MRSA) that is not detected by traditional genetic ... hospitals according to research to be published in the ... provide significant insights into how new MRSA strains emerge ...
... On June 9-10, Stevens Institute of Technology ... an event that covers the latest multi-disciplinary research ... dinner keynote from Dr. J. William Costerton, a ... will confront important issues and questions at the ...
... Scientists have identified a drug combination, when used in advanced ... no longer respond to existing therapies. They found that bexarotene ... cyclin D1. The drug combination also broadened the reach to ... due to the presence of a ras mutation in their ...
Cached Biology News:
(Date:10/8/2015)... 2015  ATCC, the premier global biological materials resource ... selected by The Michael J. Fox Foundation for Parkinson,s ... pharmaceutical, and biotechnology organizations committed to speed a cure ... States , and more than 5 million worldwide, ... States , and more than 5 million worldwide, ...
(Date:10/8/2015)... 8, 2015 The 2015 Nobel Prize in Chemistry ... Texas at Dallas. Aziz Sancar , who earned his ... in 1977, is one of three scientists who received ... and repair damaged DNA on a molecular level.  --> ... biology from UT Dallas in 1977, is ...
(Date:10/8/2015)... Oct. 8, 2015  Sigma-Aldrich Corporation (NASDAQ: ... brand within its Applied Diagnostics and Testing ... reference standards product line with ten certified Snap-N-Spike ... bile acids and their stable-labeled internal standards. These ... lithocholic acid, taurocholic acid and native and deuterium-labeled ...
(Date:10/7/2015)... Oct. 7, 2015 Boston Scientific ... of the Boston Scientific Connected Patient Challenge , ... the use of remote patient monitoring to enhance patient ... entrepreneurs can submit their ideas and collaborate on solutions ... ). Cambridge, MA where ...
Breaking Biology Technology:
... NEW YORK , May 28 /PRNewswire-Asia-FirstCall/ ... international biopharmaceutical company,with operations in the U.S. and China , announced ... BSN, RN, HP (ASCP), has been,selected to present at the American Society ... , , , ...
... 27 Celsis International, the global leader in rapid ... the U.S. Food & Drug Administration (FDA) to include information on testing ... the Celsis system. , , ... growing number of our Rapid Detection customers are using their Celsis systems ...
... NewLink Genetics Corporation announced today treatment of the first patient ... for patients who have successfully undergone pancreatic surgical resection. , ... "This pivotal study represents one of ... cancer in the United States ," said Charles Link , ...
Cached Biology Technology:
4-Hydroxy-3-nitrophenylacetyl hapten is conjugated to SGG (Sheep gamma globulin) lysine through amide bonds. This product is homologous to NP-BSA....
... are ideal for use in refrigerators, freezers, or liquid ... vibrant colors allow for color coding to project, user, ... drainage or promote cool air circulation. Supplied with 9 ... tubes. Box dimensions: 13 x 13 x ...
Biology Products: