Archive for the ‘Malaria’ Category
The above two headlines on global health funding flows and allocation caught my attention. The original study was published in PLoS Medicine. The article has some great figures (some of which I have reproduced below). A few things immediately stick out – the amount concentrated on HIV/AIDS, TB and malaria is astounding. Second the US is providing 70% of the funding and on the surface one could argue that other countries really could be pitching in more. On that note, the Gates Foundation by itself is out funding the European Commission almost 4 to 1 – if that isn’t embarrassing I don’t know what is. Finally, the US Department of Defense is high on the list (surpassing USAID). Interesting stuff:
“HIV/AIDS, tuberculosis and malaria initiatives accounted for about 80% of the $2.5 billion that was spent on research and drug development for developing countries in 2007… However, pneumonia and diarrheal illness, which are two major causes of mortality in developing countries, received less than 6% of funding.”
A few days back Aman wrote a post about Google Flu Trends. Thought I’d add a few thoughts here after reading the draft manuscript that the Google-CDC team posted in advance of its publication in Nature.
By the way, here’s what Nature says: Because of the immediate public-health implications of this paper, Nature supports the Google and the CDC decision to release this information to the public in advance of a formal publication date for the research. The paper has been subjected to the usual rigor of peer review and is accepted in principle. Nature feels the public-health consideration here makes it appropriate to relax our embargo rule
Ginsberg J, Mohebbi MH, Patel RS, Brammer L, Smolinski MS, Brilliant L. Detecting influenza epidemics using search engine query data. Draft manuscript for Nature. Retrieved 14 Nov 2008.
Assuming that few folks will read the manuscript or the article, here’s some highlights. I should say I appreciated that the article was clearly written. If you need more context, check out Google Flu Trends How does this work?…
- Targets health-seeking behavior of Internet users, particularly Google users [not sure those are different anymore], in the United States for ILI (influenza-like illness)
- Compared to previous work attempting to link online activity to disease prevalence, benefits from volume: hundreds of billions of searches over 5 years
- Key result – reduced reporting lag to one day compared to CDC’s surveillance system of 1-2 weeks
- Spatial resolution based on IP address goes to nearest big city [for example my current IP maps to Oakland, California right now], but the system is right now only looking to the level of states – this is more detailed CDC’s reporting, which is based on 9 U.S. regions
- CDC data was used for model-building (linear logistic regression) as well as comparison [for stats nerds – the comparison was made with held-out data]
- Not all states publish ILI data, but they were still able to achieve a correlation of 0.85 in Utah without training the model on that state’s data
- There have attempted to look at disease outbreaks of enterics and arboviruses, but without success.
- For those familiar with GPHIN and Healthmap, two other online , the major difference is in the data being examined – Flu Trends looks at search terms while the other systems rely on news sources, website, official alerts, and the such
- There is a possibility that this will not model a flu pandemic well since the search behavior used for modeling is based on non-pandemic variety of flu
- The modeling effort was immense – “450 million different models to test each of the candidate queries”
So what does this mean for developing world applications?
Here’s what the authors say: “Though it may be possible for this approach to be applied to any country with a large population of web search users, we cannot currently provide accurate estimates for large parts of the developing world. Even within the developed world, small countries and less common languages may be challenging to accurately survey.”
The key is whether there are detectable changes in search in response to disease outbreaks. This is dependent on Internet volume, health-seeking search behavior, and language. And if there is no baseline data, like with CDC surveillance data, then what is the best strategy for model-building? How valid will models be from one country to another? That probably depends on the countries. Is it perhaps possible to have a less refined output, something like a multi-level warning system for decision makers to followup with on-the-ground resources? Or should we be focusing on news+ like GPHIN and Healthmap?
Another thought is that we could mine SMS traffic for detecting disease outbreaks. The problem becomes more complicated, since we’re now looking at data that is much more complex than search queries. And there is often segmentation due to the presence of multiple phone providers in one area. Even if the data were anonymized, this raises huge privacy concerns. Still it could be a way to tap in to areas with low Internet penetration and to provide detection based on very real-time data.
We previously mentioned the malaria ad sponsored by ExxonMobil during the Olympics. I have seen this several times now during coverage and said in the original post:
“with regard to ExxonMobil’s commercial on Malaria during prime time, when over 1 Billion people were watching, this might have been the largest audience ever for a global health ad.”
I realized after I said this that I probably made a major miscalculation. The NBC channel broadcast I have been watching is only produced for an American audience. The top estimates I have seen for viewership at a given time hit 66 million people. So while Exxon may have had their ad broadcast across countries and major national networks, it is likely that somewhere between tens and hundreds of millions of people saw their commercial – which is still an impressive number. Thanks to Responsible China I found the youtube version of this ad, which is below. In addition I have also seen GE’s portable re-designed low cost EKG machine advertised several times as well. Despite what you may think about these companies it is better than nothing to see MNC’s promoting social causes. We blogged about the EKG machine previously and the commercial is the first one below, followed by the malaria ad. For another check, definitely check out ResponsibleChina.
More than 12 years (let that time horizon sink in) after the first indications of success, there will be a large scale trial for a new malaria vaccine. The potential global health implications of this are obvious, read the full news article, it has some good tidbits in it:
“With the exception of Mosquirix, there’s no possibility of one coming on the market within five or six years…It took eight more years of development and testing before scientists were ready to conduct a large-scale trial of the vaccine. London-based Glaxo and its partners will begin a $100 million study of Mosquirix later this year, vaccinating 16,000 children in seven African countries. If the results are positive, the drug could be on the market as soon as 2011, making it the first vaccine against the deadly disease. “
These were the words of Forest Whitaker (academy award winner for his leading role in The Last King of Scotland) on tonight’s inspired 2nd annual two and half hour Idol Gives Back show which raised funds for six causes. Forest was the ambassador for Malaria No More, and definitely gave an emotional appeal for people to call in and donate money.
Earlier today I was lucky enough to be on a conference call with the medical director (Steven Phillips) for ExxonMobil’s foundation which is a major supporter and funder of the malaria component of tonight’s American Idol show. Phillips traveled to Angola twice this year, once with American Idol contestants and winners and the second time with Forest Whitaker to get them involved in combating malaria. I was joined on the call by Bill Brieger, professor at Hopkins and an expert in malaria, definitely check out his blog – Malaria Matters. Rob Katz of NextBillion and the Acumen Fund fame was the other “blogger” on the call.
According to Phillips, ExxonMobil teamed up with American Idol because they are the most watched TV show with over 30 million viewers and because their first experimental show last year was a huge hit. Exxon is reaching out to of course let their work be known and also because he feels that “one of major issues with malaria is that it (malaria) had historically been among one of most neglected diseases.” Their funding breakdown is: 25% for advocacy, 10% for R&D (e.g partnerships with MVI, MMV, others), and 65% for disease control (goes to African NGOs or iNGOs).
The Idol show had a blockbuster lineup, some of the celebs included: Bono, Alicia Keys, Heart, Brad Pitt, Robin Williams (who was beyond awful), Gloria Estefan, Mariah Carey, Celine Dion and many others. One of the highlights was Gordon Brown, prime minister of the UK, making an appearance to announce the equivalent of $200 million in funding for bednets. The three presidential candidates were also supposed to make an appearance, but perhaps this got cut. For a great recap of the show check out Kristin’s post.
Last year the show raised $76 million, it will be interesting to see what happens after tonight. Despite various criticisms and those much more cynical than I, credit has to be given to all the corporate sponsors for reaching out… I’ll post more on this if I get a chance this weekend.
More on the business and global health front, in case you missed it: NEW YORK, June 13, 2007 — Eight leading businesses received awards recognizing their outstanding contributions in the fight against AIDS, TB and malaria… GBC honors six companies that conceived and executed effective HIV/AIDS workplace, community, core competency, national action, testing and counseling, and advocacy and leadership programs, as well as two companies with superlative TB and malaria programs. Full story; Video and full coverage on the businessfightsaids.org website.
Coca-Cola China Beverages Ltd., (community)
Standard Chartered PLC (core competency)
Abbott and Abbott Fund (national action)
Eskom Holdings Ltd. (testing and counseling)
HBO (advocacy & leadership)
Eli Lilly (tuberculosis award)
Marathon Oil Corporation (malaria award)