By Dr Modou Jobarteh, Research Associate in nutrition and dietetics
The fact that there are still individuals, families and communities still going to bed hungry every night is arguably the biggest failure of our generation.
Category: African research
Imperial College London is home to a whole host of academics researching malaria, many of whom are part of IGHI’s Centre for African Research and Engagement.
By Nikita Rathod, Communications and Events Assistant, IGHI
Third-year PhD students Laura Braun and Kai Riemer are currently recovering from one of the most pivotal weeks in their careers so far.
By IGHI guest blogger Chanice Henry, Editor, Pharma IQ & Pharma Logistics IQ
Similar to new Hollywood feature Rampage, a recent study has urged the life sciences industry not to underestimate the dangers that could hide within CRISPR Cas9.
Although the film has been criticised for wildly exaggerating the capabilities of the gene editing technique, it can be recognised for its effort to draw focus from the excitable buzz around CRISPR Cas9 towards the importance of considering the ethics and dangers associated with the tool.
A recent commentary piece also emphasised the importance of methodically debating the potential outcomes of CRISPR within the task of tackling Malaria.
Malaria is spread by the bite of female mosquitos holding the Plasmodium parasite. Plasmodium falciparum causes life threatening malaria.
Advances made so far
In the five years to 2015, 17 countries managed to eradicate malaria –including the likes of Senegal and Bolivia. In this period, mortality fell by 50% and incidences fell by 15% – preventing over 6 million deaths.
The World Health Organisation (WHO) recently launched “the world’s first malaria vaccine that has been shown to provide partial protection against malaria in young children.” After establishing efficacy in Phase 3 clinical trials a vaccine implementation programme is due to commence within this year’s immunization projects in Ghana, Kenya and Malawi.
A long way to go
Government spend on malaria prevention has seen a dramatic increase over the past decade. Although, experts note that around $6.5 billion of funding by 2020 will be key to hitting the WHO’s 2030 goal to wipe out malaria in 35 countries and shrink incidents and deaths by 90%.
Statistics claim that malaria still kills one child every two minutes.
Sub-Saharan Africa, as noted by Tanvi Nagpal, housed around 80% of the world’s malaria cases in 2016. “Their high infection rates are compounded by insufficient domestic budgets and struggling health systems.”Reports recently emerged stating of one in four blood banks in certain areas of Sub-Saharan Africa host supplies infected with malaria causing parasites.
Researchers are now turning to CRISPR Cas9 to stop the disease at the source of transmission – the mosquito.
What is CRISPR?
The genome-editing system based on CRISPR-Cas9 is becoming a valuable tool for different applications in biomedical research, drug discovery and human gene therapy by gene repair and gene disruption, gene disruption of viral sequences and programmable RNA targeting. The tool permanently manipulates gene expression by using programmable DNA nuclease and can remove faulty genes from a DNA sequence. (more…)
By IGHI guest blogger, Chris Bird, PG student in the Centre for Health Policy and Project Manager in the System Engagement Programme at the National Institute for Health and Care Excellence (NICE)
Systems under pressure
Health systems around the world face the twin pressures of a rising demand for services, coupled with financial pressure on resources to deliver them. For publicly-funded universal health services in developed countries such as the UK’s National Health Service (NHS), new investment is at an all-time low. Funding for the NHS in England has seen a real-terms rise of 4.4% over 6 years, meaning that the average annual rise was just 0.7% per year. Traditionally NHS funding had averaged at 4% per year.[1]
At the same time in the developing world, pressure on frontline services is even more acute from challenges ranging from natural disaster, population displacement, communicable disease and often scarce availability of healthcare resources and skills to respond. Innovation is the best hope for policymakers and clinical leaders to meet and sustain the WHO’s Millennium Development Goals (MDGs) that aim to address the fundamental inequality in health outcomes between the developed and developing world.
Meeting the challenge with a value-based healthcare approach
In the face of these competing pressures on healthcare systems, Michael Porter of Harvard Business School argues that the time has come for a fundamental new strategy, which represents a shift away from the supply-side model of health care organisation towards a more patient-centred system focussing on achieving best outcomes at the lowest cost. It is termed the ‘value-based healthcare’ (VBH) agenda.
Central to delivering VBH is the Integrated Practice Unit (IPU). An IPU brings all related healthcare professionals together, organised around a given condition, in a multidisciplinary setting, having geographic reach and removing the need for the patient to travel around a variety of different services to access appropriate care interventions. The IPU team takes responsibility for the full cycle of care for the condition including inpatient, outpatient and rehab. It measures outcomes, costs and processes for each patient using a common information platform. (more…)
By guest bloggers Sophie Uyoga and Charles Kamau, Research Scientists in Kilifi, Kenya
Most blood prescribed for transfusion in the developing world is mainly in emergency care. According to the WHO 2015 Report on Road Safety, the African Region has the highest risk of road traffic accident, one of the greatest contributors of emergencies needing blood transfusions. However, hospitals in this region are constantly facing blood stock outs, greatly contributes to the poor outcome all forms of medical emergencies as well as among admissions with severe anaemia. A clinical trial in East Africa by Kiguli et al., demonstrated how timely access reduces the risk of mortality among children with severe anaemia with a high proportion of those not transfused dying within 2.5 hours post admission. This therefore highlights the need to have screened donor blood readily available in the system. (more…)
5 May 2017 marked the International Day of the Midwife. Recognising the important role that midwives play to families and mothers, the day was first established in 1992. Midwives endure rigorous training to ensure that they can provide quality care for those in need. The level of skills amongst midwives however, can vary across the world.
March 2017 saw the arrival of Dr Beverly Donaldson, her midwifery colleagues Maggie Welch and Judith Robbins and paediatrician Dr Anna Battersby from Imperial College London/Imperial NHS Trust to facilitate the third midwifery training programme at the MRC Fajara The Gambia. The aim of the training was to support local midwives in their clinical practice by teaching them the necessary skills to manage basic obstetric emergencies in order to save the lives of mothers and babies in their care. Together, they give their account of the event.
“It was a busy few days following our arrival; preparing all the equipment and teaching materials over the weekend in readiness for the start of the intensive two day training programme on the Monday morning.
The first day began with lectures in maternal and neonatal mortality and the management of high risk pregnancy in The Gambia. The afternoon was dedicated to practical emergency skills training in the management of Eclampsia, Postpartum Haemorrhage and blood loss estimation – the major causes of maternal mortality. Running concurrently to the skills stations was a question and answer session in the library which gave participants the opportunity to openly discuss concerns related to maternal and neonatal care.
The second day focused on neonatal wellbeing and ‘Helping Babies Breathe’- an evidence-based educational program to teach neonatal resuscitation techniques in resource-limited countries- an initiative of the American Academy of Pediatrics (AAP) in collaboration with the World Health Organization (WHO). Anna and the team had previously adapted these materials to meet the needs of the Gambian staff and shortened it to make it more accessible to more midwives. We found this to be a simple and effective teaching method which was well received by the lovely midwives in the picture.
Following the formal training sessions, we then visited three participating maternity facilities to evaluate the effectiveness of the training by meeting with the lead midwife from each establishment and then assessing their ability to lead the teaching in their own unit. Consequently, we met with very enthusiastic midwives who were very happy to share the knowledge and skills they had been taught.
It quickly became evident that the midwives were very good at leading the teaching but they lacked the necessary equipment to continue training at their respective units. After discussion with our training faculty it was decided that we would donate the training mannequins with a view to replacing them before we facilitate the next programme.
Overall the training was very successful, was well evaluated and received very positive feedback from the midwives who attended”.
The training was organised and facilitated by Dr Beverly Donaldson with Dr Anna Battersby and the Centre of International Child Health (CICH) at Imperial, led by Prof Beate Kampmann, who also regularly works at the MRC Unit. Prof Kampmann stated: “I am very pleased that the CICH can support this training effort, as it is an excellent example of our vision to involve a multi-disciplinary group of health care professionals and advocates in our work to improve maternal and child health. Midwives worldwide play such an important role in achieving this goal and I thank the imperial team for their efforts and dedication.”
By Dr Kike Olajide, Wellcome Global Health Clinical Research Fellow, Centre for Psychiatry, Imperial College London.
Globally, the number of people with depression and anxiety is on the rise – up from 416 million in 1990 to 615 million in 2013. The World Health Organisation estimates that mental illness is now the leading cause of disability worldwide, accounting for over 15% of years lost due to disability (YLD). In addition to disability, common mental illnesses such as depression can lead to suicide. If you are aged 15 to 29 and living in Europe, the thing most likely to kill you, is you – suicide is the leading cause of death in this age group.
By Professor Kathryn Maitland, Professor of Tropical Paediatric Infectious Diseases, Director of Centre for African Research and Engagement, Imperial College London
Approximately 1200 African children are estimated to die from malaria every day, accounting for the vast majority of the global deaths from this disease. Over the past decade there has been an unprecedented increase in funding for malaria-control activities and vaccine development – the two major tools in ‘Roll back Malaria’ prevention and elimination programme. This has resulted in major scaling-up in the distribution of bed nets treated with long-lasting insecticides and public-private funding for late phase multi-site trials of the most promising anti-malaria vaccine candidate developed to date (RTS,S).
By Anastasia Koch and Bianca Masuku, Eh!woza
Khayelitsha, a peri-urban township outside of Cape Town, South Africa, has some of the highest rates of HIV and TB in the world. Many members of this community have had personal experiences with TB and HIV, either being directly infected or as a result of the death of loved ones. This is also the setting for a major clinical research site established by The Clinical Infectious Diseases Research Initiative (CIDRI). The research group, which focusses on finding better ways to intervene in and understand HIV-associated TB, was established by Professor Robert Wilkinson and has laboratory and academic space at the Institute of Infectious Disease and Molecular Medicine (IDM).