Blog posts

The Importance of the International Day For the Elimination of Violence Against Women

By Nikita Rathod, Communications and Events Assistant, Institute of Global Health Innovation

logo_en

Today marks the International Day for the Elimination of Violence against Women.

Historically, the date of the 25th of November was designated as an awareness day in December 1999 by the United Nations General Assembly through resolution 54/134. The aim of the day was to increase worldwide awareness and create opportunities for discussion about challenges and solutions.

(more…)

No time to let our guard down: Antibiotic Awareness Week 2016

By Dr Enrique Castro Sanchez and Dr Bryony Dean Franklin, Centre for Patient Safety and Translational Research (PSTRC), Imperial College London

In the last few months we have seen increased attention and alliances around the world to develop interventions to address the challenge presented by drug-resistant infections. For example, a landmark declaration at the United Nations General Assembly on the matter of Antimicrobial Resistance was signed by 193 countries, providing a historic opportunity for experts, governments and citizens to collaborate on a global response to this worldwide threat to patient safety. Only the fourth time in history that a health topic had been at the centre of attention at the UN, the meeting supported  commitment of adequate resources to guarantee a much needed sustained and robust response.

However, despite the impetus given and the clear progress already achieved, there are still areas for concern. Although increased consideration has been given to drug-resistant infections, citizens worldwide are yet to completely understand how antibiotics work and how drug resistance develops. While work at Imperial has concluded that, generally, experts and citizens agree on antibiotic misuse or overuse as being the most common driver of antimicrobial resistance, the public seems to attribute much less importance to other factors such as suboptimal rapid diagnostics or inappropriate dosing driving up rates of antimicrobial resistance, a finding with important implications for the design of public health messages related to antibiotics. 

What are the factors contributing to antimicrobial resistance? Perceptions from experts and citizens

Castro Sanchez et al, 2016, DOI: 10.1186/s12879-016-1810-x. Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/). No changes made.  

It also seems that when people are admitted to hospital and receive antibiotics, they would like to be much more involved in the decisions surrounding their use. However, doctors and pharmacists often relegate patients to a passive and unsatisfying role, hampered by unclear language and a suboptimal experience in terms of communication [http://bmjopen.bmj.com/content/6/10/e011040.short]. At a more general level, such inactive participation may be reinforced by the narrow focus of current antibiotic–related educational messages, mostly focused on encouraging people to ‘take antibiotics as directed’. (more…)

Practitioner and patient-targeted interventions to address excessive antibiotic use

By Dr Olga KostopoulouReader in Medical Decision Making and Professor Brendan DelaneyChair in Medical Informatics and Decision Making at Imperial College London 

Antibiotics Combatting antimicrobial resistance (AMR) is high on policy agendas internationally. One of the key means advocated is judicious antibiotic prescribing. Over 80% of all NHS antibiotic prescriptions are issued in primary care, where despite numerous campaigns, mandates and financial incentives, rates have fallen only slightly in the past year. Acute respiratory infections and associated complications, such as pneumonia, are the commonest justification for primary care antibiotic use, despite strong evidence of small to modest symptomatic benefits. GPs admit to prescribing because of diagnostic uncertainty, defensive practice, and real or perceived patient demand. Patients request antibiotics because of their perceived effectiveness, poor understanding of AMR, and lack of awareness of their susceptibility to complications of infections caused by their own resistant bacteria.

(more…)

How can universal sanitation be achieved by 2030? A quick look at potential models to deliver

By Eve MacKinnon, PhD candidate at University College London

World Toilet Day

To mark World Toilet Day on Saturday 19 November, guest blogger Eve MacKinnon takes a look at the developing innovation in sanitation.

In 2015 Google held a technology festival in South Africa aiming to develop ways to digitify billions of people in the continent, who as yet unconnected are a significant potential new market for their products and therefore hugely valuable for future growth.

(more…)

Introducing ‘Exosonic’, a new device to combat pancreatic cancer

By Student Challenges Competition 2015/16 Audience Choice Award winners, Antonios Chronopoulos and Tyler Lieberthal

25834997575_6712f619af_kPancreatic cancer has the lowest survival rate of all major cancers and is widely regarded as a death sentence. The 5-year survival rate is still in the single digits at 3% and this figure has not changed over the past four decades largely due to lack of specific therapies and inability of early detection. Symptoms rarely develop with early disease, which translates to more than 85% of patients receiving their diagnosis at an advanced stage when the tumour is metastatic and no longer treatable. Modern imaging techniques, such as CT and MRI are expensive and unable to detect early-stage lesions. Currently, the “gold standard” for pancreatic cancer diagnosis is a fine needle aspiration biopsy of the tissue followed by histological evaluation. As an alternative to traditional tissue biopsy which is inherently risky, costly and often impractical, blood-based tests, smartly dubbed “liquid biopsies” are becoming increasingly appealing for non-invasive screening and early detection as well as longitudinal monitoring of the disease.

In recent years, exosomes have emerged as powerful circulating cancer biomarkers opening new avenues for blood-based screening, longitudinal monitoring and early detection of a number of different cancers, including pancreatic cancer. Exosomes are tiny nanometre-sized membranous particles carrying active molecular cargo that are released from tumours and can be found in the bloodstream and most bodily fluids. However, isolation and analysis of exosomes from biofluids is both inefficient and technically challenging, impeding the clinical utilisation of exosome-based liquid biopsies.

ant-2

In  March 2016 we took part in the IGHI Student Challenges competition and won the 3rd place Audience Choice award of £1,000 towards the development of ExoSonic, a novel palm-sized, point-of-care diagnostic device that leverages cutting-edge microfluidic technology to detect early-stage pancreatic cancer from a small blood sample.  Our microfluidic chip streamlines exosome isolation and analysis by providing a platform technology that enables purification of exosomes from blood combined with ultrasensitive on-chip molecular profiling of tumour-derived exosomes. (more…)

What is the role of social media in health policy?

By Sabine Vuik, Policy Fellow and Head of Analytics, Centre for Health Policy, Institute of Global Health Innovation

inforgraphics_110061949-1115-allint-2_lBig data and advanced data mining methods are becoming a crucial element of everyday life, business and research. The new insights that these methods can provide have allowed many different industries to find new opportunities, products and markets.

The new EPSRC Centre for Mathematics of Precision Healthcare which will launch on Wednesday 23rd November, aims to bring these methods into healthcare.

Precision Healthcare uses big data and mathematics to provide unprecedented insights into individual and population health.  The Centre will link up mathematical, computational and medical departments from Imperial, to bridge traditional silos and drive innovation in this area.

Social media and health policy

The Institute of Global Health Innovation, as one of the founders of the Centre, will contribute to research on social media and its role in healthcare policy communication. My role within the new centre will be to conduct evidence based research within the Social network analysis for health policy theme (one of six research themes).

Communicating health messages to the public is complex, as the topics are often complicated and of high importance. Social media can play an important role both in disseminating messages, and in understanding the public’s opinions and interactions with the information.

Healthcare companies, governments, public health organisations as well as the general public all use social media such as Twitter to spread information. Using network analysis, conversations on Twitter can be analysed to see who is broadcasting information, how this information spreads over the network and what the different opinions and reactions are.

A previous collaboration between IGHI and the Department of Mathematics analysed the Care.data debate on Twitter. It found that there were three distinct communities involved in the debate: healthcare professionals, data activists and political parties. While information disseminated widely within each community, there was little overlap between the groups. As a result, information can get ‘trapped’ and become one-sided. (more…)

The State of Diabetes in 2016

By Professor Desmond Johnston, Vice Dean (Education) for the Faculty of Medicine at Imperial College London

wdd-logo-date-en-2048pxThe prevalence of diabetes has increased dramatically in recent years and in some countries this is still occurring. The increase applies mainly to type 2 diabetes but there are indications that the prevalence of type 1 diabetes is also rising. Diabetes of either type has major personal and societal implications, being associated with an inevitable requirement for some modification of lifestyle, living in the shadow of serious complications such as circulatory disorders and disease of the eyes and kidneys, and ultimately reduced life expectancy. The consequences are especially severe in low income countries where the costs associated with having diabetes can have major implications for personal and family finances.

Much can be done already to limit the damage caused by diabetes, individually and at a societal level, but more research is needed. Type 2 diabetes occurs most commonly in people who are overweight and who take little physical activity. People at high risk of developing type 2 diabetes can be identified in the population with risk scores and/or a simple blood test, and in some countries this is now underway in a systematic fashion. We know from randomised controlled trials that type 2 diabetes can be prevented or delayed in many high risk people by lifestyle modification (diet and physical activity) but more research is needed to define the most cost effective methods of extrapolating the benefits which have been observed in the clinical trials to the wider population. It is likely that technology will play a role, enabling education in lifestyle modification and encouragement to be delivered at low cost to large numbers of people.idf_infographics_en-1In people with established type 2 diabetes, advances in the understanding of an individual’s response to specific treatments should improve outcomes (‘personalised medicine’) but much research is needed in this area. Prevention of type 1 diabetes is more problematic but also an area of much research. Some of the risk factors for type 1 diabetes have been identified and potential interventions to reduce its incidence are being explored. For people who have already developed type 1 diabetes, new methods of insulin delivery and glucose control are being explored. Interventions which limit or delay the loss of insulin-secreting beta cells could have long-term benefit and this is another major type 1 diabetes research area. For people with diabetes of any kind, the prevention of complications remains a challenge. We know that effective treatment of high glucose, blood pressure and lipid levels helps but more research is needed.

Although huge progress has been made in diabetes prevention and management in recent years, much remains to be achieved through high quality research and implementation programmes.

BIOTOPE (BIOmarkers TO diagnose PnEumonia)

By Dr John O’Donoghue, Senior Lecturer in eHealth & Deputy Director of Imperial’s Global eHealth Unit

Mr Masters Chisale (Mzuzu Central Hospital) and Dr Chris Watson (Queens Universty Belfast) preparing the samples in Mzuzu Central Hospital.
Mr Masters Chisale (Mzuzu Central Hospital) and Dr Chris Watson (Queens Universty Belfast) preparing the samples in Mzuzu Central Hospital.

The last week has been very busy in Mzuzu, northern Malawi.  Scientists there have been packing blood and urine samples collected from 506 children with pneumonia in preparation for shipment to Dublin, Ireland.  These samples will travel 12,000km at -80oC with constant monitoring of their temperature and dry ice being packed around them at stops along the journey to ensure they remain frozen in the warm heat of Africa as they travel across the African and European continents.

Over the past twelve months the researchers from the gHealth Research group based in University College Dublin, Queens University Belfast & Imperial College London have been working with colleagues in Malawi to collect these samples.  The BIOTOPE (BIOmarkers TO diagnose PnEumonia) project is an innovative project which received funding from the Gates Foundation Grand Challenges Exploration Fund to investigate new ways to diagnose bacterial and severe pneumonia in the community. 506 children have participated in the research and as part of this, blood and urine samples have been collected and are now being shipped to Ireland for detailed analysis along with novel data from sensors and mobile phone applications monitoring the children’s health.  With this approach, new ways to help stop the million children dying each year from pneumonia are being developed along with approaches that will help reduce antibiotic resistance both in Africa and internationally.

Pneumonia continues to be the number one infectious killer of children under the age of 5 years worldwide – more than HIV, TB, Zika, Ebola and malaria combined.

People of any age in any country are at risk of contracting pneumonia but the vast majority (>90%) of childhood deaths from pneumonia occur in poor countries.

Antibiotic resistance is present in every country in the world and as recently as the 21st September 2016 the UN held a general assembly on antibiotic resistance.  This was only the fourth such General Assembly high-level event in the history of the UN to focus on a health issue highlighting the serious nature of this problem.  (more…)

Putting TB to the test: My journey so far

By Harriet Gliddon, winner of the IGHI Student Challenges Competition 2015-16

ANT_4401During March 2016, I blogged for IGHI on World TB Day about my experiences of entering the Student Challenges Competition.

The intervening six months have been busier than I could have imagined, and filled with things like delivering an invited talk at the Biosensors Summit in Sweden, submitting my PhD thesis and completing an internship at the World Health Organization.

Despite the chaos, I’ve managed to make some exciting advances with the nanomaterial-based diagnostic test for TB that I presented at the Student Challenges Competition. One component of this work has focused on validating the genetic markers that are the biological targets, or biomarkers, of the test. I have used various methods, some well established and others more experimental, to assess the reliability of the biomarkers in discriminating between patients with and without TB. As I said in March, this work is a real team effort and a large proportion of the analysis was conducted by Dr Myrsini Kaforou, who I’m very grateful to. The biomarkers validated extremely well across multiple platforms, which proves their robustness regardless of the HIV infection status of patients, and across geographical locations (Malawi and South Africa), showing that they’re robust and reproducible for use as diagnostic markers of TB. This work is currently being prepared for publication, so keep an eye out for it in the next few months!

I have been keen to use mobile phone technology to translate the current assay, which currently requires a relatively sophisticated plate reader to record the results, into something more appropriate for use in field settings. Through the i-sense EPSRC Interdisciplinary Research Centre (IRC), my colleagues and I have been lucky enough to work with Dr Matthew Penny and Dr Steve Hilton from UCL, who have developed a working prototype of a mobile phone spectrometer that can sensitively detect the fluorescence of quantum dots (the nanoparticles I have been working with). (more…)

THET Annual Conference – Rethinking International Health Partnerships

By Hamdi Issa, PhD Candidate, Institute of Global Health Innovation

Tropical Health and Education Trust (THET)On the 20th and 21st October 2016, the Tropical Health Education Trust (THET) hosted their annual conference: ‘Evidence, Effectiveness and Impact’. This two day conference brought together academics, health care professionals, policy makers, government officials and students from all over the world, to celebrate and perhaps more importantly, learn how different health partnerships are changing the face of development.

Day one of the conference explored various elements of health partnerships, notably: the UK’s contribution to health globally and how the UK can best respond to the challenges thrown down by the Sustainable Development Goals.  Day two captured the work of individuals/groups involved in different types of health partnerships and the benefits and challenges of the different health partnership models.

THET launched their new policy paper: In our mutual interest. This policy paper captures the learning acquired by THET over the years they have managed the DfID-funded Health Partnership Scheme. By examining the associated benefits and challenges to this approach, it encourages everyone involved in health partnerships to think about how they can do more – and explore how health partnerships can be ‘mutually beneficial’ with particular considerations on the value to the NHS and UK institutions.

Aside from THET enabled health partnerships, individuals representing other forms of partnerships were present. In particular, thought-provoking presentations were delivered by two very different partnership models: FK Norway and GSK-PULSE Volunteers.

FK Norway is a Norwegian governmental body that supports exchange of employees between companies and organisations in Norway and developing countries. Through a 1 to 1 exchange ratio of participants, FK Norway aims to facilitate mutual learning and development of institutions. This method of exchange was very different from the exchanges being discussed by other partnerships. This was the first presentation to display a South to North flow of knowledge transfer as opposed to the traditional flow of knowledge (North to South). The FK Norway representative used the example of ‘kangaroo care’ as a practice widely used in developing countries to care for premature babies and through the exchange partnership, saw developing country partners teach their Norwegian partners how to train mothers in ‘kangaroo care’, at time where this practice was not widely accepted in Norway. It seems like Norway has found a partnership model that is using reciprocity to have ‘institutional-level’ impacts.

In a room full of public sector professionals, representatives from GlaxoSmithKline (GSK) brought a new perspective to the health partnership paradigm. GSK run a skills based volunteering partnership called PULSE. Through this partnership, GSK employees are matched to non-profit organisation, both at home and abroad, to tackle healthcare challenges. In light of the UKs push towards health partnerships that speak to the concept of ‘mutual benefit’ – GSK’s presentation captured a partnership model where volunteer experiences go beyond personal and professional development, to having business impact. One of the three aims of the PULSE programme is ‘change GSK’. GSK volunteers are encouraged to blog about their experiences and the learning they develop abroad, and upon return to the UK volunteers have the chance to share ideas with colleagues and senior staff to activate change within GSK.

Both GSK and FK Norway partnership models offer a learning opportunity for those involved within UK public sector health partnerships. An opportunity I hope many take advantage of if we are truly ready to move towards a new era of health partnerships, partnerships that welcome a global flow of learning and innovation to benefit health service delivery in the UK.