Breaking ground and breakthroughs in medicine

From the amazing discovery of a new HIV Vaccine, to the fight against polio, climate change and its effects on malaria and a big step in tuberculosis research; we bring you a review of several efforts made at local and international levels to control certain diseases of public health significance. Malaria, polio, HIV, tuberculosis and few others, were some which raise expectation of medical researchers and policymakers in Nigeria.

Quest for a vaccine

In September 24, 2009, people in the HIV/AIDS sector heaved a sigh of relief as scientists in Thailand reported the success of a vaccine in curtailing the virus. The clinical trial conducted by the U.S. Military HIV Research programme and the Thai Ministry of Public Health, found a vaccine that has a 31.2 per cent efficacy in reducing the risk of HIV infection.

In Nigeria, the director general of the National Agency for the Control of AIDS, John Idoko, told NEXT that this brings hope. However, he added, "But even though there is hope, we have to be very careful because what we are looking for is 60 per cent and what we have is only 31 per cent. So we have a long way to go."

Dr. Idoko said, nevertheless, it is relevant to Nigeria and Africa as a whole. "The fact there is breakthrough, it is very encouraging. Though the strains used to develop the vaccines are not the ones circulating in Nigeria, since we have this success, we can develop a kind of polyvalent vaccines." (Polyvalent vaccines are effective against more than one strain).

The vaccine only protects against the HIV B and E types that are most prevalent in Thailand. The types of HIV found in Nigeria are HIV I and II. The HIV I type is the commonest and it is further divided onto subtypes A to K, with subtypes A, G and recombinant AG being the commonest. With a population of approximately 140 million, Nigeria is reportedly the third country in the world with the highest number of people living with HIV/AIDS after India and South Africa. In the last 20 years, more than 25 million have died worldwide from HIV/AIDS and another 40 million are estimated to be infected, with 10 infections occurring every minute every day, according to the Institute of Human Virology.

New face of polio

A polio virus strain, resurfaced in 2009 since it was last noticed 10 years ago. This strain, called "circulating Vaccine-Derived Polio Virus (cVDPV), made the World Health Organisation (WHO) issue a global alert warning that the country poses an "increasing risk of international spread."

Global Polio Eradication Initiative reports that it's a stunning setback for the initiative, now already nine years past its original deadline for vanquishing the virus, as this virus also called "Type 2 was eradicated 10 years ago".

The director of the World Health Organisation Polio Reference Laboratory, Ibadan, Festus Adu told NEXT, "We are simply not just vaccinating enough."

Speaking to NEXT in a phone interview, Prof. Adu added that the reason for such seeming resurgence is nothing but poor routine immunisation in the areas of spread.

"The reason we are having this resurgence is because routine immunisation is very poor in the areas where it is recorded, as this type can only appear in areas where there is low coverage of immunisation," added Prof. Adu, pointing that it is a big challenge to polio eradication because the country is still battling to contain Type 1 and Type 2 with elusive success. He recommended that the government uses a trivalent vaccine instead of monovalent as this would address all three strains of the virus.

Progress in TB research

After several attempts, Nigeria (the fifth largest TB burden bearer in the world), undertook a national surveillance of multi-drug-resistant tuberculosis (MDR-TB).

According to Oni Idigbe, the chairman of the National Tuberculosis and Leprosy Committee, the research will enable proper identification of an MDR strain. This in turn will make treatment accurate by increasing case detection rates which is current at a poor 20 per cent to 75 per cent recommended by the WHO.

He added; "This survey will help us contain the epidemic."

"It will also help us know the quantity of the second-line drugs to request for."

The financial and technical support for the $2 million study is largely provided by the CDC Atlanta, the United States Agency for International Development, WHO, the U.S. President's Emergency Plan for AIDS Relief (PEPFAR), while the federal government is providing human resources and work sites.

The MDR-TB is a strain of TB that resists at least two powerful first-line anti-TB drugs - Rifampicin and Isoniazid. TB, one of the world's leading causes of adult mortality with 9.2 million new cases and 1.7 million deaths in 2006, develops a resistant strain due to lack of adherence to the first-line drugs, administration of improper treatment regimens by health-care workers, among other things. According to experts, treatment for an individual with multi-drug resistant TB costs $7,000 a year, about 100 times the cost of treating regular TB.

Malaria forges on

According to the United Nations Environment Programme (UNEP), malaria pattern keeps changing due to global climate change. Several researches have shown that the incidence is increasing because of the irregular weather patterns of rainfall and sun shine.

A new malaria map shows that the primary malaria agent, the falciparum malaria parasite, will be able to spread into new areas, as displayed in this map, by 2050. In Nigeria, malaria is still responsible for the highest hospitalisations and killing about 300,000 people yearly. No research shown yet in the country, but experts are on the look out for these new trends in 2010.