Over the past few decades, global health research has primarily focused on the "big three" diseases: AIDS, TB and malaria. And, thanks in large part to biomedical innovation, we today have better ways to treat these dreaded, infectious diseases and lower the risk of transmission -- advances that have saved millions of lives and promise to save countless more.
However, the job of biomedical research is far from over. Given the changing nature of the global health landscape, we must act now to broaden our vision even further. First, we need to apply the power of scientific innovation to more health problems. Secondly, we need to recognize that developed nations are not the only source of such innovation.
While infectious diseases remain a significant problem, low-income nations face many other serious health challenges. In fact, the fastest growing causes of death and disability in the developing world are injuries, such as those caused by traffic accidents, and non-communicable diseases, such as cancer, heart disease and diabetes.
It will be no easy task to identify and implement the right tools to tackle this formidable -- and potentially very costly -- array of problems in resource-poor countries. To succeed, we will need the brightest minds in all parts of the world, including those from both the public and private sectors, to work together in new and highly creative ways.
As an example of such an approach, the National Institutes of Health (NIH) and the Wellcome Trust, a global charity based in London, recently formed a partnership to support population-based studies in Africa of common, chronic disorders, as well as infectious diseases. That effort, called Human Heredity and Health in Africa (H3 Africa) project, will enable African researchers to take advantage of new research approaches to understand both genetic and non-genetic factors that contribute to risk of illness. Not only will this help people living in Africa, but, since Africa is the cradle of humanity, what is learned about genetic variation and disease likely will have an impact on the health of populations around the globe.
The H3 Africa project also illustrates the second way in which we need to broaden our vision of global health. Rather than seeing biomedical innovation as something that flows from developed nations to low-income nations, we need to start viewing innovation as a two-way street from which the entire world stands to benefit. As global health advocate Lord Nigel Crisp so aptly puts it: "Innovation is happening everywhere."
Recently, some of the most creative -- and cost-effective -- strategies for medical products and procedures have arisen from research that reflects the needs and ideas of people living in poorer countries. Such innovations include: a quarter-sized microscope that can transmit high-quality images via a mobile phone, lower cost intraocular lenses for cataract surgery, non-surgical methods for treating clubfoot, a high-performance prosthetic knee joint for amputees that costs only $20, a cheaper way to deliver IV fluids to children and an inexpensive, non-electronic device to warm premature babies. While some of these innovations are tailored to the specific needs of developing nations, others may come in handy in the United States -- particularly in remote areas or low-resource settings.
So, as a nation, let us renew and strengthen our commitment to biomedical research aimed at improving the health of the world's poorest peoples. It just might improve our own.
Francis S. Collins, M.D., Ph.D., is Director of the National Institutes of Health. He will be speaking at the Partnering for Global Health Forum in Washington, D.C. on June 27.
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While one must appreciate Lord Crisp's desire to go high tech, the fact is this H3Africa project seems a wonderful way for academics, physicians, drug companies, and medical device makers to expand their market.
At the cost of being accused of being some sort of fascist, or worse yet a Tea Bagger, I think the whole NIH project is a waste of tax payers money.
Of yes, it will provide a lot of useful employment to a lot of high paid bureaucrats, and extremely highly paid pysicians, it will yield nothing to American citizens, and likely increase the suffering (by way of starvation) to millions of Africans.
You want to reduce human disease and suffering. Invent condoms (male and female) that people will actually use. Award a billion dollars for the first entity to produce a male condom that is cheap, and will actually be used. Award another billion for the female version.
It must be cheap, and leave the user completely unaware of its use.
Also provide real incentives (cash, cars, radioes, clothes) to men who VOLUNTARILY have a vasectomy, and women who VOLUNTARILY have a tubal ligation. As a further incentive: free education through secondary and post-secondary to the children already born.
And while we're at it, how about birth control for the teenagers in America who are being given the same message?
A significant aspect of low cost, Biomass cook stoves that produce Biochar is removal of BC aerosols and no respiratory disease emissions. At Scale, replacing "Three Stone" stoves the health benefits would equal eradication of Malaria & Aids combined.
Global Clean Stove Initiative:
Secretary Clinton has gotten on board with DOE, USDA, & the CDC
State Dept. Release;
100 million clean-burning stoves in kitchens around the world.
http://www.state.gov/r/pa/prs/ps/2010/09/147494.htm
Serious boots-on-ground efforts producing biochar by Cookstoves;
Nat Mulcahy's WorldStove; http://worldstove.com/
WorldStoves in Haiti ; http://www.charcoalproject.org/2010/05/a-man-a-stove-a-mission/
Paul Anderson's Champion TLUD (and offshoots from that design);
http://www.bioenergylists.org/andersontludconstruction
Rob Flanagan's efforts mainly in China, The FlanaStove; http://bionecho.org/tptut/en/production.php
and
Dr. Reddy in India, GoodStove; http://www.goodstove.com/
SCAD Farm Science Center;
5000 biochar farmers trained, 500 villages served & 150,000 trees planted
Now if we had 100,000 more of these centers, we would be getting somewhere.
http://www.dailymotion.com/video/xiqpqh_biochar-aids-india-s-farmers-environment_news
Biochar Work in Nine Developing Countries:
http://www.biochar-international.org/9country
The Biochar Fund has doubled subsistence farmer's incomes;
Exceptional results from biochar experiment in Cameroon
The broad smiles of 1500 subsistence farmers say it all, that , and the size of the Biochar corn root balls
http://www.biochar-international.org/cameroon
If we also increased their ability to work more years, we bump into the unemployment trap. We seem to be faced with awful conundrums.
You raise very important issues that are never addressed in these discussions. This blog has more in common wite B.P. commericials that suggest that oil is what will save the world.
There is not really a "cumundrum" here, there is "denial" of the facts, that you have pointed out.
The H3 Africa will not doubt bring about substantial benefits to some people.
At the cost of being accused of being a "heartless pig" or worse, let me explicate.
1. The NIH will have, of course, will have to maintain a stable of Washington based administrators, supervisors, and auditors to oversee this program.
2. University professors will have to be hired as outside consultants.
3. Very highly paid M.D.'s and scholars will have to be paid to run the program.
4. The travel and hospitality industries will of course benefit from the travel associated with the conferences necessitated by the pre-planning, planning, institution, and assessment of the program.
5. The ultimate benificiaries of the program, will of course be the drug manufactures, the medical device manufacturers, and of course the Governments of the nations that supply the poor people(s).
The victims will be the "poor peoples". As Garett Hardin said in the "Population Bomb" [paraphrasing his statement] if you introduce DEATH CONTROL without BIRTH CONTROL, you end up with disaster.
You are one of few people in a position to address this nation's long term direction, so I direct my question to you.
I had some sense, about the time that there began to be some hope of mapping the human genome, that the United States deliberately undertook to throw its public funds behind medical and bio-science research and to considerably reduce research funding for all other scientific disciplines, with the intention of nurturing a health technology export explosion.
Rare journalistic revisiting of this history judges the current status to be somewhere between utter failure and unfounded optimism that the time was simply drastically underestimated. My personal judgment would be utter failure, because health care achieved near unaffordability and virtually no measurable health progress. I am aware of exceptions to my blanket condemnation such as better outcomes in premature births and some elderly afflictions but I am not aware of any related burgeoning foreign market. My cynicism is especially bitter because of the dire lack of any means by which ambitious people could be expected to spawn related businesses in their [precious American symbolic] garages, or even participate.
Who will give us an accounting of the project status, and what would be a proper course correction? Your post here seems to be an admission that we are incapable of producing anything that can help us with our ever more dire health system issues, and certainly not anything to export. Please tell us where we should turn.
Very well said. It appears that the National Institute of Health has little interest in public health.
Rather its interest is "Gee Whiz Science".
I could not disagree with you more. I am not impressed by either the fact that Francis has an M.D. and a PhD (you know the expression, PhD. piled higher and deeper).
To me it is a blantant example of "liberalbabble", as distinguised from "psychobabble".
There can be no alleviation of chronic human suffering until the population of the earth is equal to the carrying capacity of the earth.
No amount of Deep and Abiding Faith In the Wonders of Science, otherwise known as denial, can bring about such and end to chronic disease and hunger.
Proposal: Don't spend the money on "high tech". Do the following.
1. Offer a $1,000,000,000 (One Billion Dollar) prize to the first entity to invent a male condom that men will regularly and willingly use.
2. Offer a $1,000,000,000 (One Billion Dollar) prize to the first entity to invent a female condom that women will regularly and willingly use.
The user of such condom will have to be completely unaware of its use, as will the partner. It must be cheap, and biodegradable. The award increased to be increase by the prime rate of interest, until it is claimed.
This is one of the few bright spots in US biomedical science, particularly in the face of drastically cut R&D spending at big Pharma.
I would urge you to defend the SBIR program at NIH that is absolutely necessary for innovation in biotechnology. This program is very successful should be expanded because it provides the needed help at the very early stage of discovery, when VC is not available. European Union has set aside 15% of their research budget for small businesses in biomedical science. NIH has only set aside 3%. That is absolutely insufficient to support the biotechnology in this country!
I urge you to look into this matter.
Joel Smithis
Raleigh
As part of a project (The Wellness Project) designed around nature-based primary illness prevention, experiments are ongoing to evaluate the benefits of following the original eating plan that our ancestors followed for about 2.5 million years, and abandoned about 10,000 years ago in favor of our current Frankenfoods.
Roy Mankovitz, Director
Montecito Wellness
A research organization
http://books.google.com/books?printsec=frontcover&id=5bXsuOLBi9oC#v=onepage&q&f=false
If you have problems with politics messing with NIH programs, write to your representative with complains. There is the true culprit, particularly if he/she is Republican!
Thank you for your contributions to global health. I hope you will take a few minutes to watch the following video, as it presents remarkable information that has been largely overlooked and has profound implications for the current and future health of our species.
http://www.youtube.com/watch?v=6oTfN5NDQWE