Health innovation networks to help developing countries address neglected diseases.

Gross inequities in disease burden between developed and developing countries are now the subject of intense global attention. Public and private donors have marshaled resources and created organizational structures to accelerate the development of new health products and to procure and distribute drugs and vaccines for the poor. Despite these encouraging efforts directed primarily from and funded by industrialized countries, sufficiency and sustainability remain enormous challenges because of the sheer magnitude of the problem. Here we highlight a complementary and increasingly important means to improve health equity: the growing ability of some developing countries to undertake health innovation.

A multicentric evaluation of recombinant DNA hepatitis B vaccine of Cuban origin.

INTRODUCTION: Hepatitis B infection is an important public health problem all over the world. As no specific treatment is available, greatest emphasis is placed on prevention through immunization. OBJECTIVE: To evaluate the immunogenicity (sero-protection rate) and reactogenicity of a novel recombinant DNA hepatitis B vaccine of Cuban origin (Enivac HB). POPULATION AND METHODS: The study was conducted at two independent centres (New Delhi and Jaipur) and 111 healthy volunteers without any symptomatic or serological evidence of HBV infection were administered the vaccine intramuscularly in a dose of 20 ug at day 0, day 30 and day 180. Blood samples were collected for evaluation of sero-protection on days 30, 60, 90 and 210 at both centres and, in addition, at day 120 at New Delhi. All subjects were evaluated for any adverse event for 120 hours subsequent to each dose of the vaccine. RESULTS: The mean age of the volunteers was 24 years and the male:female ratio was 61:50. An overall sero-protection rate of 24.3% was obtained at day 30, 68.5% at day 60, 94.5% at day 90 and 99.1% by day 120. Following the third dose of the vaccine (at day 180), we lost one subject to follow up and further evaluation could be done in a total of 110 volunteers. The sero-protection rate by day 210 was found to be 100% (110/110). The vaccine was well tolerated with no serious adverse reactions. Minor side effects such as injection site tenderness, erythema and/or low grade fever were observed in 4.5% of the subjects. CONCLUSIONS: The recombinant DNA hepatitis B vaccine of Cuban origin is safe, well tolerated and highly immunogenic.

Brain metabolite changes on in vivo proton magnetic resonance spectroscopy in children with congenital hypothyroidism.

Localized in vivo proton magnetic resonance spectroscopy and imaging were performed in five children with untreated congenital hypothyroidism to look for biochemical markers of abnormal myelin and neuronal development. The patients had high levels of choline-containing compounds, which returned to normal with euthyroidism. These metabolic alterations may reflect blocks in myelin maturation that are reversible by thyroid hormone replacement throughout childhood.