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Skin and breast cancer drugs approved for NHS use in Scotland

Two cancer drugs have been approved for patients on the NHS in Scotland. An immunotherapy for some p..

Two cancer drugs have been approved for patients on the NHS in Scotland. An immunotherapy for some people with advanced skin cancer and a targeted drug for some patients with breast cancer got the green light this week.

The fresh batch of decisions from the Scottish Medicines Consortium (SMC) this week were hailed as “great news” by Gordon Matheson, Cancer Research UKs public affairs manager in Scotland.

“The decisions mean that a treatment called pembrolizumab is now available for some patients whose skin cancer has spread to the lymph nodes.”

Pembrolizumab (Keytruda) will now be an option for patients whose melanoma has spread to the lymph nodes and who have already had surgery.

Matheson said the treatment provides another treatment option for patients whove had surgery to remove their cancer but who are at high risk of it returning.

New option for patients with melanoma after surgery

Pembrolizumab works by boosting the immune systems ability to kill cancer cells and can help target any cancer cells left behind after surgery.

In a clinical trial involving over 1000 patients, pembrolizumab increased the length of time patients lived without their cancer coming back.

15 in 20 of those taking pembrolizumab were cancer free 12 months after treatment, compared to just over 12 in 20 of those taking a dummy drug. And in data provided to the SMC, 7 in 10 patients taking pembrolizumab were alive without their cancer coming back 18 months after treatment, compared to 5 in 10 patients taking the dummy drug.

But severe side effects, including type 1 diabetes and bowel inflammation, were more common in patients taking pembrolizumab. And one person died as a result of taking pembrolizumab, which caused muscle inflammation.

Clinical experts told the SMC they considered pembrolizumab to be an advancement in treatment as it significantly reduced the risk of cancer coming back after surgery.

Pembrolizumab was approved for NHS use in England in November 2018 by the National Institute of Health and Care Excellence (NICE). NICE decisions are also adopted by Wales and Northern Ireland, so the drug should be available for eligible patients there too.

Targeted drug gets green light for advanced breast cancer

The SMC also approved two combinations, including the drug abemaciclib for breast cancer, in their latest batch of decisions.

The targeted cancer drug works by blocking growth molecules inside cancer cells, which stops them from dividing. Its been developed for patients whose cancer cells test positive for certain hormone receptors, but not the HER2 receptor.

Abemaciclib will now be available as part of two different treatment combinations to patients whose breast cancer has spread. It can either be used with the hormone treatment fulvestrant or in combination with a group of hormone therapies called aromatase inhibitors.

Both combos will be available to patients whove already had hormone therapy. But the combination of abemaciclib and aromatase inhibitors will also be available to women who havent had any treatment for their breast cancer.

Matheson said the double abemaciclib decision would “provide new treatment options for patients with HER2-negative breast cancer.”

“This will be very welcome for patients and their families,” he said.

The data behind the decisions

Combining abemaciclib with fulvestrant was shown to slow disease progression and delay the need for chemotherapy in a trial involving 669 patients with advanced breast cancer.

Taking a combination of abemaciclib and fulvestrant increased the time before patients cancers got worse, compared to taking fulvestrant alone. Patients taking the drug combo were alive for an average of 16.5 months without their cancer getting worse, compared to 9.3 months for those just taking fulvestrant.

But serious side effects were more common in the group taking the drug combination, with 1 in 5 people experiencing side effects including severe diarrhoea and blood clots.

The trial has not been running for long enough to know how much the drug combination will improve long-term survival for these patients.

Abemaciclib has also been tested in combination with an aromatase inhibitor in a separate trial involving 493 women with advanced, untreated breast cancer. Adding abemaciclib to aromatase inhibitors significantly increased the time patients lived without their disease getting worse compared to those taking aromatase inhibitors alone.

The most frequent severe side effects for those taking the combo in the trial were low levels of one type of white blood cell (neutropenia) and diarrhoea.

The two drug combinations got the green light for NHS England for a similar group of patients in January and April this year. The combos should also be available in Wales and Northern Ireland.

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Burkina Faso: Growing Violence Threatens Health Care

Away from the worlds attention, Burkina Faso has been slipping into violence. In less than a year, t..

Away from the worlds attention, Burkina Faso has been slipping into violence. In less than a year, the number of displaced has increased fivefold, from 50,000 last December, to 270,000 in August. As ever, the most vulnerable suffer most: the very young, and the very old.

When Alidou Sawadogos elderly mother fell ill, he faced a long and dangerous journey to get treatment for her.

“When she collapsed, a friend called me,” he explains. “By the time I arrived she was already unconscious. I decided to take her to the health center and luckily someone who had a motorcycle helped me. Because of the violence many people who are sick wait at home and die. Everyone is afraid of taking the road to the health center in Barsalogho.”

Across Burkina Faso, the rising insecurity has forced over a hundred health centers to close, or to limit their work. Half a million people now have little or no access to health care. Dedicated health workers, among them Dr Bertrand Dibli in Barsalogho, are struggling to meet the needs, and to stay safe themselves.

“This is one of the few health centers that isnt closed,” he says. “We dont have enough equipment. And the insecurity has caused huge anxiety among health workers. Even coming here to Barsalogho is a huge challenge because the route is so dangerous.”

The ICRC has been working to support Burkina Fasos health professionals, with medical kits, and vaccination campaigns. During his visit to the country, ICRC President Peter Maurer expressed his concern at the multiple challenges facing Burkina Fasos people.

“We are very concerned,” he said. “Very worried about the upsurge in violence, its a vicious circle that is trapping the civilian population between armed groups.”

“We also see,” Mr Maurer added, “that it is not only the violence that is affecting the country, it is also under development, and climate change. Together with the violence that is obstructing the health services, its an accumulation of factors.”

And so the ICRC – jointly with the Burkinabé Red Cross – is also delivering food to the displaced, and helping to improve access to water supplies. All of this, says nurse Jeanette Kientega, is desperately needed by a population uprooted by conflict, and denied access to basic health care.

“By the time they are able to get here, it is often too late” she says. “Sometimes we can help, but if they have already been ill a long time, it is difficult. We try to do what we can.” (more…)

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World Bank and WHO Statement on Partnership & Deployment of Financing to WHO for Ebola Response in DRC

WASHINGTON, August 23, 2019—The World Bank and the World Health Organization (WHO), along with the G..

WASHINGTON, August 23, 2019—The World Bank and the World Health Organization (WHO), along with the Government and other key partners, are working in close partnership on the Ebola Crisis Response in the Democratic Republic of the Congo (DRC). Central to this partnership is the assessment of the financing needs, and deployment of resources, with the goal to put an end to the current deadly outbreak.

The World Bank is today announcing that US$50 million in funding is to be released to WHO for its lifesaving operational work on the frontlines of the outbreak. The WHO is announcing that this US$50 million in funds will close the financing gap for its emergency health response in DRC through to the end of September 2019, and is calling on other partners to mirror this generous support in order to fund the response through to December.

The funding comprises US$30 million from the Pandemic Emergency Financing Facility (PEF) and US$20 million from the World Bank. The US$50 million in grant funding is part of the larger financial package of approximately US$300 million that the World Bank announced last month to support the fourth Strategic Response Plan for the DRC Ebola outbreak.

“WHO is very grateful for the World Banks support, which fills a critical gap in our immediate needs for Ebola response efforts in DRC, and will enable the heroic workers on the frontlines of this fight to continue their lifesaving work,” said Dr. Tedros Adhanom Ghebreyesus, Director-General, World Health Organization. “We keenly await further funding from other partners to sustain the response through to the end of the year.”

The DRC government, working in collaboration with the World Bank, WHO, and other key partners, has finalized the Fourth Strategic Response Plan (SRP4), which outlines the total resources needed for the DRC Ebola Crisis Response from July to December 2019. The financing announced today is part of the World Banks previously announced financial package of up to US$300 million and covers over half of SRP4s needs, with the remainder requiring additional funding from other donors and partners.

“The World Bank is working closely with WHO, the Government of DRC, and all partners to do everything we can to put an end to the latest Ebola outbreak,” said Annette Dixon, Vice President, Human Development at the World Bank. “The partnership between our organizations and the Government is critical for responding to the emergency as well as rebuilding systems for delivery of basic services and to restoring the trust of communities.”

The Government of DRC requested US$30 million from the PEF Cash Window to be paid directly to WHO. The PEF Steering Body approved the request bringing the PEFs total contribution to fighting Ebola in DRC to US$61.4 million. The PEF is a financing mechanism housed at the World Bank; its Steering Body is co-chaired by the World Bank and WHO, and comprises donor country members from Japan, Germany and Australia. The quick and flexible financing it provides saves lives, by enabling governments and international responders to concentrate on fighting Ebola—not fundraising.

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Borno State launches first Malaria Operational Plan, reawakens fight against malaria

Maiduguri, 13 August 2019 – Following recommendations from malaria interventions in Borno State Nige..

Maiduguri, 13 August 2019 – Following recommendations from malaria interventions in Borno State Nigeria, the Malaria Annual Operational Plan (MAOP) was developed and launched on 08 August 2019 with technical support from the World Health Organization (WHO) and partners. Aligned to the National Malaria Strategic Plan (2014 -2020), MAOP was developed through a broad-based stakeholders workshop involving malaria stakeholders, reviewed on different thematic areas and endorsed by the Commissioner for Health and Permanent Secretary, Borno State Ministry of Health.

Speaking during the launch, the Borno state Malaria Programme Manager, Mr Mala Waziri described the MAOP as the first to be endorsed and disseminated in Borno State. “WHO has made us proud by supporting the first ever Malaria Operational Plan right from development, review, printing to dissemination.”

Dr Ibrahim Kida, the Ministerial Secretary Borno State Ministry of Health and Incident Manager of the state, described the launch as “an historic event as stakeholders across the health sector made commitments to use the document as an implementation guide for all malaria programs”. The plan was also described as an advocacy tool for planning domestic funds mobilization.

The MAOP has seven objectives among which are: provide at least 50% of targeted population with appropriate preventive measures by 2020; ensure that all persons with suspected malaria who seek care are tested with Rapid Diagnostic Test (RDT) or microscopy by 2020 and all persons with confirmed malaria seen in private or public health facilities receive prompt treatment with an effective anti-malarial drug by 2020.

The MAOP will further ensure that at least 50% of the population practice appropriate malaria prevention and management by 2020, ensuring timely availability of appropriate anti-malarial medicines and commodities required for prevention, diagnosis and treatment of malaria in Borno State by 2020.

In addition, it seeks to ensure that all health facilities report on key malaria indicators routinely by 2020 and finally strengthen governance and coordination of all stakeholders for effective program implementation towards an A rating by 2020 on a standardized scorecard. These strategic objectives have specific targets and the MAOP takes into account the humanitarian response.

“Malaria remains a leading cause of poor health in Nigeria. According to the 2018 WHO Malaria Report, 53million cases are recorded annually in Nigeria, roughly 1 in 4 persons is infected with malaria contributing 25% of the global burden,” says Dr Nglass Ini Abasi, WHO Malaria Consultant for the North East.

“Furthermore, 81,640 deaths are recorded annually (9 deaths every hour), which accounts for 19% of global malaria deaths (1 in 5 global malaria deaths) and 45% malaria deaths in West Africa. The Nigeria Malaria Strategic Plan (NMSP) 2014-2020 has a goal to reduce malaria burden to pre-elimination levels and bring malaria-related mortality to zero and WHO is working assiduously with Government to ensure the burden is reduced accordingly.”

Results from WHO’s Early Warning, Alert and Response System (EWARS) week 30 report from 223 sites, (including 32 IDP camps) show that malaria was the leading cause of morbidity and mortality accounting for 35% of cases and 46% of reported deaths. In addition, results from the Nigeria Humanitarian Response Strategy (NHRS 2019-2021) indicate 7.1million people are in dire need of healthcare and 6.2million are targeted for immediate attention.

Despite recent improvements, insecurity remains a challenge limiting access to the functional health facilities. Easily preventable and treatable diseases such as malaria, acute respiratory infection and diarrheal diseases account for the greatest proportion of morbidity and mortality among the vulnerable population. Furthermore, Malaria is endemic in North East Nigeria and the transmission is perennial with a marked seasonal peak from July to November every year. (more…)

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