Disease Defense Burnout

Government solves- low costs and proven solutions

First, everyone has obligations of humanitarian assistance to help others in dire need if the cost or imposition is minimal.3 This idea underlies the notion of a “Good Samaritan.” Most people recognize that, if a person is walking past a shallow pond and sees a child drowning in it, that person should wade in and pull the child out—even if that means risking minor injury or being delayed. Severe moral opprobrium and social stigmatization—if not legal penalties—are appropriate if you do not rescue the child. By analogy, societies have an obligation to help people affected by Ebola when the cost or imposition of doing so is minimal. Severe morbidity and mortality from Ebola are tragic occurrences, independent of where people live and whether societies or other countries have special relationships with those affected. Effective help for Ebola is available at relatively minimal cost for high-income countries. Supportive treatment and containment measures—implementing isolation of suspected cases, infection control and universal precautions, contact tracing and monitoring, surveillance, and raising awareness in local communities and internationally—have a proven track record of controlling Ebola outbreaks. Moreover, the resources necessary for these measures are small, even trivial. So far, the World Health Organization (WHO) has pledged $100 million, the World Bank $200 million, the European Commission $181 million, and the United States $75 million to combat this outbreak.4 Even if ultimately $1.5 billion is needed, this represents less than 1 penny for every $100 of the US $16 trillion gross domestic product in 2012, and just 1 penny for every $390 of the gross domestic product of the world’s 20 largest economies. By any measure, this constitutes an insignificant imposition on citizens of high-income countries. Virtually all high-income countries are thus in a position to effectively help curb the Ebola epidemic, without sacrificing much of importance. The moral obligation of humanitarian assistance requires doing so.

Military structures solve diseases

Webster 14— Medical News contributor (Paul Christopher, “Using military resources to fight disease,” Canadian Medical Association. Journal, Jun 10, 2014, http://search.proquest.com/docview/1535387339?pq-origsite=gscholar). WM

In a sign that international concern about infectious diseases is attract- ing attention in military circles, the United States government has launched the Global Health Security Agenda (GHSA), a multinational effort to con- front antibiotic resistance, epidemics, bioterrorism and disease outbreaks. To kickstart the effort, the govern- ment earmarked US$40 million from the budgets of the Department of Defense (DOD) and the US Centers for Disease Control and Prevention (CDC), with another US$45 million requested in this year's budget. "We're bringing DOD resources to the Global Health Security Agenda by leveraging the department's long history of medical and health inno- vation," Andrew C. Weber, assistant sec- retary of defense for nuclear, chemical a n d biological defens e p rograms, explained at the Feb. 13 launch. The aim is to create a worldwide "interconnected network of emergency operations centres to help manage these outbreaks," according to Laura Holgate, senior director of weapons of mass destruction terrorism and threat reduc- tion at the National Security Council in Washington, DC. Pooling funds from defence and health programs will extend the agenda's reach, Holgate said in video-recorded comments. "When you look at how we're orga- nized across our government on our vari- ous health and security strategies, you can see some common threads among them," she said. "We all face the same threats." The mixture of global health and security funding may prove problematic, however, says Ron Labonte, Canada Research Chair in Globalization and Healt h Equity at the University of Ottawa in Ontario. "It raises the question whether this is a defence or health agenda, and it is worrying that infectious diseases are being defined as a kind of terrorist threat." With the growth of antimicrobial resistance substantially rooted in phar- maceutical industry practices and inter- national trade agreements, he argues, bolstered security measures may amount to "a kind of proximate prevention, rather than structural change." S up po rt f ro m t h e D OD f o r t he GHSA indicates the Pentagon sees improving global health as a potential new mission, says J. Stephen Morrison, director of the Global Health Policy Center at the Center for Strategic and International Studies in Washington, DC. Between 2002 and 2005, DOD's share of US official development assis- tance increased from 5.6% to 21.7%, Morrison noted in a 2008 report. "There has been a shift within DOD thinking," says Morrison. "There's a broadening awareness of the legitimacy of a global health security agenda." Morrison acknowledges that military involvement inevitably creates tension. "This debate has been underway for some time. The civilian agencies don't want to see their roles usurped." Military encroachment into public health matters can be highly controver- sial, says Morrison. For example, the US used an immunization effort in the hunt for Osama Bin Laden in Pakistan in 2011. The US "must do more to seg- regate its efforts to prevent, detect and r esp on d to f ut ur e o u t br eak s f r o m counter-terror approaches," he argues. "There's always been a hesitation about health security policies. But I think that's changing. It's becoming a more constructive dialogue." Morrison notes that the US military operates an international network of lab- oratories and health surveillance and research facilities in Cambodia, Egypt, Georgia, Germany, Kenya, Peru and Thailand that are well-suited to serving the GHSA's plan to establish emergency disease operations centres in India, Kenya, Ethiopia, Tanzania and six other as-yet-unnamed nations. Canada will also contribute funding from security resources to the GHSA, according to Jean-Bruno Villeneuve, a sp ok e s p er s o n f o r Fo rei gn A ffai rs , Trade and Development Canada. "The GHSA is intended to bring together a cross-sectoral representation of health, defense, foreign affairs and agriculture ministries from participating coun- tries," he stated in an email. The Public H e al t h A g e n c y o f Ca n a d a i s a l s o "closely following GHSA develop- ments," according to Villeneuve. Canadian support for the effort will come in part from the Global Partnership Program, which earmarked $367 million in 2012 for th e Glo bal Partnership Against the Spread of Weapons and Materials of Mass Destruction. The escalation of infectious diseases to national security threat status suggests a new global health paradigm may be emerging. According to the World Eco- nomic Forum's 2014 Global Risk Report, antibiotic resistance is a risk roughly on par with terrorist attacks. A report issued by The CDC last year stated that antibiotic resistance was a complex problem and inaction could have "potentially catastrophic conse- quences." - Paul Christopher Webster, Toronto, Ont.

Biosensing solves infectious diseases now

Florida Atlantic University 4/6 (“New biosensing platform could quickly and accurately diagnose disease and monitor treatment remotely,” Phys.org is a leading web-based science, research and technology news service, Apr 06, 2015, http://phys.org/news/2015-04-biosensing-platform-quickly-accurately-disease.html). WM

In much the same way that glucometers and pregnancy tests have revolutionized in-home diagnostic testing, researchers from Florida Atlantic University and collaborators have identified a new biosensing platform that could be used to remotely detect and determine treatment options for HIV, E-coli, Staphylococcus aureas and other bacteria. Using a drop of blood from a fingerprick, this novel biosensing platform provides clinically relevant specificity, sensitivity and detection of pathogens from whole blood and plasma. The thin, lightweight and flexible materials developed by these researchers can be fabricated and operated without the need for expensive infrastructure and skilled personnel, potentially solving real-world healthcare problems for both developed and developing countries. Using this technology, they also have developed a phone app that could detect bacteria and disease in the blood using images from a cellphone that could easily be analyzed from anywhere in the world. The research collaborators have published their findings in Nature's Scientific Reports in an article titled "Paper and Flexible Substrates as Materials for Biosensing Platforms to Detect Multiple Biotargets." In the article, the researchers address the limitations of current paper and flexible material-based platforms and explain how they have integrated cellulose paper and flexible polyester films as new diagnostic tools to detect bioagents in whole blood, serum and peritoneal fluid. They employed three different paper and flexible material-based platforms incorporated with electrical and optical sensing modalities. They were able to demonstrate how these new materials can be widely applied to a variety of settings including medical diagnostic and biology laboratories. Using paper and flexible substrates as materials for biosensors, Asghar and his colleagues have identified a new rapid and cost-effective way to diagnose diseases and monitor treatment in point-of-care settings. They have been able to show how their new platforms are uniquely able to isolate and detect multiple biotargets selectively, sensitively, and repeatedly from diverse biological mediums using antibodies. "There is a dire need for robust, portable, disposable and inexpensive biosensing platforms for clinical care, especially in developing countries with limited resources," said Asghar. Existing paper and flexible material-based platforms use colorimetric, fluorometric and electrochemical approaches that require complex labeling steps to amplify their signal, are very costly to fabricate and also require expensive equipment and infrastructure. "The future of diagnostics and health monitoring will have potentially cell-phone based or portable readers sipping saliva or blood and continuously monitoring human health taking it way beyond where we are with counting steps today," said Demirci, who is the corresponding author. Asghar notes that because their materials are easy to make, easy to use, and can easily and safely be disposed by burning, they provide appealing strategies for developing affordable tools that have broad applications such as drug development, food safety, environmental monitoring, veterinary medicine and diagnosing infectious diseases in developing countries. "Our paper microchip technologies can potentially have a significant impact on infectious diseases management in low- and middle-income countries where there is limited laboratory infrastructure," said Shafiee. Demirci notes that these platforms could potentially be adapted and tailored to detect other pathogens and biotargets with well-known biomarkers.

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