e-Pharmalink is an electronic newsletter of the Ecumenical Pharmaceutical Network (EPN), an independent, non-profit Christian organization, whose mission is to support churches and church health system provide and promote just and compassionate quality pharmaceutical services through networking, access to medicine and treatment literacy programmes.

This newsletter aims at equipping pharmacists and other health professionals with information about international trends relevant to their work and opportunities that could support them in their efforts to provide effective and efficient services, particularly in poor countries. It is a summary of news reported by a wide range of publications or organizations and includes web links to the original sources. Anyone can receive this e-mail.

HIV and Aids

Many patients taking HIV drugs can now expect to live into their 70s
According to the study published in the July 26th edition of The Lancet, showed that an individual starting successful HIV treatment aged 20 would be expected to live to be 63, and that a patient initiating an anti-HIV drugs regimen aged 35 could live to the age of 67. It also provided evidence of the dramatic and continued decline in the risk of death amongst people with HIV since effective HIV treatment became available.
http://www.aidsmap.com/en/news/3CEC691F-4668-4F12-BC64-E65E0EA6142F.asp

Early Antiretroviral Therapy and Mortality among HIV-Infected Infants
Infants with human immunodeficiency virus type 1 (HIV-1) infection have higher rates of disease progression and mortality than older children, even with a high percentage of CD4 lymphocytes (CD4 percentage). According to a trial published in New England Journal of Medicine that addressed the optimal time of initiation and duration of antiretroviral therapy in infants with inutero or intrapartum HIV-1 infection. Early HIV diagnosis and early antiretroviral therapy reduced early infant mortality by 76% and HIV progression by 75%.
http://content.nejm.org/cgi/content/full/359/21/2233

Gilead aiming to put four HIV drugs in one pill
The `Quad` pill will combine tenofovir and emtricitabine (already marketed as a two-drug pill called Truvada) with a new antiretroviral drug now in phase III studies, called elvitegravir. This drug belongs to a new class of antiretroviral drugs called integrase inhibitors, and will be combined with another new drug, called GS9350, which boosts levels of elvitegravir. 
http://www.aidsmap.com/en/news/7F4D31FA-A34B-4571-902B-78817E1F0EDF.asp   

Uganda says no to ARV donations
Uganda's National Medical Stores (NMS), the government's main supplier, has resolved to Reject donations of life-prolonging antiretroviral (ARV) medication until procurement is coordinated in the entire health sector.
http://www.irinnews.org/Report.aspx?ReportId=82498

Teenagers getting high on HIV drugs in S Africa     
Anti-retroviral drugs used to treat HIV and Aids are being bought and smoked by teenagers in South Africa to get high. Reports suggest that the drugs are being sold by patients and even healthcare staff for money. School children have been spotted smoking the drugs, which are ground into powder and sometimes mixed with painkillers or marijuana.
http://news.bbc.co.uk/2/hi/africa/7768059.stm

Access Issues

High medicine prices and poor availability: So much evidence but where is the action?  
Millions of people in low- and middle-income countries cannot afford or obtain the medicines they need. These are the sobering findings of an analysis by Alexandra Cameron and others published in Lancet. The analysis is based on findings from 45 surveys carried out since 2001 in 36 countries using a standardized methodology developed by HAI and WHO. Across the surveys, public sector availability of generics averaged a disappointing 38%. Even in the private sector, the availability of generics was far from ideal.
http://www.haiweb.org/medicineprices/01122008/1%20Dec%202008%20Press%20release.pdf

Novartis and MMV launch new pediatric formulation of malaria drug
Novartis and Medicines for Malaria Venture have launched the Coartem dispersible tablet, a new pediatric formulation of Coartem, for the treatment of uncomplicated malaria in infants and children. Novartis said that Coartem dispersible contains the same amounts of artemether and lumefantrine as Coartem, the leading artemisinin-based combination therapy (ACT) in Africa, and is the first dispersible fixed-dose ACT developed especially for children.
http://www.tradingmarkets.com/.site/news/Stock%20News/2148473/

Drug Resistance

Prolonged nevirapine in breast-fed babies prevents HIV infection but leads to drug-resistant HIV
Babies born to HIV positive mothers and given the antiretroviral drug nevirapine through the first six weeks of life to prevent infection through breast-feeding, are at high risk for developing drug-resistant HIV if they get infected. In a study led by researchers at Johns Hopkins Children's Center, risks of drug resistance in the first year of life were compared in Indian infants getting a standard single dose of nevirapine at birth and those on the six-week regimen.
http://www.eurekalert.org/pub_releases/2009-01/jhmi-pni010509.php

XDR-TB: Deadlier and more mysterious than ever
Extensively drug-resistant tuberculosis (XDR-TB) is a growing public health threat that is only just beginning to be understood by medical and public health officials.
Patients with XDR-TB are four times as likely to fail treatment and three times more likely to die than patients with other forms of multi-drug-resistant TB (MDR-TB), according to a recent study that directly compared patients with XDR-TB to individuals with other types of MDR-TB to determine the differences in treatment outcomes and long-term survival rates.
http://www.eurekalert.org/pub_releases/2008-11/ats-xda110308.php
http://www.thoracic.org/sections/publications/press-releases/resources/XDR-TB%20111508.pdf

Reports

World Malaria Report 2008
The World malaria report 2008 describes the global distribution of cases and deaths, how WHO-recommended control strategies have been adopted and implemented in endemic countries, sources of funding for malaria control, and recent evidence that prevention and treatment can alleviate the burden of disease. …"
http://www.who.int/malaria/wmr2008/malaria2008.pdf

Implementation of a National Anti-Tuberculosis Drug Resistance Survey In Tanzania
The aim of this study was to describe the implementation process of a national anti-tuberculosis drug resistance survey in Tanzania, in relation to the study protocol and standard operating procedures. Factors contributing positively to the implementation of the survey were a continuous commitment of the key stakeholders, the existence of a well-organized National Tuberculosis Programme, and a detailed design of cluster-specific arrangements for rapid sputum transportation.
http://www.biomedcentral.com/content/pdf/1471-2458-8-427.pdf

Ensuring the Quality of Medicines in Resource-Limited Countries: An Operational Guide
The manual underscores the importance of medicines quality to global public health. It provides an overview  of major topics  that need  to be considered  to properly  ensure quality of drugs in resource limited settings.
http://www.usp.org/worldwide/dqi/index.html

Funding and training opportunity

Africa Health Systems Initiative: Research Competition
The Global Health Research Initiative (GHRI) invites teams of researchers and decision-makers to submit research proposals focusing on: Human Resources for Health (HRH) and/or Health Information Systems (HIS). Registration is due on 13 March 2009. Full application is due on 22 April 2009.Geographic areas of focus:  Francophone West Africa - Mali, Burkina Faso, Benin - Great Lakes and Eastern Africa - Tanzania, Uganda, Kenya - Southern Africa - Malawi, Mozambique, Zambia
http://www.idrc.ca/en/ev-114684-201-1-DO_TOPIC.html

i+solutions 2009 training calendar
i+solutions in cooperation with WHO  will offer the following training in 2009

• Managing Drug Supply in low and middle income countries
• ARV Procurement and Supply management
• Monitoring and Evaluation of Procurement and Supply Management
• Procurement and Quantification Management of Medicines and Medical supplies
• Procurement & Supply Management of Artemisin-based Combination Therapies
• Executive Training in Procurement and Supply management