Cuba

Havana Embassy Staff: ‘Concussion Without Concussion’?

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JAMA study finds real brain injuries, but no hard evidence as to the cause

 

Action Points

  • Persistent cognitive, vestibular, and oculomotor dysfunction, sleep impairment and headaches were observed among US government personnel in Cuba, associated with reports of directional audible and/or sensory phenomena of unclear origin, and without history of head trauma.
  • Note that the initial symptoms appeared to be auditory related and an expert panel concluded that the findings of the triage otolaryngology evaluations most likely were related to neurotrauma from a non-natural source.

Examinations of U.S. Embassy personnel who developed neurological symptoms in 2016 while stationed in Havana, Cuba, indicated that they really did sustain brain injuries, even though none of the individuals experienced head trauma, researchers reported in JAMA.

The embassy employees reported persistent cognitive, vestibular, and oculomotor problems plus sleep impairment and headaches after experiencing an intensely loud, unusual noise or sensation of unknown origin, according to Douglas Smith, MD, and colleagues at the University of Pennsylvania in Philadelphia.

The symptoms resemble mild brain traumatic injury, or concussion, they reported in JAMA. It is unclear if or how the noise is related to the symptoms, and the report shed no light on what else might have caused the symptoms. Some have speculated that the embassy personnel were attacked with an acoustic weapon beamed from outside the embassy.

“These patients are having problems with working memory, sustained attention, and concentration,” co-author Randel Swanson II, DO, PhD, said in an accompanying podcast interview. Like concussion patients, work takes more energy for these people because they lack cognitive reserve. “Something’s happened to the network and it takes them so much more energy so they’re fatigued and by the end of the day, they have massive headaches,” he said.

“This is really concussion without concussion,” Smith added.

In late 2016, U.S. government personnel in Havana reported various neurological symptoms after experiencing strange sounds, described mostly as loud and high pitched, that were associated with a sensation described as pressure-like or vibratory. Initial symptoms appeared to be auditory related and led to a triage program centered on otolaryngology evaluations for embassy community members at the University of Miami. Sixteen individuals who heard the sound presented neurological signs and symptoms that resembled a concussion. Over time, eight additional people reported similar problems.

In July 2017, the U.S. Department of State convened an expert panel which concluded that the triage findings most likely were related to neurotrauma from a non-natural source and recommended further study at the University of Pennsylvania Center for Brain Injury.

Of 24 individuals with suspected exposure to the noise or sensation, 21 completed multidisciplinary evaluation an average of 203 days later. The group included 10 men (average age 39) and 11 women (average age 47).

Nearly all — 20 of 21 people, or 95% — reported immediate neurological symptoms associated with the noise. One individual woke from sleep with acute symptoms including headache, unilateral ear pain, and hearing changes, but did not experience the phenomena.

Twenty embassy personnel reported persistent symptoms — ones that lasted for more than 3 months — that included cognitive (81%), balance (71%), and auditory (68%) problems, sleep impairment (86%), and headaches (76%).

Objective findings included cognitive (76%), vestibular (81%), and oculomotor (71%) abnormalities, the researchers noted. Three individuals experienced moderate to severe sensorineural hearing loss. Fifteen people (71%) required medication for sleep dysfunction and 12 (57%) for headache. Fourteen people stopped working; seven eventually returned to work with restrictions, home exercise programs, and cognitive rehabilitation. All 21 patients had MRI neuroimaging and most had conventional findings within normal limits.

Several important factors need to be considered in this case series, observed Christopher Muth, MD, of Rush University Medical Center in Chicago, and Steven Lewis, MD, of Lehigh Valley Health Network in Allentown, Pennsylvania, in an accompanying editorial.

While the embassy employees were in a common geographic area when their symptoms first appeared, not everyone had the same symptoms. It’s unclear whether individuals who developed symptoms later knew about previous reports, they noted.

“Furthermore, the quantitative results for specific tests (e.g., neuropsychological tests) are not yet available for all affected patients, so independent assessment as to the scope and severity of deficits among all individuals remains challenging,” they wrote.

And the analogy to concussion may be not be quite right because many of the symptoms described also occur in conditions like persistent postural-perceptual dizziness (PPPD), they noted, although “PPPD alone does not appear to explain the entirety of the symptoms reported nor the clustering of individuals affected.”

The symptoms have raised outside concerns about delusional disorders or mass psychogenic illness. But several of the manifestations in this group of patients — including the oculomotor and vestibular testing abnormalities — could not have been manipulated, the researchers maintained.

“Furthermore, mass psychogenic illness is often associated with transient, benign symptoms with rapid onset and recovery often beginning with older individuals,” they wrote. “In contrast, the Havana cohort experienced persisting disability of a significant nature and are broadly distributed in age.”

“Rather than seeking time away from the workplace, the patients were largely determined to continue to work or return to full duty, even when encouraged by healthcare professionals to take sick leave,” they added.

The researchers plan further neuroimaging to evaluate the embassy employees. “Since the clinical features appear so similar to concussion, we will use diffusion tensor imaging and advanced MRI that examines the connectivity of the brain’s network,” Smith told MedPage Today. “This is commonly shown disrupted in concussion. However, if we do find changes, we anticipate that the distribution will be different than in concussion, where some findings are related to head impact.”

In the meantime, the State Department issued a level 3 travel advisory to Cuba, recommending that Americans reconsider trips there due to “health attacks directed at U.S. Embassy Havana employees.”

Cuba’s Had A Lung Cancer Vaccine For Years, And Now It’s Coming To The U.S.

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 President Barack Obama became the first president to visit Cuba in almost 90 years when he and first lady Michelle Obama traveled to the island nation in March. But one of the most exciting things about the thawing of relations between Cuba and the U.S. is happening stateside right now: the possibility of clinical trials on a drug to prevent lung cancer, and possibly other cancers, too.
 CimaVax, which is both a treatment and vaccine for lung cancer, has been researched in Cuba for 25 years and free to the Cuban public since 2011. New York Governor Andrew Cuomo’s trade mission to Cuba in April 2015 resulted in a signed agreement to bring CimaVax to the U.S., but as with all international drugs and treatments, U.S. researchers need to conduct clinical trials and replicate international scientists’ results before it becomes available to the American public.
“We’re still at the very early stages of assessing the promise of this vaccine, but the evidence so far from clinical trials in Cuba and Europe has been striking,” said Dr. Kelvin Lee, Jacobs Family Chair in Immunology and co-leader of the Tumor Immunology and Immunotherapy Program at Roswell Park Cancer Institute in Buffalo, New York, the research center that is evaluating CimaVax for U.S. use.
 The hoped-for success of CimaVax availability in the U.S. is just one example of the possibilities that come with open trade between the two nations. When Obama loosened the United State’s 55-year trade embargo against Cuba in December, he allowed for such joint research deals to be finalized. Similar programs might have been impossible just a few years ago.
 “You never know how long these things would take,” said Candace Johnson, CEO of Roswell Park. “We would have loved to have had this already started because we’ve been working on this for quite a while, but we’re persistent and we’ll get it done.”

Cuba has long been known for its high-quality cigars, and lung cancer is a major public health problem and the fourth-leading cause of death in the country. A 2007 study of patients with stages IIIB and IV lung cancer, published in the Journal of Clinical Oncology, confirmed the safety of the CimaVax and showed an increase in tumor-reducing antibody production in more than half of cases. It proved particularly effective for increased survival if the study participant was younger than 60.

So far, 5,000 patients worldwide have been treated with CimaVax, including 1,000 patients in Cuba. Lee said the latest Cuban study of 405 patients, which has not yet been published, confirms earlier findings about the safety and efficacy of the vaccine. What’s more, the shot is cheap — each costs the Cuban government just $1, Wired reported. Studies have found there are no significant side effects.

“We think it may be an effective way to prevent cancer from developing or recurring, so that’s where a lot of our team’s excitement comes in,” Lee said. “There’s good reason to believe that this vaccine may be effective in both treating and preventing several types of cancer, including not only lung but breast, colorectal, head-and-neck, prostate and ovarian cancers, so the potential positive impact of this approach could be enormous.”

How it works

CimaVax induces people to build antibodies against a certain growth factor that cancer cells make. For people who already have lung cancer, this response results in the body actually getting rid of the cancer cells. And for people who are currently healthy but at high risk for lung cancer — say, a lung cancer patient in remission — the treatment acts as a vaccine to prevent future relapse. Johnson envisions that it could one day be a standard preventive vaccine that a person gets in childhood, much like the way we get vaccinated against polio, measles, mumps and rubella.

In addition to CimaVax, Roswell Park scientists are also reviewing other vaccine approaches from researchers at Cuba’s Center of Molecular Immunology (where CimaVax was invented) that could one day help patients overcome brain and pancreas cancer, as well as blood cancers like leukemia and lymphoma. While they aren’t as far along as CimaVax, Johnson said she is excited for the possibility these other treatments hold.

“They are a very innovative group of scientists, and they have vaccines and drugs that we think could play a very significant role in our fight against cancer,” she said. “We’re delighted to be working with them and we hope very soon that we can start our trial on CimaVax — hopefully the first of many clinical trials to be done with some of these Cuban vaccine approaches.”

To be clear, the CimaVax doesn’t cure cancer. It’s a therapeutic vaccine that works by targeting the tumor itself, specifically going after the proteins that allow a tumor to keep growing. (And as PBS points out, a person can’t just take a shot of CimaVax and continue to smoke without fear of lung cancer.)

“We hope to determine in the next few years whether giving CimaVax to patients who’ve had a lung cancer removed, or maybe even to people at high risk of developing lung or head-and-neck cancers because of a history of heavy smoking, may be beneficial and may spare those people from having a cancer diagnosis or recurrence,” Lee said.

What needs to happen first

Roswell Park faces many bureaucratic hurdles before clinical trials for CimaVax actually begin.

Because an embargo on Cuba is still in effect, Roswell Park had to apply for a license from the Office of Foreign Assets Control at the Treasury Department to bring CimaVax into the U.S. The license allows them to use it for lab research, but not to give it out to patients, Johnson explained.

Then, in order to start testing CimaVax on Americans, Roswell Park has to get approval for a trial from the U.S. Food and Drug Administration. Currently, Roswell Park and the FDA are communicating about the design of the trial, Johnson said.

Once the FDA signs off, Johnson has to submit the project to Roswell Park’s Scientific Review Committee to evaluate its scientific merit, as well as their Institutional Review Board, a body that evaluates the ethical aspects of any medical research involving human subjects. These two final processes alone can take months to complete, Johnson said, and she hopes to start on Phase 1 and II clinical trials, which assess the effectiveness and safety of a drug, sometime in 2016. The entire process, from start to finish, can take years to complete — even when the experimental drug was invented in the U.S.

To that end, the United States is currently at work developing two lung cancer vaccines of its own, GVAX and BLP 25, though neither has been studied for as long as CimaVax.

Cuba’s public health record

How does a tiny island nation with limited economic resources pioneer a powerhouse cancer vaccine? “They’ve had to do more with less,” Johnson told Wired in May. “So they’ve had to be even more innovative with how they approach things. For over 40 years, they have had a preeminent immunology community.”

Despite decades of economic problems and the U.S. trade embargo, Cuba has been a model of public health. According the New York Times, life expectancy for Cubans is 79 years, on par with the United States, despite the fact that its economy per person is eight times smaller. While many drugs and even anesthesia have been hard to come by over the years, Cuba has one of the best doctor to patient ratios in the world. Moreover, the Cuban government’s investment in primary care for residents and preventative health measures like public education, housing and nutrition have paid huge dividends in the health of citizens, especially relative to similarly poor countries.

Looking forward, ongoing research collaborations between the two nations are almost certainly on the horizon as relations between Cuba and the U.S. continue to thaw. For now, Lee says the researchers at Roswell Park have their eyes trained on about 20 cancer treatment and prevention technologies in Cuba — including another lung cancer vaccine called racotumomab that the group hopes to study in clinical trials at Roswell.

Source:http://www.huffingtonpost.in

Cuba Has a Lung Cancer Vaccine—And America Wants It.

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CUBA HAS FOR several years had a promising therapeutic vaccine against lung cancer. The 55-year trade embargo led by the US made sure that Cuba was mostly where it stayed. Until—maybe—now.

Lung cancer. Coloured X-ray of the chest of an 84 year old woman with a malignant (cancerous) tumour (yellow) in the apex of the right lung (top left).

The Obama administration has, of course, been trying to normalize relations with the island nation. And last month, during New York Gov. Andrew Cuomo’s visit to Havana, Roswell Park Cancer Institute finalized an agreement with Cuba’s Center for Molecular Immunology to develop a lung cancer vaccine and begin clinical trials in the US. Essentially, US researchers will bring the Cimavax vaccine stateside and get on track for approval by the Food and Drug Administration.

“The chance to evaluate a vaccine like this is a very exciting prospect,” says Candace Johnson, CEO of Roswell Park. She’s excited, most likely, because research on the vaccine so far shows that it has low toxicity, and it’s relatively cheap to produce and store. The Center for Molecular Immunology will give Roswell Park all of the documentation (how it’s produced, toxicity data, results from past trials) for an FDA drug application; Johnson says she hopes to get approval for testing Cimavax within six to eight months, and to start clinical trials in a year.

How did Cuba end up with a cutting edge immuno-oncology drug? Though the country is justly famous for cigars, rum, and baseball, it also has some of the best and most inventive biotech and medical research in the world. That’s especially notable for a country where the average worker earns $20 a month. Cuba spends a fraction of the money the US does on healthcare per individual; yet the average Cuban has a life expectancy on par with the average American. “They’ve had to do more with less,” says Johnson, “so they’ve had to be even more innovative with how they approach things. For over 40 years, they have had a preeminent immunology community.”

Despite decades of economic sanctions, Fidel and Raul Castro made biotechnology and medical research, particularly preventative medicine, a priority. After the 1981 dengue fever outbreak struck nearly 350,000 Cubans, the government established the Biological Front, an effort to focus research efforts by various agencies toward specific goals. Its first major accomplishment was the successful (and unexpected) production of interferon, a protein that plays a role in human immune response. Since then, Cuban immunologists made several other vaccination breakthroughs, including their own vaccines for meningitis B and hepatitis B, and monoclonal antibodies for kidney transplants.
The thing about making such great cigars is, smoking is really, really bad for you. Lung cancer is the fourth-leading cause of the death in Cuba. Medical researchers at the Center for Molecular Immunology worked on Cimavax for 25 years before the Ministry of Health made it available to the public—for free—in 2011. Each shot costs the government about $1. A Phase II trial from 2008 showed lung cancer patients who received the vaccine lived an average of four to six months longer than those who didn’t. That prompted Japan and some European countries to initiate Cimavax clinical trials as well.

To be fair, Cimavax probably won’t be a game-changing cancer drug in its current form. The vaccine doesn’t attack tumors directly, instead going after a protein that tumors produce which then circulates in the blood. That action spurs a person’s body to release antibodies against a hormone called epidermal growth factor, which typically spurs cell growth but can also, if unchecked, cause cancer. (Although most people normally think of a vaccine as something that prevents a disease, technically a vaccine is a substance that stimulates the immune system in some way.) So the point of Cimavax is to keep lung tumors from growing and metastasizing, turning a late-stage growth into something chronic but manageable.

But in the US and Europe, people with lung cancer already have treatment options with the same goal. Roswell Park researchers say they plan to explore the vaccine’s potential as a preventative intervention—making it more like a traditional vaccine. Furthermore, epidermal growth factor plays an important role in many other cancers, like prostate, breast, colon, and pancreatic cancer. “All those things are potential targets for this vaccine,” says Kelvin Lee, an immunologist at the company. Mostly for financial reasons, Cubans didn’t test Cimavax that way at all.

And that drug isn’t the only one with potential in the Cuban pharmacopeia. Thomas Rothstein, a biologist at the Feinstein Institute for Medical Research, has for six years worked with the Center for Molecular Immunology on another vaccine to treat lung cancer called Racotumomab, with an entirely different mechanism. (It messes with a particular lipid found in tumor cell membranes.) “Investigators from around the world are trying to crack the nut of cancer,” Rothstein says. “The Cubans are thinking in ways that are novel and clever.”

Although President Obama has used his executive power to lift some restrictions against medical and research equipment, Congress must lift the Cuban embargo before collaborative research can ramp up. Johnson hopes to see Cuba embrace more entrepreneurialism in science, and see the US soak up more creative approaches to medical research. Constrained by politics, the Cuban researchers had to innovate in ways the US and Europe did not. Now maybe they’ll be able to teach their colleagues what they learned.

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Cuba Has Made At Least 3 Major Medical Innovations That We Need

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The trade embargo is holding up research in some crucial areas.

By most measures, the United States’ business-friendly environment has proven to be fertile for medical innovation. Compared to other countries, America has filed the most patents in the life sciences, is conducting most of the world’s clinical trials and has published the most biomedical research.

That’s what makes the medical prominence of Cuba all the more surprising to those who view a free market as an essential driver of scientific discovery. Cuba is very poor, and yet the country has some of the healthiest, most long-lived residents in the world — as well as a medical invention or two that could run circles around U.S. therapies, thanks to government investment in scientific research and a preventive public health approach that views medical care as a birthright.

The island nation, hemmed in by a 54-year trade embargo with the U.S., can’t exchange goods with one of the world’s largest economies and the largest medical market. Still, the country is an unlikely global leader in public health and scientific investment.

“If people knew about these cutting-edge treatments coming out of Cuba, people would want to have them,” said Pierre LaRamée, executive director of the Oakland-based Medical Education Cooperation with Cuba, which advocates for Cuban medical inventions in the U.S. and publishes an international, peer-reviewed journal focusing on Cuban health and medicine.

“All of these arcane rules and restrictions related to the embargo that are designed to block commerce with Cuba are keeping Americans from having access to these treatment opportunities,” LaRamée said.

The White House is continuing to lift trade restrictions between the U.S. and Cuba. The most promising change yet came Tuesday, when the Obama administration announced that American dollars will now be usable in financial transactions in Cuba. The administration is also easing travel restrictions, allowing individuals to visit Cuba for “people to people” educational tours, whereas before Americans were only allowed to make such trips as part of a tour group. 

However, most transactions between Cuba and the U.S. are still prohibited, which is why Cuban drugs face additional regulatory hurdles for testing and marketing compared to other drugs developed overseas. The Treasury Department’s Office of Foreign Assets Control has authorized the importation of some Cuban medicines in the past, but only enough to conduct research and clinical trials, according to a spokeswoman for the Treasury.

Perhaps the most well-known Cuban innovation is the vaccine CimaVax. Invented by researchers at the Center of Molecular Immunology (CIM) in Havana, CimaVax targets a growth factor in cancer cells in a way that can arrest the spread of the disease. It can be used as both a treatment for lung cancer patients and a preventive measure for people at high risk of the disease.

A reported 5,000 patients worldwide have been treated with CimaVax. It has no known side effects, and the shot costs the Cuban government $1 to make.

The New York-based Roswell Park Cancer Institute is evaluating CimaVax for use in the U.S. It’s also trying to get clinical trials underway to replicate Cuban scientists’ findings, per U.S. Food and Drug Administration regulations.

More Americans die from lung cancer than from any other type of cancer, which is why many people are eager for CimaVax to hit the U.S. market soon.

Here are three additional medical innovations that the U.S. could benefit from if relations between the U.S. and Cuba continue to thaw.

1. More cancer treatments

Cancer is not one disease, but a collection of hundreds of different illnesses. This makes finding one “cure” difficult, if not impossible. But over the years, scientists have developed a variety of different treatments that can transform cancer into a chronic, survivable condition.

About 1.7 million Americans will be diagnosed with cancer this year, and about 600,000 are expected to die of it.

In addition to CimaVax, Roswell Park is also investigating Racotumomab andVSSP — two more promising cancer drugs invented by CIM. Racotumomab targets a molecule that scientists believe is found on all cancer cells, which means the drug could one day be effective against blood cancers as well as the solid tumors that accompany diseases like lung, breast, prostate and colon cancer. VSSP, originally designed as a compound to help boost the immune response to vaccines, also appears to enhance the anti-cancer immune response.

Racotumomab is in phase two and three trials in Cuba (these clinical trial stagesassess effectiveness, side effects and adverse reactions), while VSSP is in early clinical trials. The VSSP research is so preliminary that Cuban scientists’ documents still have to be translated from Spanish into English, says Dr. Kelvin Lee, chair of Roswell Park’s department of immunology.

These drugs aren’t as fully developed as CimaVax, says Lee, but they appear to have great potential. Roswell Park is preparing for a clinical trial to test Racotumomab in multiple myeloma, and it’s prepping VSSP for three trials — two in kidney cancer and one in breast cancer.

2. A treatment for diabetic foot ulcers

When uncontrolled diabetes causes nerve and blood vessel damage in a person’s foot, it can lead to one of the most debilitating complications of the disease: the development of foot ulcers — deep, red sores that can penetrate to the bone. These ulcers can become vulnerable to gangrene (tissue death), and in a worst-case scenario can result in toe, foot or leg amputations.

About 73,000 U.S. adults with diabetes had their lower limbs amputated in 2010, according to the American Diabetes Association. Multiple studies of different populations of people who have had their lower limbs amputated show that the procedure is linked to an increased risk of early death, suggesting either that surgery is a trauma many people don’t survive, or that people who submit to this kind of amputation are some of the most vulnerable and at-risk patients in care.

Since 2006, Cuba has had a drug for foot ulcers called Heberprot-P that prevents the need for amputations. Invented by scientists at the Center for Genetic Engineering and Biotechnology in Havana, the treatment, which its creators describe as an “epidermal growth factor,” is injected near the affected area and can accelerate the skin’s healing process, closing a wound safely over the course of about three months. By 2013, Heberprot-P had been registered in 15 other countries and used to treat more than 100,000 patients.

Dr. David Armstrong, director of the Southern Arizona Limb Salvage Alliance and a professor of surgery at University of Arizona, says he’s excited about the treatment, though he emphasized that Heberprot-P would still have to go through trials in the States to demonstrate its effectiveness.

“What I want is for this to come to clinical trials in the U.S., to give it a fair shot and see whether or not it lives up to its current promise,” he said.

Armstrong also noted that besides amputation, the only treatment currently available to Americans with diabetic foot ulcers is a cream with a “black box warning,” indicating that the treatment has serious or life-threatening side effects.

3. Treatment for advanced head and neck tumors

Surgery is the primary way to treat most head and neck tumors, but these procedures can severely affect people’s ability to chew, swallow or talk.

Head and neck cancers make up approximately 3 percent of all cancers in the U.S., affecting about 52,000 Americans every year. Alcohol and tobacco use, as well as human papillomavirus, are major risk factors of the diseases.

Nimotuzumab, patented in the U.S. in 1999 by CIM scientists, is a treatment for various head and neck cancers, including squamous cell carcinoma of the head and neck (tumors that form on the mucosal surfaces of the mouth, throat and nose), glioma (brain tumors) and nasopharyngeal cancer. Monoclonal antibodies in the medicine attach to epidermal growth factor receptors on the surface of the cancer cell, thus preventing it from dividing and spreading the cancer.

Nimotuzumab has had orphan drug status in the U.S. for the treatment of glioma since 2004 and for pancreatic cancer since 2015. This designation is granted to promising drugs that are not yet licensed in the U.S. Researchers can test the drug for rare diseases in clinical trials, but it’s not available to the general public. In fact, Lee said, Roswell Park is preparing for another clinical trial of Nimotuzumab in combination with an FDA-approved treatment to see how effective it will be against lung cancer.

Dr. Eric Bouffet, director of the brain tumor program at Toronto’s Hospital For Sick Children, is the only investigator to date who has completed a Nimotuzumab trial in North America. He tested its efficacy in children against diffuse pontine glioma (aggressive and difficult-to-treat brain tumors) across multiple sites in Canada and the U.S., and found that the drug wasn’t effective. He published the results in 2014.

“As far as Nimotuzumab is concerned, at least in the pediatric oncology setting, there isn’t any study that has been successful enough to influence the FDA to allow it [to] be licensed or approved for pediatric use in North America,” Bouffet said.

But despite early disappointment in U.S. trials, Dr. Dimitrios Colevas, a medical oncologist who specializes in new drug development for head and neck cancer at Stanford, says that Nimotuzumab may be unique compared to other cancer medicines that also target epidermal growth factor receptors, in that it doesn’t seem to have the same toxic side effects.

The drugs Cetuximab and Panitumumab, which are in the same class as Nimotuzumab but are available in the U.S., can cause unsightly and unpleasant acne-like rashes, while international reports about Nimotuzumab suggest its incidence of rash is a lot lower. Indeed, an Italian study found that Nimotuzumab, in combination with another drug and radiation treatment, appeared to induce a response with few side effects.

However, Colevas can’t know for sure if Nimotuzumab has fewer side effects than other drugs in its class, or how effective Nimotuzumab is compared to related treatments, because Bouffet’s is the only trial of the drug that has been completed in the U.S. In contrast, China has completed or is currently conducting at least 25 Nimotuzumab trials. For any other drug that wasn’t made in Cuba, Colevas said, that ratio would probably be reversed.

“This drug is not some new drug, [and] it’s been around as long as the others,” Colevas said. “Wouldn’t it have been nice if they all could have been available for testing, and we could have allowed scientific and medical reasons to drive why one or the other came to the market in a particular place, rather than political embargoes?”

As economic and diplomatic relations between the U.S. and Cuba continue to normalize, here’s hoping that these promising Cuban medical treatments can be investigated fully in the U.S. Americans have been waiting long enough.

Cuba Becomes First Ever Country To Eliminate Mother-To-Child Transmission of HIV

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Cuba has once again demonstrated that its outstanding health care system is something to admire and learn from, becoming the first country ever to receive World Health Organization (WHO) validation that it has eliminated mother-to-child transmission of HIV and syphilis.

Although the term “elimination” may lead you to believe that this form of transmission has been wiped out, that is not necessary to meet the requirements set out by the WHO for validation. Rather, the country needs to demonstrate that it has seen less than 50 infections from this route of transmission per 100,000 live births for at least one year. But Cuba has surpassed these requirements: In 2013, only two babies were born with HIV and just five with syphilis.

“Eliminating transmission of a virus is one of the greatest public health achievements possible,” WHO Director-General Dr. Margaret Chan said in a statement. “This is a major victory in our long fight against HIV and sexually transmitted infections, and an important step towards having an AIDS-free generation.”

Worldwide, there are 16 million women living with HIV, and each year 1.4 million of them will become pregnant. The risk of passing on the virus to the child is only around 1% if anti-HIV drugs are provided during phases where infection could occur, which spans the pregnancy stage right through to breastfeeding. But if left untreated, there is up to a 45% chance that the child will become infected during one of these stages.

Although syphilis receives significantly less attention than HIV, infection during pregnancy can also spell seriously bad news as it can lead to stillbirth or neonatal death in the absence of antibiotic therapy.

In order to reduce the mother-to-child transmission rate of both of these, an initiative was set up in 2010 that improved access to testing and treatment for these infections, caesarian deliveries and breastfeeding substitutes. These services, which form part of Cuba’s universal health system, are being implemented in a number of other countries and are demonstrably helping towards the global target of less than 40,000 new infections annually.

While Cuba may be the first country to receive the WHO validation stamp, this is not to say that other countries have not reached elimination status. As pointed out by Pan American Health Organization Director Carissa Etienne, it’s likely that the U.S. and Canada have already eliminated mother-to-child transmission of both of these infections, but haven’t sought validation. Thirty other countries have, however, requested validation, so we may see the list begin to grow soon.

Cuba becomes first nation to eliminate mother-to-child HIV .

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Cuba’s success demonstrates that universal access and universal health coverage are feasible and indeed are the key to success.

Cuba, Cuba HIV, Cuba HIV transmission, HIV, HIV patients, HIV Cuba, Mother to child HIV, Cuba mother to child HIV, WHO, Cuba latest news, HIV latest news, World latest news

Each year, 1.4 million women living with HIV around the world become pregnant. Left untreated, they have a 15 to 45 per cent chance of passing the virus to their children during pregnancy, labor, delivery or breastfeeding. (Source: Reuters)

By: AFP | Wasington | Published on:July 1, 2015 8:20 am

Cuba has become the first country in the world to eliminate mother-to-child transmission of HIV and syphilis, the World Health Organisation has said.

“Eliminating transmission of a virus is one of the greatest public health achievements possible,” WHO Director-General Margaret Chan said yesterday.

“This is a major victory in our long fight against HIV and sexually transmitted infections, and an important step towards having an AIDS-free generation.”

Universal health coverage, improved access to tests and increased attention to maternal care were credited with the success, defined by health authorities as fewer than 50 cases of mother-to-child transmission of syphilis or HIV per 100,000 live births.

A small number of cases are allowed to persist, despite the certification, because antiretroviral treatment to prevent mother-to-child-transmission of HIV is not 100 per cent effective.

Rather, WHO and the Pan American Health Organisation (PAHO) define the milestone as “a reduction of transmission to such a low level that it no longer constitutes a public health problem.”

Health authorities have been working in Cuba since 2010 to “ensure early access to prenatal care, HIV and syphilis testing for both pregnant women and their partners, treatment for women who test positive and their babies, caesarean deliveries and substitution of breastfeeding,” said a WHO statement.

“Cuba’s success demonstrates that universal access and universal health coverage are feasible and indeed are the key to success, even against challenges as daunting as HIV,” said PAHO Director Carissa Etienne.

Each year, 1.4 million women living with HIV around the world become pregnant. Left untreated, they have a 15 to 45 per cent chance of passing the virus to their children during pregnancy, labor, delivery or breastfeeding. But the risk of transmission is just over one per cent if antiretroviral medicines are given to both mothers and children.

The number children born annually with HIV was 400,000 in 2009. By 2013, the number was down to 240,000 in 2013. But intense effort is needed to meet the global target of less than 40,000 new child infections per year by 2015, health authorities say.

“It shows that ending the AIDS epidemic is possible and we expect Cuba to be the first of many countries coming forward to seek validation that they have ended their epidemics among children,” said Michel Sidibe, executive director of the United Nations AIDS agency.

Tropical Storm Isaac douses Haiti killing 4, heads toward Florida.

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 pushed over Cuba on Saturday after sweeping across Haiti’s southern peninsula, where it caused flooding and at least four deaths, adding to the misery of a poor nation still trying to recover from the terrible 2010 earthquake.

Isaac’s centre made landfall just before midday near the far-eastern tip of Cuba, downing trees and power lines. In the picturesque city of Baracoa, the storm surge flooded the seaside Malecon and a block inland, destroying two homes.

Forecasters said Isaac poses a threat to Florida Monday and Tuesday, just as the Republican Party gathers for its national convention in Tampa. It could eventually hit the Florida Panhandle as a Category 2 hurricane with winds of nearly 160 km/h.

Florida Gov. Rick Scott declared a state of emergency, officials urged vacationers to leave the Florida Keys and the U.S. National Hurricane Center said a hurricane warning was in effect there, as well as for the west coast of Florida from Bonita Beach south to Ocean Reef and for Florida Bay.

At least four people were reported dead in Haiti, including a 10-year-old girl who had a wall fall on her, according to the country’s Civil Protection Office. There were no immediate details on how the others died.

The government also reported two injuries, “considerable damage” to agriculture and homes, the evacuation of nearly 12,000 people.

The Grive River overflowed north of Port-au-Prince, sending chocolate-brown water spilling through the sprawling shantytown of Cité Soleil, where many people grabbed what possessions they could and carried them on their heads, wading through waist-deep water.

“From last night, we’re in misery,” said Cité Soleil resident Jean-Gymar Joseph. “All our children are sleeping in the mud, in the rain.”

Scores of tents in quake settlements collapsed, including more than 50 in Cité Soleil, forcing people to scramble through the mud to try to save their belongings.

About 300 homes in Cité Soleil lost their roofs or were flooded a metre deep, according to Rachel Brumbaugh, operation manager for the U.S. non-profit group World Vision.

Doctors Without Borders said it anticipated a spike in cholera cases due to flooding and it was preparing to receive more patients.

The international airport reopened by the afternoon but there was still extensive flooding throughout Port-au-Prince after 24 hours of steady rain.

Forecasters predicted the storm would likely march up through the Gulf of Mexico and approach the Florida Keys on Sunday, then continue north off the state’s west coast as a hurricane on Monday, just as the Republican National Convention is scheduled to start.

Tampa is within the tropical storm watch zone, meaning forecasters believe tropical storm conditions are possible there within the next 48 hours.

Gov. Scott said during a media briefing that delegates were being told how to stay safe during a storm. Officials are ready for storm surge, bridge closures and other problems that could arise during the convention.

After hitting land near the easternmost tip of Cuba on Saturday, Isaac’s centre spent just a few hours over the island before re-emerging into the water, where it was expected to pick up strength.

On Saturday afternoon, the storm was centred about 195 kilometres) east of Camaguey, Cuba, with maximum sustained winds of 95 km/h, the Hurricane Center reported. It was moving northwest along the Cuban coastline at 33 km/h.

Tropical storm-force winds extended nearly 335 kilometres from the centre, giving Isaac a broad sweep as it passed.

In Baracoa, authorities cut off electricity as a preventive measure. Civil defence officials patrolled the streets and told onlookers to be careful as they gawked at the powerful surf kicked up by the storm. Waves crashing against the seawall sent spray high into the air and deposited rocks and other debris on land.

Dariel Villares and a cousin who lives next door lost their seaside homes.

“A high wave came and knocked down both walls: mine and my cousin’s,” Villares said. “Now we’re removing everything of value.”

There were no reports of fatalities, Red Cross worker Javier de la Cruz said.

Flooding was reported in low-lying coastal areas and 230 people were in emergency shelters, according to state TV.

Far to the west, the Sol Cayo Coco beach resort moved guests out of ground floor rooms. Intermittent rains and gusty winds buffeted Havana, 900 kilometres away.

Cuba has a highly organized civil defence system that goes door to door to enforce evacuations of at-risk areas, largely averting casualties from storms even when they cause major flooding and significant damage to crops.

Near the island’s southeastern tip, the U.S. military suspended ferry service at the Guantanamo Bay Naval Base and bunked guards inside prison facilities, but operations were returning to normal by late afternoon.

“The bad weather did not materialize here as tropical storm Isaac turned away,” Navy Capt. Robert Durand said.

Authorities in the Dominican Republic evacuated nearly 7,800 people from low-lying areas, and at least 10 rural settlements were cut off by flooding, according to Juan Manuel Mendez, director of rescue teams. Power was knocked out in parts of the capital, Santo Domingo.

There were no reports of injuries, but 49 homes across the country were destroyed.

Authorities discontinued a tropical storm warning, but rainfall was expected to reach up to 30 centimetres over the weekend.

“We still have a big cloudy area over the island that will produce lots of rain (until Sunday afternoon),” said Francisco Holguin of the local meteorological agency.

Source: thestar.com