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POLYPILL HOLDS PROMISE FOR PEOPLE WITH CHRONIC DISEASE
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Polypills are also
expected to increase
patient adherence. This
has been shown with
combination drugs for
diabetes, hypertension and HIV/
AIDS, according to a study published
in the Bulletin in December 2004.
A study to find out if this is also
the case in patients with established
cardiovascular disease is to start recruiting
from January to March 2006.
The GAP, or Guidelines Adherence to
Polypill study, set up by the George
Institute for International Health,
will randomize 1000 patients with
established cardiovascular disease to a
polypill-based approach or to standard
care. The patients will be followed for
two years.
A similar study of 600 patients is
to start in New Zealand next year, led
by Anthony Rodgers
of the University of
Auckland. Patients
with a definite indication
for all medicines,
such as following a
heart attack or stroke,
will be randomized
to polypill or conventional
care. The main
outcome measures will
include compliance,
blood-pressure and
cholesterol levels.
Fixed-dose combinations
are now a
core component of care
for people with HIV/AIDS, tuberculosis
and malaria. As well as improving
clinical outcomes, they simplify
distribution of multiple medications,
which can be an important advantage
in resource-limited health-care settings.
Some public health experts say
another way of improving access to
Farming practices, long-held lifestyle
traditions and poverty-line economics
all make recent outbreaks of avian flu
in Asia a far bigger global public health
threat than the westward spread of the
disease into Europe’s poultry flocks.
For many rural Asian communities,
backyard chickens and very
small-scale poultry farms are part of
the landscape. Children play in the
same yard where the household’s flock
scratch and where chickens that die are
typically eaten in order not to waste a
valuable source of protein.
Best defence against avian flu
is to fight the virus in Asia
The spread of avian flu to Africa and Europe
has triggered panic as misconceptions abound
over the nature of the threat this poses to
human health.
A small child with ducks outside her house in Indonesia. As shown by this picture, families in many Asian
countries live in close proximity to their poultry.
WHO/SEARO
medicines and treatment for chronic
disease would be through publicprivate
partnerships (PPPs). A report
by a team from the London School
of Economics and Political Science,
led by Dr Mary Moran, found that
PPPs have driven the recent considerable
increase in research activity into
so-called neglected diseases, such as
malaria and tuberculosis.
After a time when few new
therapies were introduced, there are
now over 60 drug research projects
under way. Three-quarters of these are
conducted under the auspices of PPPs
and should result in six or seven new
drugs being developed by 2010.
There are no PPPs working in
the area of chronic disease, a situation
Rodgers, who is director of the
Clinical Trials Research Unit at the
University of Auckland, in New
Zealand, wants to change. Rodgers
is involved in early consultations to
set up a PPP to make treatment for
chronic diseases more accessible to
people in need.
“We desperately need a not-for
profit organization that enables public-
private partnerships to make new
medicines more available. Not just
new technologies like the polypill, but
also health-care delivery solutions.” O
Jacqui Wise, Cape Town