The Public Health Ministry plans to have the Rural Doctors Society officially investigate its planned procurement of medical devices under the Thai Khemkhaeng budget.
"We will let the society's representatives sit in on a committee to oversee and investigate the procurement," the ministry's Permanent Secretary Dr Paijit Warachit said yesterday.
He was speaking after the Rural Doctors Society revealed many items listed in the procurement plan were overpriced. These items included UV fans and biochemistry blood test devices.
The society's chairman Dr Kriangsak Watcharanukulkiet said some items were in fact not necessary at all.
"For example, not all tambon hospitals need a one-tonne truck. Some of these hospitals have just a few staff members. They won't be able to find a driver. In addition, maintenance and petrol costs could put them in trouble," Kriangsak said.
He also pointed out that many manufacturers were willing to give free biochemistry blood test devices worth Bt3million to state hospitals as long as the facilities agreed to buy solutions from them.
Kriangsak said his society did not seek to shoot down the procurement plan.
"But we are calling for a review because there is clearly a way to save the budget," he said.
Health Professional Association chairman Paisal Bangchuad added that many advanced medical devices from the planned procurement would be useless at tambon hospitals.
"Most staff members at the tambon hospitals are not doctors. We cannot administer advanced equipment," he said.
He said the tambon hospitals wanted devices that could be shared with health volunteers.
"We hope the ministry will prepare some budget for each hospital to buy what is necessary for its operations. For example, some hospitals may want boats, not pickups," he said.
Paijit said he had instructed provincial public-health chiefs to suspend the procurement of controversial items. "I am going to appoint a deputy permanent secretary to oversee the overall procurement too," he said.
Public Health Minister Witthaya Kaewparadai said a committee tasked with investigating the budget use for the procurement of medical devices would comprise six to seven members.
"In this committee will be representatives from provincial hospitals, community hospitals and the Rural Doctors Society," he added.
Wednesday, September 30, 2009
SEARCH FOR A WONDER VACCINE
"To successfully develop a vaccine takes a very long time,a huge budget and a long-running procedure ... Vaccine development is not always done for commercial purposes. So we researchers desperately need strong support from all partiesinvolved PUNNEE PITISUTTITHUM
Ajourney of a thousand miles all begins with a single step, and so does the journey of Punnee Pitisuttithum."The development of an HIV/Aids vaccine is like a hurdle race. There are a number of barriers that we researchers must jump across. And in this race, to reach the finish line is not a piece of cake," said Punnee, head of the Department of Clinical Tropical Medicine, Mahidol University.
For more than 10 years, the 52-year-old researcher has been devoting her time and energy working on HIV/Aids vaccine trials. Her job is to test preventive serums over and over to see whether any of them can work against the particular HIV strain found in Thailand. After a considerable amount of trial and error,the effort Punnee along with her team invested eventually paid off when the result of the HIV/Aids vaccine trial recently carried out was announced.
The result of the trial shows that the vaccine has 31.2 percent efficacy in preventing HIV/Aids infection.In other words, it appears to be able to reduce the chance of catching the virus by around one-third in tested volunteers. Yet it cannot lower the level of virus in the blood in infected cases.
But even though the effectiveness of the new vaccine is yet to reach the 50 percent efficacy rate needed to apply for a vaccine licence, and that the vaccine seems to not be powerful enough, the result can still be considered an important scientific breakthrough. The experimental project, according to Punnee, does indeed give new hope in the HIV/Aids vaccine research field and at the same time paves the way for the development of more successful anti-HIV drugs in the future.
"During the past five to six years, apart from testing the HIV/Aids vaccine, we [research team]have also been working to empower the community through vaccine trials. We have raised awareness and created a better understanding regarding the importance of HIV/Aids prevention. Volunteers that took part in the trial along with other people in the community have become a part of the project and have begun to have a sense of belonging. We have created networks among volunteers and established a volunteer club. At the same time, we have also trained our staff so that they meet international standards.'
"This way, we have improved our research infrastructure, boosted capacity building and prepared groundwork for future studies which, to me, is as important as the trial itself," commented Punnee,who is also chief of the Clinical Infectious Diseases Research Unit.
Graduated from the Lady Hardinge Medical College,Delhi, India, Punnee has been working with the Vaccine Trial Centre, a clinical facility founded within Mahidol University's Department of Tropical Medicine, for more than 20 years. Her main responsibility is to examine the safety and efficacy of vaccines sent from vaccine manufacturing companies in other countries and to also check, analyse and confirm whether they are safe to use in Thailand. So far she has experience in clinical vaccine trials for cholera,polio and cervical cancer.
According to the professor, the HIV/Aids vaccine trials in Thailand first started in 1994, after the spread of the epidemic in the early 1990s. At that time, a team of researchers only attempted to use one vaccine that could stimulate just one arm of the immune system. Unfortunately, it failed.
"In the trial we conducted earlier, we used an HIV/Aids vaccine called Aidsvax, which could create antiviral immunity only in human blood. But it didn't succeed. The vaccine was not able to prevent the HIV/Aids infection. So we came up with a new regimen.This time we created immunity for both human blood and human cells," recalled Punnee of how the recent HIV/Aids vaccine trial was initiated.
The vaccine clinical trial, referred to as RV 144,was carried out under the concept of "prime-boost"combination, the scientist explained. Simply speaking,RV 144 tested two vaccines. The first, Alvac HIV or the "prime", enabled the body to make immune defences to target cells invaded by the virus before the infection could spread out of control. The second,Aidsvax B/E or the "boost", stimulated the production of immunity in the blood. The vaccine combination,Punnee remarked, was based on HIV strains that commonly circulate in Thailand.
Alvac HIV was developed by Sanofi Pasteur, the vaccine division of French-based drug manufacturer Sanofi-Aventis, while Aidsvax B/E was originally developed by Genetec Inc and is now licenced to Global Solutions for Infectious Diseases.
The trial, Punnee went on, was designed primarily to test the ability of the vaccine formula to prevent HIV/Aids infection, as well as its ability to reduce the amount of viral load of those who became infected.
RV 144 involved 16,402 HIV-negative male and female volunteers aged 18 to 30. Having lived in Rayong and Chon Buri province, these heterosexual Thai candidates were at average risk of contracting the HIV/Aids.
All participating candidates were divided into two groups: one group received the prime-boost vaccine regimen and the other was administered placebos.Vaccines were injected into volunteers over the course of six months. After that, the test subjects were required to have a follow-up blood test once every six months for the next three years.
Prior to their participation in the trial, all candidates were notified of and consented to the potential risks associated with receiving the experimental vaccine combination. Throughout the study period, they also received counselling on HIV/Aids prevention.
RV 144 began in October 2003. In total, it took about six years for the trial to be fully completed.And this, according to Punnee, was the first successful prime-boost vaccine trial in the world, which signifies that the development of a safe and effective vaccine against one of the world's most dangerous pandemics is still possible.
Involving such a large number of volunteers being tested, RV 144 was also Thailand's first communitybased and the world's largest HIV/Aids vaccine trial ever conducted, added the professor.
"Right now there are approximately 600,000 Thai people living with HIV/Aids infection. And each year there are about 16,000 new cases of HIV/Aids infection reported in Thailand. The vaccine will therefore be like the light at the end of the tunnel for the world population," said the researcher.
As the HIV/Aids vaccines were manufactured in Western countries, the next question is:"Then why was the vaccine trial performed here in Thailand?"
"Testing a vaccine in countries other than the particular one that will use the vaccine is ethically wrong," Punnee explained."If we, for example, want to use the HIV/Aids vaccine in Thailand, it is critical that we test it here to see whether it works with the particular strain that spreads here. And it's the same with this [RV 144] trial. If other countries wish to use this vaccine regimen, they have to test and further develop it in their respective countries, too."
"Admittedly, Thailand itself is not yet capable of creating such vaccines. And we have absolutely no idea as to when we will be ready to do so. But carrying out the trial and having the HIV/Aids vaccines tested here in Thailand will enable our country to have negotiating power in terms of the vaccine price to be sold here. With our participation in the trial run, Thais will have vaccines that are cheaper and more affordable," she added.
The future of vaccine development in Thailand,according to the vaccine analyst, looks quite promising.Since the Avian influenza outbreak several years ago, Thailand has been on alert and started building and improving the country's potential in producing vaccines to shelter its people from illnesses. The Ministry of Public Health is now therefore working actively on its plan to set up a plant to manufacture vaccines both for use and for study. One of the country's most significant threats is, however, the lack of scientists who are capable of developing knowledge and expertise needed for vaccine production.
"Thailand has come a long way from where it first began in terms of vaccine research and development.During the past 20 years, our vaccine clinical trials have met international standards. Even so, we still have quite a long way to go because to successfully develop a vaccine takes a very long time, a huge budget and a very long-running procedure. Successful laboratory research, for instance, does not necessarily mean that the vaccine will work well for everybody.More studies are essential to ensure that the vaccine will be safe to use.
"Vaccine development is no easy task. And it is not always done for commercial purposes. So we researchers desperately need strong support from all parties involved," Punnee noted.
Now that the result of the RV 144 HIV/Aids vaccine trial has been disclosed, Punnee and her team are well aware that a lot more work, studies and challenges lay ahead.
Yet the researcher considers the recent vaccine trial as the first step towards success. She fully hopes that a safe and highly effective HIV/Aids vaccine will one day be accessible to people not just in Thailand but also around the globe.
"The ultimate goal of all vaccines is to function as a preventive measure against a specific disease prior to a person being infected. So my highest hope for the HIV/Aids vaccine is that some day in the future the young generation will be eligible to receive the vaccine, especially before their first sexual experience.In the meantime, we researchers have a lot of work to do. And the result of our previous trial will be a stepping stone to our path towards developing a successful vaccine."
Ajourney of a thousand miles all begins with a single step, and so does the journey of Punnee Pitisuttithum."The development of an HIV/Aids vaccine is like a hurdle race. There are a number of barriers that we researchers must jump across. And in this race, to reach the finish line is not a piece of cake," said Punnee, head of the Department of Clinical Tropical Medicine, Mahidol University.
For more than 10 years, the 52-year-old researcher has been devoting her time and energy working on HIV/Aids vaccine trials. Her job is to test preventive serums over and over to see whether any of them can work against the particular HIV strain found in Thailand. After a considerable amount of trial and error,the effort Punnee along with her team invested eventually paid off when the result of the HIV/Aids vaccine trial recently carried out was announced.
The result of the trial shows that the vaccine has 31.2 percent efficacy in preventing HIV/Aids infection.In other words, it appears to be able to reduce the chance of catching the virus by around one-third in tested volunteers. Yet it cannot lower the level of virus in the blood in infected cases.
But even though the effectiveness of the new vaccine is yet to reach the 50 percent efficacy rate needed to apply for a vaccine licence, and that the vaccine seems to not be powerful enough, the result can still be considered an important scientific breakthrough. The experimental project, according to Punnee, does indeed give new hope in the HIV/Aids vaccine research field and at the same time paves the way for the development of more successful anti-HIV drugs in the future.
"During the past five to six years, apart from testing the HIV/Aids vaccine, we [research team]have also been working to empower the community through vaccine trials. We have raised awareness and created a better understanding regarding the importance of HIV/Aids prevention. Volunteers that took part in the trial along with other people in the community have become a part of the project and have begun to have a sense of belonging. We have created networks among volunteers and established a volunteer club. At the same time, we have also trained our staff so that they meet international standards.'
"This way, we have improved our research infrastructure, boosted capacity building and prepared groundwork for future studies which, to me, is as important as the trial itself," commented Punnee,who is also chief of the Clinical Infectious Diseases Research Unit.
Graduated from the Lady Hardinge Medical College,Delhi, India, Punnee has been working with the Vaccine Trial Centre, a clinical facility founded within Mahidol University's Department of Tropical Medicine, for more than 20 years. Her main responsibility is to examine the safety and efficacy of vaccines sent from vaccine manufacturing companies in other countries and to also check, analyse and confirm whether they are safe to use in Thailand. So far she has experience in clinical vaccine trials for cholera,polio and cervical cancer.
According to the professor, the HIV/Aids vaccine trials in Thailand first started in 1994, after the spread of the epidemic in the early 1990s. At that time, a team of researchers only attempted to use one vaccine that could stimulate just one arm of the immune system. Unfortunately, it failed.
"In the trial we conducted earlier, we used an HIV/Aids vaccine called Aidsvax, which could create antiviral immunity only in human blood. But it didn't succeed. The vaccine was not able to prevent the HIV/Aids infection. So we came up with a new regimen.This time we created immunity for both human blood and human cells," recalled Punnee of how the recent HIV/Aids vaccine trial was initiated.
The vaccine clinical trial, referred to as RV 144,was carried out under the concept of "prime-boost"combination, the scientist explained. Simply speaking,RV 144 tested two vaccines. The first, Alvac HIV or the "prime", enabled the body to make immune defences to target cells invaded by the virus before the infection could spread out of control. The second,Aidsvax B/E or the "boost", stimulated the production of immunity in the blood. The vaccine combination,Punnee remarked, was based on HIV strains that commonly circulate in Thailand.
Alvac HIV was developed by Sanofi Pasteur, the vaccine division of French-based drug manufacturer Sanofi-Aventis, while Aidsvax B/E was originally developed by Genetec Inc and is now licenced to Global Solutions for Infectious Diseases.
The trial, Punnee went on, was designed primarily to test the ability of the vaccine formula to prevent HIV/Aids infection, as well as its ability to reduce the amount of viral load of those who became infected.
RV 144 involved 16,402 HIV-negative male and female volunteers aged 18 to 30. Having lived in Rayong and Chon Buri province, these heterosexual Thai candidates were at average risk of contracting the HIV/Aids.
All participating candidates were divided into two groups: one group received the prime-boost vaccine regimen and the other was administered placebos.Vaccines were injected into volunteers over the course of six months. After that, the test subjects were required to have a follow-up blood test once every six months for the next three years.
Prior to their participation in the trial, all candidates were notified of and consented to the potential risks associated with receiving the experimental vaccine combination. Throughout the study period, they also received counselling on HIV/Aids prevention.
RV 144 began in October 2003. In total, it took about six years for the trial to be fully completed.And this, according to Punnee, was the first successful prime-boost vaccine trial in the world, which signifies that the development of a safe and effective vaccine against one of the world's most dangerous pandemics is still possible.
Involving such a large number of volunteers being tested, RV 144 was also Thailand's first communitybased and the world's largest HIV/Aids vaccine trial ever conducted, added the professor.
"Right now there are approximately 600,000 Thai people living with HIV/Aids infection. And each year there are about 16,000 new cases of HIV/Aids infection reported in Thailand. The vaccine will therefore be like the light at the end of the tunnel for the world population," said the researcher.
As the HIV/Aids vaccines were manufactured in Western countries, the next question is:"Then why was the vaccine trial performed here in Thailand?"
"Testing a vaccine in countries other than the particular one that will use the vaccine is ethically wrong," Punnee explained."If we, for example, want to use the HIV/Aids vaccine in Thailand, it is critical that we test it here to see whether it works with the particular strain that spreads here. And it's the same with this [RV 144] trial. If other countries wish to use this vaccine regimen, they have to test and further develop it in their respective countries, too."
"Admittedly, Thailand itself is not yet capable of creating such vaccines. And we have absolutely no idea as to when we will be ready to do so. But carrying out the trial and having the HIV/Aids vaccines tested here in Thailand will enable our country to have negotiating power in terms of the vaccine price to be sold here. With our participation in the trial run, Thais will have vaccines that are cheaper and more affordable," she added.
The future of vaccine development in Thailand,according to the vaccine analyst, looks quite promising.Since the Avian influenza outbreak several years ago, Thailand has been on alert and started building and improving the country's potential in producing vaccines to shelter its people from illnesses. The Ministry of Public Health is now therefore working actively on its plan to set up a plant to manufacture vaccines both for use and for study. One of the country's most significant threats is, however, the lack of scientists who are capable of developing knowledge and expertise needed for vaccine production.
"Thailand has come a long way from where it first began in terms of vaccine research and development.During the past 20 years, our vaccine clinical trials have met international standards. Even so, we still have quite a long way to go because to successfully develop a vaccine takes a very long time, a huge budget and a very long-running procedure. Successful laboratory research, for instance, does not necessarily mean that the vaccine will work well for everybody.More studies are essential to ensure that the vaccine will be safe to use.
"Vaccine development is no easy task. And it is not always done for commercial purposes. So we researchers desperately need strong support from all parties involved," Punnee noted.
Now that the result of the RV 144 HIV/Aids vaccine trial has been disclosed, Punnee and her team are well aware that a lot more work, studies and challenges lay ahead.
Yet the researcher considers the recent vaccine trial as the first step towards success. She fully hopes that a safe and highly effective HIV/Aids vaccine will one day be accessible to people not just in Thailand but also around the globe.
"The ultimate goal of all vaccines is to function as a preventive measure against a specific disease prior to a person being infected. So my highest hope for the HIV/Aids vaccine is that some day in the future the young generation will be eligible to receive the vaccine, especially before their first sexual experience.In the meantime, we researchers have a lot of work to do. And the result of our previous trial will be a stepping stone to our path towards developing a successful vaccine."
CONNECTIONS CREATE GROWTH FOR THAI OPTICAL
By some measures, Thai Optical Group, a listed lens manufacturer, may look like any other original equipment manufacturer. But its special relationship with major retailers of glasses in Thailand and the UK tells a different story.
According to Thai Optical Group (TOG) chairman Sawang Pracharktam, the company is expecting a "jump in business" in the next three years. This is because a 25-per-cent stake in TOG was bought last year by Specsavers, the biggest optical retailer in UK, and Specsavers is planning to increase its number of stores around the world from 1,500 to 2,000 over the next few years. The expansion is likely to demand more lenses from TOG.
When Specsavers bought the stake in TOG, it also revealed plans to increase its lens purchases from TOG from 30 per cent of its needs at present to 50 per cent.
Sawang said the increase would take time and Specsavers had already sent its experts to help TOG to improve its production lines and efficiency, in order to meet the firm's pricing and volume targets.
Specsavers bought the controlling stake in TOG because it wanted to ensure that it wouldn't be bought by other companies, he said. TOG remains one of a handful of independent lens manufacturers that have survived competition and takeovers in the world market.
TOG reported flat growth in sales revenue in the first half of this year, although profit rose by 14.67 per cent to Bt74.5 million. The firm suffered an 11-per-cent slide in sales and profit during the second quarter because political unrest in April led to the cancellation of small orders requiring a short delivery time of four days.
Due to advancements in technology, and in order to reduce their costs, some retailers of glasses in developed countries have begun ordering prescribed lenses for individual customers from cheaper foreign sources like TOG.
"We can ship them back the lenses, complete with the frame, within four days of the order being placed - the same lead time they would get if they ordered from a local laboratory," he said.
TOG's laboratory now supplies several thousand pairs of glasses per day to individual customers in France, Germany, Australia and the Netherlands, through local retailers.
Sawang said the firm had no plans yet to provide direct services to individual customers in foreign countries, because such a move might not be ethical.
TOG still relies on original-equipment manufacturing for 80 per cent of its revenue, with the rest coming from its own brand.
Sawang said distribution channels had increased in recent years. As an independent manufacturer, TOG can sell its lenses to brand owners, other manufacturers, independent laboratories and chain stores, as well as selling its own brand lenses through some of the same channels.
The group's major strategy over the next few years will include building its own sales channels, enabling it to reach customers in potentially rich markets such as Vietnam, Singapore and Malaysia, where it plans to establish lens laboratories next year.
TOG will reap benefits from its special relationship with Better Vision, one of Thailand's largest retailers of glasses, which has already opened 12 retail shops in Malaysia and 13 in Singapore, he said. Better Vision, or Hor Waen in Thai, is run by the same family that formed TOG.
In Thailand, TOG sells its lenses through its exclusive distributor Nam Sin Thai, also run by the Pracharktam family, which resells the lenses to Better Vision.
Sawang said a financial adviser was studying a possible merger between Better Vision and TOG.
TOG is expected to grow by 8 per cent this year, down from 15 per cent, which has been its annual target for many years. Nevertheless, the firm is aiming to increase its sales revenue and net profit to more than Bt2.5 billion and Bt300 million, respectively, in 2014, he said.
Last year, it booked a net profit of Bt143.38 million from revenue of Bt1.52 billion.
According to Thai Optical Group (TOG) chairman Sawang Pracharktam, the company is expecting a "jump in business" in the next three years. This is because a 25-per-cent stake in TOG was bought last year by Specsavers, the biggest optical retailer in UK, and Specsavers is planning to increase its number of stores around the world from 1,500 to 2,000 over the next few years. The expansion is likely to demand more lenses from TOG.
When Specsavers bought the stake in TOG, it also revealed plans to increase its lens purchases from TOG from 30 per cent of its needs at present to 50 per cent.
Sawang said the increase would take time and Specsavers had already sent its experts to help TOG to improve its production lines and efficiency, in order to meet the firm's pricing and volume targets.
Specsavers bought the controlling stake in TOG because it wanted to ensure that it wouldn't be bought by other companies, he said. TOG remains one of a handful of independent lens manufacturers that have survived competition and takeovers in the world market.
TOG reported flat growth in sales revenue in the first half of this year, although profit rose by 14.67 per cent to Bt74.5 million. The firm suffered an 11-per-cent slide in sales and profit during the second quarter because political unrest in April led to the cancellation of small orders requiring a short delivery time of four days.
Due to advancements in technology, and in order to reduce their costs, some retailers of glasses in developed countries have begun ordering prescribed lenses for individual customers from cheaper foreign sources like TOG.
"We can ship them back the lenses, complete with the frame, within four days of the order being placed - the same lead time they would get if they ordered from a local laboratory," he said.
TOG's laboratory now supplies several thousand pairs of glasses per day to individual customers in France, Germany, Australia and the Netherlands, through local retailers.
Sawang said the firm had no plans yet to provide direct services to individual customers in foreign countries, because such a move might not be ethical.
TOG still relies on original-equipment manufacturing for 80 per cent of its revenue, with the rest coming from its own brand.
Sawang said distribution channels had increased in recent years. As an independent manufacturer, TOG can sell its lenses to brand owners, other manufacturers, independent laboratories and chain stores, as well as selling its own brand lenses through some of the same channels.
The group's major strategy over the next few years will include building its own sales channels, enabling it to reach customers in potentially rich markets such as Vietnam, Singapore and Malaysia, where it plans to establish lens laboratories next year.
TOG will reap benefits from its special relationship with Better Vision, one of Thailand's largest retailers of glasses, which has already opened 12 retail shops in Malaysia and 13 in Singapore, he said. Better Vision, or Hor Waen in Thai, is run by the same family that formed TOG.
In Thailand, TOG sells its lenses through its exclusive distributor Nam Sin Thai, also run by the Pracharktam family, which resells the lenses to Better Vision.
Sawang said a financial adviser was studying a possible merger between Better Vision and TOG.
TOG is expected to grow by 8 per cent this year, down from 15 per cent, which has been its annual target for many years. Nevertheless, the firm is aiming to increase its sales revenue and net profit to more than Bt2.5 billion and Bt300 million, respectively, in 2014, he said.
Last year, it booked a net profit of Bt143.38 million from revenue of Bt1.52 billion.
Vaccine results confuse scientists
Experts agree that a vaccine is the onlyway to conquer Aids,but the virus mutates unbelievably fast, can hide from the immune system and attacks the very cells sent to battle it.
More than 25 years into the Aids pandemic, scientists finally have a vaccine that protects some people - but instead of celebrating, they are going back to the drawing board.
The vaccine - a combination of two older vaccines - only lowered the infection rate by about a third after three years among 16,000 ordinary Thai volunteers.
Vaccines need to be at least 50% effective,and usually 70 to 80% effective, to be useful.
Worse, no one knows why it worked."Additional studies are clearly needed to understand how this vaccine regimen reduced the risk of HIV infection," said Dr Eric Schoomaker, surgeon-general of the US Army, which helped pay for the study.
Dr Anthony Fauci, director of the US National Institute of Allergy and Infectious Diseases, said:"We need to bring the best minds together and map the way forward."
The vaccine is a combination of SanofiPasteur's ALVAC canarypox/HIV vaccine,which includes synthetic versions of three HIV genes, and the failed HIV vaccine AidsVax, made by a San Francisco firm called VaxGen and now owned by the nonprofit Global Solutions for Infectious Diseases.
"It is likely that significant efforts will be needed to fully understand the study results and to appreciate how they will inform the next steps to develop and deliver a safe and effective HIV vaccine," said Dr Peter Kim,president of Merck Research Laboratories.Merck's first Aids vaccine failed in 2007.
"I am not sure this will encourage com-panies to immediately jump in," said Mitchell Warren of the non-profit Aids Vaccine Advocacy Coalition."What we hear from pharma and from small biotechs is that they are fascinated by an Aids vaccine but as a business proposition, it is too risky."
The Thai trial may help them re-evaluate,Mr Warren said. But first, some scientific direction is necessary."What is needed there is more in-depth analysis, to extend these findings, doing both clinical [human] and preclinical [animal)]studies to find out why it is working and how we can make it better,"said Jim Tartaglia, vice president of research and development at Sanofi. Companies and non-profits along with governments have been working to make a vaccine against the human immunodeficiency virus that causes Acquired Immune Deficiency Syndrome.The fatal and incurable virus has killed 25 million people and infects 33 million now.
Experts agree that a vaccine is the only way to conquer it, but the virus mutates unbelievably fast, can hide from the immune system and attacks the very cells sent to battle it. To work, any HIV vaccine would have to activate both arms of the immune system - the antibodies that home in on invaders such as viruses to neutralise them,and the T-cells that recognise and destroy viruses. This vaccine did not appear to generate much of either response, and yet prevented infection 30% of the time.
Even more confusing, among the 51 people who were vaccinated but were infected anyway, the virus thrived just as well as it did among unvaccinated HIV patients. Researchers would not have expected that they would have expected the vaccine to at least make the infection less serious, as influenza vaccines do, for example. Dr Fauci wonders if the vaccines stimulated some component of the immune system that has been overlooked.
Dr Donald Francis, a former government vaccine expert who helped develop AidsVax and who helped found Global Solutions for Infectious Diseases, said his team would be developing smaller studies to answer some of these questions."We have a limited amount of vaccine now," Dr Francis said.
The findings do offer renewed hope for finding a better vaccine.
"There are now six approaches that look better than Merck's vaccine in the best of the animal models," said Dr Seth Berkley,head of the International AidsVaccine Initiative, which funds studies.
IAVI believes the rewards could be substantial - not just stopping the worst pandemic of our times, but financially."At its peak, an HIV vaccine could represent 5% to 13% of the total global vaccine market,"IAVI estimates. At $2 a dose for the developing world and $100 in richer countries, IAVI estimated companies might bring in $1.6 billion to $3.8 billion a year with an HIV vaccine. Yet the private sector accounts for just 10% of all Aids vaccine research and development funding.
More than 25 years into the Aids pandemic, scientists finally have a vaccine that protects some people - but instead of celebrating, they are going back to the drawing board.
The vaccine - a combination of two older vaccines - only lowered the infection rate by about a third after three years among 16,000 ordinary Thai volunteers.
Vaccines need to be at least 50% effective,and usually 70 to 80% effective, to be useful.
Worse, no one knows why it worked."Additional studies are clearly needed to understand how this vaccine regimen reduced the risk of HIV infection," said Dr Eric Schoomaker, surgeon-general of the US Army, which helped pay for the study.
Dr Anthony Fauci, director of the US National Institute of Allergy and Infectious Diseases, said:"We need to bring the best minds together and map the way forward."
The vaccine is a combination of SanofiPasteur's ALVAC canarypox/HIV vaccine,which includes synthetic versions of three HIV genes, and the failed HIV vaccine AidsVax, made by a San Francisco firm called VaxGen and now owned by the nonprofit Global Solutions for Infectious Diseases.
"It is likely that significant efforts will be needed to fully understand the study results and to appreciate how they will inform the next steps to develop and deliver a safe and effective HIV vaccine," said Dr Peter Kim,president of Merck Research Laboratories.Merck's first Aids vaccine failed in 2007.
"I am not sure this will encourage com-panies to immediately jump in," said Mitchell Warren of the non-profit Aids Vaccine Advocacy Coalition."What we hear from pharma and from small biotechs is that they are fascinated by an Aids vaccine but as a business proposition, it is too risky."
The Thai trial may help them re-evaluate,Mr Warren said. But first, some scientific direction is necessary."What is needed there is more in-depth analysis, to extend these findings, doing both clinical [human] and preclinical [animal)]studies to find out why it is working and how we can make it better,"said Jim Tartaglia, vice president of research and development at Sanofi. Companies and non-profits along with governments have been working to make a vaccine against the human immunodeficiency virus that causes Acquired Immune Deficiency Syndrome.The fatal and incurable virus has killed 25 million people and infects 33 million now.
Experts agree that a vaccine is the only way to conquer it, but the virus mutates unbelievably fast, can hide from the immune system and attacks the very cells sent to battle it. To work, any HIV vaccine would have to activate both arms of the immune system - the antibodies that home in on invaders such as viruses to neutralise them,and the T-cells that recognise and destroy viruses. This vaccine did not appear to generate much of either response, and yet prevented infection 30% of the time.
Even more confusing, among the 51 people who were vaccinated but were infected anyway, the virus thrived just as well as it did among unvaccinated HIV patients. Researchers would not have expected that they would have expected the vaccine to at least make the infection less serious, as influenza vaccines do, for example. Dr Fauci wonders if the vaccines stimulated some component of the immune system that has been overlooked.
Dr Donald Francis, a former government vaccine expert who helped develop AidsVax and who helped found Global Solutions for Infectious Diseases, said his team would be developing smaller studies to answer some of these questions."We have a limited amount of vaccine now," Dr Francis said.
The findings do offer renewed hope for finding a better vaccine.
"There are now six approaches that look better than Merck's vaccine in the best of the animal models," said Dr Seth Berkley,head of the International AidsVaccine Initiative, which funds studies.
IAVI believes the rewards could be substantial - not just stopping the worst pandemic of our times, but financially."At its peak, an HIV vaccine could represent 5% to 13% of the total global vaccine market,"IAVI estimates. At $2 a dose for the developing world and $100 in richer countries, IAVI estimated companies might bring in $1.6 billion to $3.8 billion a year with an HIV vaccine. Yet the private sector accounts for just 10% of all Aids vaccine research and development funding.
SAMITIVEJ HOSPITAL JOINS PROGRAMME WITH PDA TO HELP PROVINCIAL PATIENTS
Samitivej Hospital recently joined Mechai Viravaidya's Population and Community Development Associations programme to improve living conditions of the rural poor in Nakhon Ratchasima and other north easteen provinces.
The hospital is encouraging customers to donate new and used toys to children under the toy-sharing programme in Buri Ram.
It also recently made a Btl-million donation to develop Nuangpluang Village in Nakhon Ratchasima with a commitment to fund the project annually.
To Samitivej CEO and managing director Raymond Chong, the longterm corporate-social-responsibility (CSR) projects are aimed at creating opportunities for their medical staffto serve people in rural areas, as well.
"I would like our staff always to come to the village to educate people about health and guide children on planning for a career," he said.
"We don't want to do only a one-off charity event and then depart. We intend to strengthen the bond with villagers in many regards. Nuangpluang will be the first village Samitivej will develop as a community".
The hospital's CSR project for Nakhon Ratchasima is called Healthy Community.
"It sets out to assist villagers by improving their health and developing career skills and overall living conditions," Chong said.
The PDA, founded and chaired by Mechai, will run the project for the hospital.
Mechai is well known for his family-planning efforts decades ago. The campaign earned him the nickname "Mr Condom".
Chong said the Btl-million allocated for Nongpluang would be used as a community fund for villagers seeking employment opportunities. It will also be used to pay for scholarships.
For the toy-sharing project, Chong said big boxes had been set up at its three hospital-on Sukhumvit and Srinakarin roads in Bangkok and in Chon Buri's Sri Racha district-tostore donated toys.
In only one month 2,000 items have been donated, demonstrating the public's willingness to bring happiness to provincial children.
The toys are meant as rewards for desserving children who have performed some sort of public duty, such as growing saplings, replaning trees or collecting garbage.
Mechai, whose family has been a loyal patron of Samitivej Hospital for four generations, initiated the toy project in Buri Ram afew months ago.
Tanatat Puttasuwan, director of CSR at the PDA, said the aim of the toy-sharing project was to foster a spirit of philanthropy among youngsters.
Children wishing to borrow the toys must perform a good deed, such as some sort of activity that promotes recycling and green projects.
"There is a real danger of children becoming too self-centred and failing to show regard for others," he said. "The toy-sharing programme should help instil sense of compassion and empathy for others who are less fortunate," Tanatat said.
In only one month, 2,000 items have been donated, demonstrating the public's willingness to bring happiness to provincial children.
The hospital is encouraging customers to donate new and used toys to children under the toy-sharing programme in Buri Ram.
It also recently made a Btl-million donation to develop Nuangpluang Village in Nakhon Ratchasima with a commitment to fund the project annually.
To Samitivej CEO and managing director Raymond Chong, the longterm corporate-social-responsibility (CSR) projects are aimed at creating opportunities for their medical staffto serve people in rural areas, as well.
"I would like our staff always to come to the village to educate people about health and guide children on planning for a career," he said.
"We don't want to do only a one-off charity event and then depart. We intend to strengthen the bond with villagers in many regards. Nuangpluang will be the first village Samitivej will develop as a community".
The hospital's CSR project for Nakhon Ratchasima is called Healthy Community.
"It sets out to assist villagers by improving their health and developing career skills and overall living conditions," Chong said.
The PDA, founded and chaired by Mechai, will run the project for the hospital.
Mechai is well known for his family-planning efforts decades ago. The campaign earned him the nickname "Mr Condom".
Chong said the Btl-million allocated for Nongpluang would be used as a community fund for villagers seeking employment opportunities. It will also be used to pay for scholarships.
For the toy-sharing project, Chong said big boxes had been set up at its three hospital-on Sukhumvit and Srinakarin roads in Bangkok and in Chon Buri's Sri Racha district-tostore donated toys.
In only one month 2,000 items have been donated, demonstrating the public's willingness to bring happiness to provincial children.
The toys are meant as rewards for desserving children who have performed some sort of public duty, such as growing saplings, replaning trees or collecting garbage.
Mechai, whose family has been a loyal patron of Samitivej Hospital for four generations, initiated the toy project in Buri Ram afew months ago.
Tanatat Puttasuwan, director of CSR at the PDA, said the aim of the toy-sharing project was to foster a spirit of philanthropy among youngsters.
Children wishing to borrow the toys must perform a good deed, such as some sort of activity that promotes recycling and green projects.
"There is a real danger of children becoming too self-centred and failing to show regard for others," he said. "The toy-sharing programme should help instil sense of compassion and empathy for others who are less fortunate," Tanatat said.
In only one month, 2,000 items have been donated, demonstrating the public's willingness to bring happiness to provincial children.
Sunday, September 27, 2009
BGH unit taps sports medicine
Bangkok Hospital Group is rebranding its bone and joint treatment unit in both the domestic and overseas markets, hoping to cash in on expected high demand when the economy rebounds.
The rebranding will focus on promoting the advanced technology available for treatment and surgery, said Dr Pornthep Mamanee, chief of sports medicine,knee and shoulder surgery at the affiliate of SET-listed Bangkok Dusit Medical Services Plc (BGH).
"The department is focusing on developing human resources in this sector to serve the huge demand from local and overseas patients. We will conduct training programmes for technicians and physicians from this year onward," he said."Qualified personnel with the knowledge of new treatments are still far below the actual demand in the market."
New technologies such as robotic surgery and arthroscopy using imaging equipment are minimally invasive and shorten recovery times. Dr Pornthep said treatment times for some conditions were just one or two days compared with more than five days previously.
The department expects the number of patients for the services will rise by 10-15% from 450 last year,70% of whom are foreigners.
Bangkok Hospital opened its bone and joint centre seven years ago and attracted just 20 patients in the first year, but new technology in recent years has encouraged more people to seek treatment.
"Thailand will be another hub for sports medicine within the next few years and we need to accelerate human resource development for this sector in line with other health-care businesses,"said Dr Pornthep.
Only a few state medical schools offer training courses in new technology related to the sector. They include Siriraj Hospital, Chulalongkorn Hospital and Ramathibodi Hospital.
Bangkok Hospital Group, the country's largest private hospital operator, this year has also upgraded and rebranded some other specialty units including neurology, in a bid to raise public awareness during the economic downturn.
The rebranding will focus on promoting the advanced technology available for treatment and surgery, said Dr Pornthep Mamanee, chief of sports medicine,knee and shoulder surgery at the affiliate of SET-listed Bangkok Dusit Medical Services Plc (BGH).
"The department is focusing on developing human resources in this sector to serve the huge demand from local and overseas patients. We will conduct training programmes for technicians and physicians from this year onward," he said."Qualified personnel with the knowledge of new treatments are still far below the actual demand in the market."
New technologies such as robotic surgery and arthroscopy using imaging equipment are minimally invasive and shorten recovery times. Dr Pornthep said treatment times for some conditions were just one or two days compared with more than five days previously.
The department expects the number of patients for the services will rise by 10-15% from 450 last year,70% of whom are foreigners.
Bangkok Hospital opened its bone and joint centre seven years ago and attracted just 20 patients in the first year, but new technology in recent years has encouraged more people to seek treatment.
"Thailand will be another hub for sports medicine within the next few years and we need to accelerate human resource development for this sector in line with other health-care businesses,"said Dr Pornthep.
Only a few state medical schools offer training courses in new technology related to the sector. They include Siriraj Hospital, Chulalongkorn Hospital and Ramathibodi Hospital.
Bangkok Hospital Group, the country's largest private hospital operator, this year has also upgraded and rebranded some other specialty units including neurology, in a bid to raise public awareness during the economic downturn.
Hospital graft claims denied
Doctors can choose to buy own supplies
The government has not ordered state hospitals to buy specific supplies as part of the Thai Kem Kaeng national development spending project, Public Health Minister Witthaya Kaewparadai says.
About 86.6 billion baht has been allocated for medical facilities under the Thailand: Investing from Strength to Strength scheme.
Rural doctors claim the project calls for the purchase of medical equipment at inflated prices and local hospitals are not being invited to participate in the procurement.
However, Mr Witthaya said yesterday that provincial public health authorities and hospital directors had full authority over the choice of medical supplies and could order the supplies that would meet the demands of their patients.
He denied central authorities had intervened in the procurement process at local hospitals.
Of the 86.68 billion baht allocated to the Public Health Ministry,60% will go towards putting up public health buildings and the rest towards medical equipment.
Mr Witthaya said the Public Health Ministry had stepped up measures to ensure the spending was transparent.
Special working groups would follow all aspects of the project's implementation.
Khamron Chaisiri, director of the Thai
Kem Kaeng office, said the ministry had set up a committee to supervise procurement and coordinate the process with hospital directors and public health doctors at the provincial level.
The ministry, through the committee, will assign experts on procurement, laws and construction to work with provincial authorities,and will field regional inspectors to monitor the spending.
As part of the public health improvement project,2,151 state clinics will be upgraded to tambon-based hospitals.Each facility will receive 1.35 million baht for the development, with 500,000 baht to go towards construction and 855,000 baht towards medical supplies.
Local health authorities have come up with 46 items for procurement. They include dentistry units, electrocardiographs, foetal heart rate detectors, massage beds, sonographers and outdoor audio systems.
However,Pongthep Wongwatcharapaibul, secretary-general of the Rural Doctor Foundation, yesterday said the government was also offering what hospitals did not want, such as UV sanitisers. He also said supplies listed for purchase under the project were overpriced.
Dr Pongthep said a UV sanitiser was quoted at 40,000 baht but its market price was only 6,000 baht. A respirator was quoted at 1.2 million baht but a hospital had bought one for 500,000 baht. Hospital representatives were not given a say on the choice of medical supplies. A probe was needed into the way the scheme was being run.
The government has not ordered state hospitals to buy specific supplies as part of the Thai Kem Kaeng national development spending project, Public Health Minister Witthaya Kaewparadai says.
About 86.6 billion baht has been allocated for medical facilities under the Thailand: Investing from Strength to Strength scheme.
Rural doctors claim the project calls for the purchase of medical equipment at inflated prices and local hospitals are not being invited to participate in the procurement.
However, Mr Witthaya said yesterday that provincial public health authorities and hospital directors had full authority over the choice of medical supplies and could order the supplies that would meet the demands of their patients.
He denied central authorities had intervened in the procurement process at local hospitals.
Of the 86.68 billion baht allocated to the Public Health Ministry,60% will go towards putting up public health buildings and the rest towards medical equipment.
Mr Witthaya said the Public Health Ministry had stepped up measures to ensure the spending was transparent.
Special working groups would follow all aspects of the project's implementation.
Khamron Chaisiri, director of the Thai
Kem Kaeng office, said the ministry had set up a committee to supervise procurement and coordinate the process with hospital directors and public health doctors at the provincial level.
The ministry, through the committee, will assign experts on procurement, laws and construction to work with provincial authorities,and will field regional inspectors to monitor the spending.
As part of the public health improvement project,2,151 state clinics will be upgraded to tambon-based hospitals.Each facility will receive 1.35 million baht for the development, with 500,000 baht to go towards construction and 855,000 baht towards medical supplies.
Local health authorities have come up with 46 items for procurement. They include dentistry units, electrocardiographs, foetal heart rate detectors, massage beds, sonographers and outdoor audio systems.
However,Pongthep Wongwatcharapaibul, secretary-general of the Rural Doctor Foundation, yesterday said the government was also offering what hospitals did not want, such as UV sanitisers. He also said supplies listed for purchase under the project were overpriced.
Dr Pongthep said a UV sanitiser was quoted at 40,000 baht but its market price was only 6,000 baht. A respirator was quoted at 1.2 million baht but a hospital had bought one for 500,000 baht. Hospital representatives were not given a say on the choice of medical supplies. A probe was needed into the way the scheme was being run.
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