Indiscriminate disposal of used condoms: a neglected infectious disease threat for children in Africa

Neglected diseases: under-funded research and inadequate health interventions: Can we change this reality?

In February 2014, health officials from around the world announced the Global Health Security Agenda, a critical effort to strengthen national and global systems to prevent, detect, and respond to infectious disease threats and to foster stronger collaboration across borders. With its increasing global roles and broad range of regulatory responsibilities in ensuring the availability, safety, and security of medical and food products, the US Food and Drug Administration (FDA) is engaged in a range of efforts in support of global health security. This article provides an overview of FDA's global health security roles, focusing on its responsibilities related to the development and use of medical countermeasures (MCMs) for preventing, detecting, and responding to global infectious disease and other public health emergency threats. The article also discusses several areas-antimicrobial resistance, food safety, and supply chain integrity-in which FDA's global health security roles continue to evolve and extend beyond MCMs and, in some cases, beyond traditional infectious disease threats.

Background As demonstrated during the global Ebola crisis of 2014–2016, healthcare institutions in high resource settings need support concerning preparedness during threats of infectious disease outbreaks. This study aimed to exploratively develop a standardized preparedness system to use during unfolding threats of severe infectious diseases. MethodsA qualitative three-step study among infectious disease prevention and control experts was performed. First, interviews (n = 5) were conducted to identify which factors trigger preparedness activities during an unfolding threat. Second, these triggers informed the design of a phased preparedness system which was tested in a focus group discussion (n = 5) were conducted to identify which factors trigger preparedness activities during an unfolding threat. Second, these triggers informed the design of a phased preparedness system which was tested in a focus group discussion (n = 5) were conducted to identify which factors trigger preparedness activities during an unfolding threat. Second, these triggers informed the design of a phased preparedness system which was tested in a focus group discussion (ResultsFour preparedness phases were identified: preparedness phase green is a situation without the presence of the infectious disease threat that requires centralized care, anywhere in the world. Phase yellow is an outbreak in the world with some likelihood of imported cases. Phase orange is a realistic chance of an unexpected case within the country, or unrest developing among population or staff; phase red is cases admitted to hospitals in the country, potentially causing a shortage of resources. Specific preparedness activities included infection prevention, diagnostics, patient care, staff, and communication. Consensus was reached on the need for the development of a preparedness system and national coordination during threats. ConclusionsIn this study, we developed a standardized system to support institutional preparedness during an increasing threat. Use of this system by both curative healthcare institutions and the (municipal) public health service, could help to effectively communicate and align preparedness activities during future threats of severe infectious diseases.

The behavioral immune system (BIS), which evolved to protect humans from infectious disease threats, prompts people to be sensitive to disease-connoting cues. A common denominator of many disease-connoting cues is benign physical abnormalities, such as birthmarks and obesity. Previous studies found that among people whose BIS was activated (e.g., people who were exposed to situational disease prime or chronically concerned about disease threat), disease-connoting cues could make people feel threatened by infectious disease and induce their malevolence. Malevolence is a necessary feature of malevolent creativity (MC), which is defined as creativity that deliberately leads to harmful or immoral results. According to the motivated focus account of creativity, a threat could promote creativity when creativity is relevant to the threat. Thus, infectious disease threats might increase malevolent creativity. However, whether infectious disease threats could influence MC is unknown. Therefore, the current study aims to explore the effect of infectious disease threat on MC by two disease-connoting cues (birthmark, obesity). In Study 1 (n = 174), a 2 (threat prime: infectious disease, natural disaster) × 2 (disease-connoting cue: birthmarked face, normal face) between-subjects design was used. Participants were asked to complete a malevolent creativity task (MCT). In Study 2 (n = 131), we used a perceived vulnerability to disease scale (PVD) to assess people's dispositional tendencies of concerns about disease and selected high as well as low PVD participants. A 2 (PVD: high, low) × 2 (disease-connoting cue: obese, average-weight) between-subjects design was used. Participants were asked to complete the negotiation task to assess their MC. The results of Study 1 showed that, compared with participants in the normal face condition, participants in the birthmarked face condition showed higher MC fluency and total MC when they were exposed to situational disease prime. Compared with the natural disaster prime group, the infectious disease prime group showed higher MC fluency and total MC when they were provoked by a birthmark person. The results of Study 2 showed that, compared with the average-weight condition, the obese condition led to higher MC fluency and originality among high PVD participants. Compared with low PVD participants, high PVD participants showed higher MC fluency and originality when they negotiated with an obese person. Our studies suggest that among people whose BIS is situationally or chronically activated, birthmarks and obesity could increase MC, and people's malevolent creativity might be induced by disease-connoting cues during the pandemic.

Threat of infectious disease during an outbreak: Influence on tourists' emotional responses to disadvantaged price inequality

Higher education institutions and their students face a wide range of infectious disease threats (IDTs). However, there is a lack of theory-driven research on how to provide communication for multiple IDTs to motivate protective action taking. To close this gap, this study focuses on college students and two IDT types: respiratory and sexually transmitted infections. We tested an IDT appraisal model with data from an online survey conducted at two U.S. universities with 842 students. Findings indicate that IDT type led to different patterns of threat appraisal and protective action taking intentions. More specifically, participants perceived sexually transmitted threats as significantly more predictable and more controllable than respiratory threats. Participants also had higher intention to take protective action in response to respiratory threats than sexually-transmitted threats. We also found that external attribution-dependent (EAD) emotions (i.e., anger, sadness, surprise, and confusion) and an internal-attribution-dependent (IAD) emotion (i.e., hope) were sequential mediators in the relationship between IDT appraisal and protective action taking intentions for both infectious disease types. Implications for IDT communication research and practice are discussed.

Grounded in the multidisciplinary field of strategic risk and health communication, this study proposed and tested a new infectious disease threat (IDT) appraisal model, focused on mapping individuals’ coping strategy preferences as predicted by their perceived predictability and controllability of the disease. A 2 (predictability: high vs. low) × 2 (controllability: high vs. low) within-subjects online experimental design (N = 1,032 U.S. adults) was employed, in which four IDT scenarios (sexually transmitted infection [STI]; waterborne ID; foodborne ID; vector-borne ID) were shown to participants in a counterbalanced fashion, to examine the effects of IDT appraisals on how individuals cope with outbreaks. Results support the hypothesized model, in which assessments of predictability, controllability, and responsibility of an IDT situation drive individuals’ affect valence, information seeking, and conative reactions in passive and active ways. Findings further provide insights into what information seeking strategies and IDT coping behaviors individuals prefer based on their differential IDT appraisals, thus suggesting how public health authorities and risk communication professionals can optimally communicate about infectious diseases to help individuals understand these situations and respond appropriately.

The world has developed an elaborate global health system as a bulwark against known and unknown infectious disease threats. The system consists of various formal and informal networks of organizations that serve different stakeholders; have varying goals, modalities, resources, and accountability; operate at different regional levels (i.e., local, national, regional, or global); and cut across the public, private-for-profit, and private-not-for-profit sectors. The evolving global health system has done much to protect and promote human health. However, the world continues to be confronted by longstanding, emerging, and reemerging infectious disease threats. These threats differ widely in terms of severity and probability. They also have varying consequences for morbidity and mortality, as well as for a complex set of social and economic outcomes. To various degrees, they are also amenable to alternative responses, ranging from clean water provision to regulation to biomedical countermeasures. Whether the global health system as currently constituted can provide effective protection against a dynamic array of infectious disease threats has been called into question by recent outbreaks of Ebola, Zika, dengue, Middle East respiratory syndrome, severe acute respiratory syndrome, and influenza and by the looming threat of rising antimicrobial resistance. The concern is magnified by rapid population growth in areas with weak health systems, urbanization, globalization, climate change, civil conflict, and the changing nature of pathogen transmission between human and animal populations. There is also potential for human-originated outbreaks emanating from laboratory accidents or intentional biological attacks. This paper discusses these issues, along with the need for a (possibly self-standing) multi-disciplinary Global Technical Council on Infectious Disease Threats to address emerging global challenges with regard to infectious disease and associated social and economic risks. This Council would strengthen the global health system by improving collaboration and coordination across organizations (e.g., the WHO, Gavi, CEPI, national centers for disease control, pharmaceutical manufacturers, etc.); filling in knowledge gaps with respect to (for example) infectious disease surveillance, research and development needs, financing models, supply chain logistics, and the social and economic impacts of potential threats; and making high-level, evidence-based recommendations for managing global risks associated with infectious disease.

Strengthening the BTWC: The role of the Biological and Toxin Weapons Convention in combating natural and deliberate disease outbreaks

ACCF/AHA/CDC Conference Report on Emerging Infectious Diseases and Biological Terrorism Threats

Over the past decade there has been an increased awareness in the field of international relations of the potential impact of an infectious disease epidemic on national security. While states’ attempts to combat infectious disease have a long history, what is new in this area is the adoption at the international level of securitized responses regarding the containment of infectious disease. This article argues that the securitization of infectious disease by states and the World Health Organization (WHO) has led to two key developments. First, the WHO has had to assert itself as the primary actor that all states, particularly western states, can rely upon to contain the threat of infectious diseases. The WHO's apparent success in this is evidenced by the development of the Global Outbreak Alert Response Network (GOARN), which has led to arguments that the WHO has emerged as the key authority in global health governance. The second outcome that this article seeks to explore is the development of the WHO's authority in the area of infectious disease surveillance. In particular, is GOARN a representation of the WHO's consummate authority in the area of coordinating infectious disease response or is GOARN the product of the WHO's capitulation to western states’ concerns with preventing infectious disease outbreaks from reaching their borders and as a result, are arguments expressing the authority of the WHO in infectious disease response premature?

One means of improving healthcare workers’ knowledge of and attitudes to vaccines is through running vaccine conferences which are accessible, affordable, and relevant to their everyday work. Various vaccinology conferences are held each year worldwide. These meetings focus heavily on basic science with much discussion about new developments in vaccines, and relatively little coverage of policy, advocacy, and communication issues. A negligible proportion of delegates at these conferences come from Africa, home to almost 40% of the global burden of vaccine-preventable diseases. To the best of our knowledge, no major vaccinology conference has ever been held on the African continent apart from World Health Organization (WHO) meetings. The content of the first International African Vaccinology Conference was planned to be different; to focus on the science, with a major part of discussions being on clinical, programmatic, policy, and advocacy issues. The conference was held in Cape Town, South Africa, from 8 to 11 November 2012. The theme of the conference was “Advocating for efforts to protect African children, families, and communities from the threat of infectious diseases”. There were more than 550 registered participants from 55 countries (including 37 African countries). There were nine pre-conference workshops, ten plenary sessions, and 150 oral and poster presentations. The conference discussed the challenges to universal immunisation in Africa as well as the promotion of dialogue and communication on immunisation among all stakeholders. There was general acknowledgment that giant strides have been made in Africa since the global launch of the Expanded Programme on Immunisation in 1974. For example, there has been significant progress in introducing new and under-utilised vaccines; including hepatitis B, Haemophilus influenza type b, pneumococcal conjugate, rotavirus, meningococcal A conjugate, and human papillomavirus vaccines. In May 2012, African countries endorsed the Global Vaccine Action Plan at the World Health Assembly. However, more than six million children remain incompletely vaccinated in Africa leading to more than one million vaccine-preventable deaths annually. In addition, there are persistent problems with leadership and planning, vaccine stock management, supply chain capacity and quality, provider-parent communication, and financial sustainability. The conference delegates agreed to move from talking to taking concrete actions around children's health, and to ensure that African governments commit to saving children's lives. They would advocate for lower costs of immunisation programmes in Africa, perhaps through bulk buying and improved administration of vaccine rollout through the New Partnership for Africa's Development.

In developed countries, it is said that "threats of infectious diseases are already thought as things of the past". However, as you can see in the case of Ebola hemorrhagic fever that occurred in West Africa, this is a big mistake. Among infectious diseases, only smallpox has been successfully eradicated worldwide. In addition to the three major infectious diseases of HIV/AIDS, tuberculosis, and malaria, there is another group called emerging and reemerging infectious diseases. Recently, neglected tropical diseases (NTDs) have been listed as threats by the WHO, as have drug-resistant bacteria. The spread of these pathogens is increasing due to an increase in global travel. Malaria and more than half of the NTDs are parasitic diseases, such as trypanosomiasis and soil-borne helminthiasis. These are caused by parasites, with eukaryotes similar to their host mammals. In the case of these NTDs, protective immune responses induced by differences between a pathogen and host do not work well, and there is no vaccine against parasites. As for drugs developed to treat these diseases, because the properties of enzymes and target receptors are very similar, and effective drugs simultaneously show efficacy against both the disease and the host, severe side effects often occur. Therefore, the search for targets specifically present in parasites, and screening for drugs that inhibit their physiological functions, is extremely important. Here, as an example of the development of antiparasitic drugs, I will introduce a study on malaria.

Disaster response under One Health in the aftermath of Nepal earthquake, 2015

The threat of infectious diseases caused by pathogenic microorganisms to both human health and the economy is enormous. Coronavirus Disease 2019 (COVID-19) remains a global pandemic. In contrast to many other infectious diseases, monkeypox spreads rapidly and cannot be ignored. Collection of data on contagious diseases can provide quantitative evidence to support effective pandemic control strategies. Global data on predominant infectious diseases collected in the past several weeks and a summary of their epidemiology are presented herein.