Progress against tetanus, HIV, and malaria

By Donald G. Mcneil Jr. Sep. 25, 2017

Infant and maternal tetanus was officially eliminated from the Americas this year, the Pan American Health Organization announced Thursday.

At one time, the infection killed about 10,000 newborns annually in the Western Hemisphere; tetanus still kills about 35,000 infants around the world.

It was one of several significant global health advances, including new programs against malaria and HIV, announced last week in conjunction with the meeting of the U.N. General Assembly in New York.

Haiti was the last country in the Americas to eliminate neonatal tetanus. That does not mean complete eradication, because the bacteria that cause tetanus exist everywhere in soil and animal droppings.

Rather, elimination means that — thanks to vaccination of mothers and clean birth procedures — less than one case occurs per 1,000 live births.

Also this week, the President’s Malaria Initiative said it would expand its work to new countries in West and Central Africa, protecting 90 million more people.

The initiative, founded in 2005 as part of the U.S. Agency for International Development, has been a major force in driving down worldwide malaria deaths by about 40 percent in the past decade.

The disease most often kills young children and pregnant women.

The expansion in Cameroon, Ivory Coast, Niger, Sierra Leone and Burkina Faso was made possible because Congress increased funding for the initiative in fiscal year 2017, a representative said.

In his speech to the United Nations on Tuesday, President Donald Trump praised the malaria initiative and the President’s Emergency Plan for AIDS Relief as examples of leadership in humanitarian assistance by the United States.

A combination of aid agencies, drug companies and governments also announced that a new 3-in-1 antiretroviral cocktail to treat HIV soon would be available to 92 countries, including virtually all of Africa, for about $75 a year.

The new AIDS cocktail is the first available in poor countries to contain dolutegravir, which is widely used in wealthy countries because it is highly effective and has few side effects.

The pill also contains lamivudine and tenofovir disoproxil fumarate.

Almost 37 million people in the world have HIV, according to UNAIDS, the U.N.'s AIDS-fighting agency, but fewer than 20 million people are now on antiretroviral medicine, which not only saves their lives but prevents them from passing on the disease.