V3:2CD1SSCCIBBROADMGH1811INSTITUTECanterfarComsutstianalS lstaprative BiolA Race Against ResistanceDeborah T.Hung,M.D.-Ph.D.Broad Institute of MiT and HarvardandDepartmentofMolecularBiologyCenterforComputational and Integrative BiologyMassachusettsGeneralHospitalandDepartment of Microbiologyand Molecular GeneticsHarvardMedicalSchool22October2008
A Race Against Resistance Deborah T. Hung, M.D.-Ph.D. Broad Institute of MIT and Harvard and Department of Molecular Biology Center for Computational and Integrative Biology Massachusetts General Hospital and Department of Microbiology and Molecular Genetics Harvard Medical School 22 October 2008
Theglobalproblem~56million deaths/yearworldwideOther14%InfectiousRespiratorydiseasesdisease27%6%Injuries10%Cancer13%Cardiovasculardisease30%worldwide
Deaths 2004, WHO Infectious diseases 27% Cardiovascular disease 30% Cancer 13% Injuries 10% Respiratory disease 6% Other 14% The global problem ~ 56 million deaths/year worldwide worldwide
Theglobalproblem~56milliondeaths/yearworldwideNutritional1%图Maternal2%OtherPerinatal14%Infectious6%RespiratorydiseasesInjuriesdisease27%11%Infectious6%diseasesInjuries45%10%CancerNoncommunic13%Cardiovascularabledisease35%30%worldwidedevelopingnations~1/3oftotaldeathsworldwide
Deaths 2004, WHO Infectious diseases 45% Noncommunic able 35% Injuries 11% Perinatal 6% Maternal 2% Nutritional 1% Deaths 2004, WHO Infectious diseases 27% Cardiovascular disease 30% Cancer 13% Injuries 10% Respiratory disease 6% Other 14% The global problem ~ 56 million deaths/year worldwide ~ 1/3 of total deaths worldwide worldwide developing nations
LeadinginfectiouskillersMillions of deaths, worldwide,all ages, 19983.5Over age five3.0Under age five2.52.32.2siasn2.01.51.51.11.00.90.5AIDS*AcuteDiarhoealTBMalariaMeasiesrespiratorydiseasesinfections(including"HVpestshTBhuuAdpneumoniaandSaucxWHQ 1989influenza)The majorityarecurable
Leading infectious killers The majority are curable
Targeting childrenHigher-incomecountry/regionBurtina FasoThe death30%United States5Cokimbe13%of a childEurope5Egypt32%Percentageofwomenaged15to49,hdonesa26%Middle-and lower-incomemarriedorpreviouslymarried,regionswho have hadat least one child dieKena49%Africa77Mt52%Eastern64Kamba26Mediterranean57SoutheastAsiaPaistan30Peru25%Pacificregion45LatinAmericaPiiippnes19%38andCaribbean45%Senegal38EasternEurope40%UnkedPrpubfoafTanzaniaChild deaths frominfectious diseases,Yemen2selected regions2000-2003(percentage)>51%ofdeathsinchildrenworldwide=infection
> 51% of deaths in children worldwide = infection Targeting children
TheEconomicBurdenAIDSEconomic$14 bilionburdenprevenionandhealhWhen niectioLEcare costs,diseasesarenotworldnida,controlled,they canMalariaDrugBSEarmualyplaceatremendous$500resistance$3billionPlagueCholerabudenonmillicn$4 billiondirect$770$1.7bllioneoonomies.directtreamentandm Ilin IcetIcst buristcDets,costs,indirectseabodIncomeStb-US.UK.export,andtade,Saharanarmualy1997Peru,mda,1994Afica.1991armuallyEconomicSmallpoxPoliosavings$1.07 blllon$1.56 billonesimatedprjectedTha costofsaaingsinSaurx WHOcaangscontrolirgdrectcostsanruelyoreliminaing1997prl86inieciousdiseasseis ofen recoveredmanyimesoverinfuturesavings
The Economic Burden
NeededinterventionsPreventabledeathsItisestimatedthatthemajorityofdeathsfrominfectiousdiseasescanbepreventedwithexisting,cost-effedivestrategies.Childhood vaccinations have proven extremely efiective in reducing deaths fiom measles andotherpreventablediseases.Bednetsandotherpreventionandtieatmentstrategiescanprevent50%ofallmalariadeaths.DOTS(Directy Observed Tieatment, Short-course)canprevent60%ofall tuberculosisdeaths.DeathsavoldableIMCI (Integrated Management of ChidhoodwithIllnessas)canpre/entmastchildhoodceathsfrompneumonia,diamhoea,malariaandexistingmeasles.An important partof IMCI is oraltoolsrehydrationtherapy,whichcanpreventupto90%ofdeathsfromdiarrhoealdiseases.Antibiotics used in timely and correctdoses,combined with ctherstrategles suchasIMCl,arehighlyefective inpreventingdeathsfrompneumoniaHIVpreventionstrategiessuchascondompromotion,sexeducationandtreatmentof STlsDeaths unavolcablehavebeenproventoreducethewlthoutnentoolsspreadofHIVIAIDSSarexWHO
Needed interventions
NeededinterventionsPreventabledeathsItisestimatedthatthemajorityofdeathsfrominfectiousdiseasescanbepreventedwithexisting,cost-effectivestrategiesChildhood vaccinations have proven extremely efiective in reducing deaths fiom measles andotherpreventabiediseasesBednetsandotherpreventionandtieatmentstrategiescanprevent50%of allmalariadeaths.DOTS (Directy Observed Tieatment, Short-course)canprevent60%ofall tuberculosisdeaths.DeathsavoldableIMCI (Integrated Management of ChidhoodwithIllnessas)canpreventmastchildhoodceathsfrompneumonia,diamhoea,malariaandexistingmeasles.An importantpartof IMCIisoraltoolsrehydrationtherapy,whichcanpreventuptc90%of ceaths fromdirrhoeal diseasesAntibiotics used in timely and corectdases,combinedwith ctherstrategies such as IMCl,arehighlyefiective inpreventingdeathsfrompneumoniaHIVpreventionstrategiessuchascondompromotion,sexeducationandtreatmentof STlsDeaths unavolcablehavebeen provento reducethewlthoutnetoolsspreadofHIVIAIDSSarexWHO
Needed interventions
Antibiotics:“wonderdrugs1928- SirAlexanderFleming'sdiscovery ofpenicillinAntibiotics have saved millions of lives and easedthe suffering of patients of all ages formorethan60years.These"wonderdrugs"deservemuchofthecreditforthedramaticincreaseinlifeexpectancyinthe United States and aroundtheworld inthe2Othcentury
Antibiotics have saved millions of lives and eased the suffering of patients of all ages for more than 60 years. These “wonder drugs” deserve much of the credit for the dramatic increase in life expectancy in the United States and around the world in the 20th century. Antibiotics: “wonder drugs” 1928 - Sir Alexander Fleming’s discovery of penicillin
Antibiotics:“wonderdrugs1928- SirAlexanderFleming'sdiscovery ofpenicillinAntibiotics have saved millions of lives and easedthe suffering of patients of all ages formorethan60years.These"wonderdrugs"deservemuchofthecreditforthedramaticincreaseinlifeexpectancyintheUnitedStates and aroundtheworld inthe2Othcentury“(it is) time to close the book on infectious disease."WilliamStewart, USSurgeonGeneral1967
Antibiotics have saved millions of lives and eased the suffering of patients of all ages for more than 60 years. These “wonder drugs” deserve much of the credit for the dramatic increase in life expectancy in the United States and around the world in the 20th century. Antibiotics: “wonder drugs” 1928 - Sir Alexander Fleming’s discovery of penicillin “(it is) time to close the book on infectious disease.” William Stewart, US Surgeon General 1967