Houston Chronicle Sunday

Personaliz­ed medicine may get stimulant

- By Robert Pear

sioned an independen­t review, which recommende­d creating a $100 million emergency fund for health crises and beefing up rapidrespo­nse health experts. Neither has been done.

The human toll of Ebola can be starkly seen in one plot of land in Liberia’s capital where only Ebola victims are buried now.

“Recriminat­ions are counterpro­ductive, but it will be necessary to understand whether this outbreak could have been responded to quicker with less cost and less suffering,” U.N. Ebola chief, Dr. David Nabarro, told the U.N. General Assembly last week Ready for normal life

Julius Kamara, a father to two girls whoremain home, said sometimes the plastic buckets in Sierra Leone’s capital for hand-washing are now empty. There are fewer checkpoint­s, restrictio­ns on movements are being lifted but gatherings are banned and bars and clubs are closed.

“We are all looking forward to when life can get back to normal,” he said. Sierra Leone plans to reopen schools in March, following Guinea which opened them this week. Liberia is set to reopen schools on Feb. 2.

“The epidemic has turned,” Ismael Ould Cheikh Ahmed, the new head of the U.N. Mission for Ebola Emergency Response, recently declared. The number of cases in Guinea and Sierra Leone is at its lowest since August, and in Liberia it’s the lowest since June.

Still, he and other officials caution that they lack critical informatio­n about the cases that do remain. Only about half of new cases in Guinea and Liberia are from known contacts, meaning that the remainder is getting infected from unknown sources.

No such statistics even exist for Sierra Leone, where deaths are being underrepor­ted.

“There are still numbers of newcases that are alarming, and there are hotspots that are emerging in new places that make me believe there is still quite a lot of the disease that we’re not seeing,” said Nabarro, the U.N. Ebola chief.

The outbreak has not killed as many people as some prediction­s. At its height, one estimate warned that as many as 1.4 million people could become infected by mid- January if there were no additional interventi­ons. Instead, the probable, suspected and confirmed case toll is 21,797 with 8,675 deaths. Many stumbled

Nearly every agency and government stumbled in its response to Ebola, now expected to cost the three most-affected countries at least $1.6 billion in lost economic growth in 2015.

In an internal draft document last year, WHO acknowledg­ed there was “a failure to see that conditions for explosive spread were present right at the start.”

WHO blamed incompeten­t staff and said it let bureaucrat­ic bungles delay people and money to fight the virus. The document said the agency was hampered by budget cuts and the need to battle other diseases flaring around the world.

Brice de le Vingne, director of operations for Doctors Without Borders, said the Ebola outbreak exposed a vacuum in global health leadership. “The world today doesn’t have a proper organizati­on to respond quickly to this kind of catastroph­e.”

WASHINGTON — President Barack Obama will seek hundreds of millions of dollars for a new initiative to develop medical treatments tailored to genetic and other characteri­stics of individual patients, officials say.

The proposal, mentioned briefly in his State of the Union address, will be described in greater detail in his budget in the coming weeks. The effort is likely to receive support from members of both parties, lawmakers said.

“This is an incredible area of promise,” said Sen. Bill Cassidy, R-La., a gastroente­rologist. “There will be bipartisan support.”

The money would support biomedical research at the National Institutes of Health and the regulation of diagnostic tests by the Food and Drug Administra­tion, officials at the two agencies said. Bipartisan support

The tests analyze the DNA. Doctors use that informatio­n to identify patients with cancer or other diseases who are most likely to benefit from a particular treatment — and those who would be harmed or not respond at all.

“In some patients with cystic fibrosis, this approach has reversed a disease once thought unstoppabl­e,” Obama said in his address to Congress.

Rep. Fred Upton, RMich., chairman of the Energy and Commerce Committee, and Rep. Diana DeGette, D-Colo., who is on the committee, welcomed Obama’s proposal.

As a senator in 2006 and 2007, Obama offered a bill to do just that — the Genomics and Personaliz­ed Medicine Act. Sen. Richard Burr, R-N.C., was a cosponsor of the 2007 bill. Initiative praised

“Personaliz­ed medicine represents a revolution­ary and exciting change in the fundamenta­l approach and practice of medicine,” Obama said then. He cited the drug Herceptin, for the treatment of a particular­ly aggressive form of breast cancer, as an example.

Dr. Ralph Snyderman, a former chancellor for health affairs at Duke University, often described as the father of personaliz­ed medicine, said he was excited by the president’s initiative. Although the new tests and treatments are often expensive, he added, personaliz­ed medicine can save money while producing better results. “It focuses therapy on individual­s in whom it will work,” he said. “You can avoid wasting money on people who won’t respond or will have an adverse reaction.”

Dr. Margaret Hamburg, FDA commission­er, has reorganize­d her agency to speed the review of drugs and diagnostic tests used in personaliz­ed medicine.

But Cassidy said he was skeptical. To fulfill the promise of personaliz­ed medicine, he said, will require “a much more nimble federal bureaucrac­y.”

 ?? Zoom Dosso / AFP / Getty Images ?? Liberian residents remain quarantine­d Saturday in Omega town, a suburb of Monrovia, after one of their relatives died from Ebola.
Zoom Dosso / AFP / Getty Images Liberian residents remain quarantine­d Saturday in Omega town, a suburb of Monrovia, after one of their relatives died from Ebola.

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