Fixed-dose combinations for cardiovascular disease and hypertension: Perspectives and lessons learned from HIV/AIDS and TB
London School of Hygiene & Tropical Medicine
The Global Centre for Chronic Conditions at LSHTM, The George Institute for Global Health, Sydney and Médecins sans Frontières co-hosted this symposium on "Fixed-dose combinations for cardiovascular disease and hypertension: Perspectives and lessons learnt from HIV/AIDS and TB".
Fixed-dose combinations (FDC) for prevention of atherosclerotic cardiovascular disease (CVD), including FDCs for secondary prevention and hypertension, have shown promising results but progress on their uptake and use has been slow. Notably, applications to include these FDCs for secondary prevention and hypertension in the World Health Organization (WHO) Essential Medicine List (EML) have not been successful.
This international symposium brought experts working on FDCs for CVD and hypertension together with experts working in the fields of HIV and TB, as well as representatives from governmental, non-governmental organizations, civil society, industry and funders.
The final aim was to provoke a lively discussion around the barriers to FDC implementation and to explore the next steps in moving this agenda forward through further research, advocacy and policy change.
Professor Baron Peter Piot, Director of the London School of Hygiene & Tropical Medicine, gave the welcome address and speakers will include Dr Helen Bygrave, MSF Access Campaign, Dr Ruth Webster, The George Institute for Global Health, Dr Stephen MacMahon, Professor of Global Health, University of Oxford, and Dr Giorgio Roscigno, next2people and previously Global Alliance for TB Drug Development and representatives from the World Health Organization, among others.
Dr Helen Bygrave trained as a physician in Cambridge and London and continues to work as a GP in East London. As an HIV/TB advisor in the Southern Africa Medical Unit (SAMU) she has supported programmes across Sub-Saharan Africa since 2005 and also now works as a consultant for the International AIDS society and WHO, developing international and national guidance on how to provide differentiated service delivery models for HIV. Building on the lessons learned from the scale up of HIV care she has just started to work with the MSF Access Campaign as a technical advisor on non-communicable diseases focusing on diabetes and cardiovascular disease.
Dr Taskeen Khan, is currently a medical officer responsible for cardiovascular disease programme implementation in the Non Communicable Disease (NCD) management unit at the World Health Organization (WHO) Headquarters in Geneva, Switzerland. Taskeen is from South Africa and was previously a national technical officer for NCDs in the WHO country office in Pretoria and also supported the regional office in Congo Brazzaville. Taskeen holds a medical degree from the University of Natal in South Africa, has a Master of Medicine in Community Medicine from the University of the Witwatersrand in South Africa and is a fellow of the college of public health medicine of South Africa. Previously, she has worked at individual, health facility, community, district and national levels of government as well as in academia focusing on NCDs, health policy and health systems.
Professor Stephen MacMahon is Principal Director and Co-founder of The George Institute for Global Health. He also holds positions as Professor of Cardiovascular Medicine, UNSW Sydney and Professor of Medicine and Oxford Martin Senior Fellow at the University of Oxford, Honorary Professor at Peking University Health Science Center and Honorary Consultant at the Royal Prince Alfred Hospital, Sydney. For his global work on the prevention and treatment of heart disease and stroke, he was elected a Fellow of the Australian Academy of Science, the British Academy of Medical Sciences and the Australian Academy of Health & Medical Sciences. In 2013, Stephen was named EY Social Entrepreneur of the Year and in 2016, named by Thomson Reuters as one of the “World’s Most Influential Scientific Minds”. Additionally, in 2017 at the Queens Birthday Honours list Stephen was appointed the Order of Australia (AO).
Dr Pablo Perel is a cardiologist and epidemiologist with expertise in clinical trials, systematic reviews and implementation research. He trained in internal medicine and cardiology in Argentina and did an MSc and PhD in Epidemiology at LSHTM where he is the Co-Director of the Centre for Global Chronic Conditions. He is Deputy Editor of the Cochrane Heart Group and the Global Heart Journal. He divides his time between London and Geneva where he works as Senior Science Advisor for the World Heart Federation.
Dr Giorgio Roscigno is a senior and passionate public health specialist with a very long experience in the private and public sectors. He has been working as a medical doctor from 1972 to 1982 in Ethiopia, Sudan, DRC, Algeria and Italy. In 1982, he joined the pharmaceutical Industry and worked in Switzerland, France, the UK and Italy. He left the Industry in 2000. During this period, he developed up to FDA approval all the fixed dose combinations for TB, the first non-toxic drug for Sleeping Sickness and Rifapentine. From 2000 to 2014, he was involved as Founder and CEO of the Global Alliance for TB (2000/2003); FIND (2003/2013), The African Society for Laboratory Medicine (COO 2013/2014) and NEXT2PEOPLE (Executive Chair 2015 -now). Dr Roscigno has been actively involved in the creation of the Stop TB Partnership and covered overtime positions in the Board and chaired Working Groups in Drugs and Diagnostics.
Hanan J. Sboul, MBA, CAE is the Secretary General of the Jordanian Association of Pharmaceutical Manufacturers. She represents the pharmaceutical industry sector locally, regionally & internationally. Ms. Sboul is a member of USP Council Governance Committee, a member of the Steering Committee for Jordan Pharmaceutical Center of Excellence, a member of the Higher Education Council, Jordan University of Science & Technology Council, ex-member of the Hashemite University Board of Trustees, Council of Pharmacy School at Jordan University and at Jordan University of Science & Technology, ex Board Member of the Fund for Employment, Technical, Vocational Education & Training, ex Board Member of Scientific Research Support Fund, ex member of Higher Committee for Drugs at JFDA. Ms. Sboul received her MBA from Jordan University in 2000 and her B.A in Pharmacy from armouk University in 1986. She was the first Association Executive from Jordan to receive the Certified Association Executive Certificate from the American Society for Association Executives.
Dr Marco Vitoria is a medical officer in the Department of HIV/AIDS at the World Health Organization (WHO) in Geneva, Switzerland. He has been in this role since 2003, providing technical support in treatment and care issues, consolidating global antiretroviral treatment guidelines and other normative documents, and training and evaluating HIV care programmes at the international level, particularly in resource-limited settings. Dr. Vitoria has an extensive experience in HIV clinical and programme management, particularly in Brazil, having been involved in this field since the mid-1990s. From 1998 to 2003, he worked on HIV treatment scale-up in Brazil for the Brazilian National AIDS Programme.
Dr Ruth Webster is the Head, Research Programs within the Office of the Chief Scientist at The George Institute and a Senior Lecturer in the Faculty of Medicine, University of New South Wales. She has a PhD in Medicine from the University of Sydney and holds a NHMRC Early Career Fellowship. She is the international Coordinator of the SPACE (Single Pill to Avert Cardiovascular Disease) Collaboration and study director for the TRIUMPH and INTEGRATE studies. Her research is focused on improving adherence to essential medications in those at highest risk of cardiovascular disease.
Image credit: Adrienne Yancey for opensource.com
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