Disease: international efforts

In this volume, the Editors have compiled a group of articles that they feel represents a continuation of the aims of this publication to provide the clinical chemist with reviews of state-of-the-art methodology, newer areas of medicine and physiology that affect the clinical chemist, and those areas related to the latest information relating ehemistry to disease. Brown, Kalow, Pilz, Whittaker, and Woronick present an article entitled The Plasma Cholinesterases A New Perspective. This is truly an international effort and is presented by the authors on behalf of the Commission on Toxicology of the Clinical Chemistry Division of the International Union of Pure and Applied Chemistry. It provides a superb review of human serum cholinesterase and its variants and a critical assessment of the physical and chemical properties of the enzyme. 

Several other international efforts involve consortia. In fact the leading causes of human deaths worldwide are not heart disease, stroke, or cancer, but diseases of malnutrition and infectious pathogens. The top three killers are diseases of famine (e.g., anemia), malaria, tuberculosis, and HIV (human immunodeficiency virus)/AIDS (acquired immunodeficiency syndrome). Malaria is considered as the foremost killer of children, whereas AIDS is considered as the world s foremost killer of adults. Millions of children in Africa die of malaria every year. 

Animals are treated routinely with antibiotics to prevent, treat, or control disease. Even under the best conditions of agricultural management, crowding and stress can lead to disease. While historically there have also been non-therapeutic uses of antibiotics, typically as production tools to improve endpoints such as feed efficiency and weight gain, there is a call to diminish these uses worldwide, and concern for the development of resistance to antibiotics used in human medicine as a result of their use in animal agriculture has led to international efforts to evaluate that risk. The results of the therapeutic uses are healthy animals that contribute to a healthful and plentiful food supply. 

Several computer models are available to help predict disease spread in order to facilitate national, or even international, efforts to manage... 

National and international trends over the past 15 years depict modest improvements in the treatment and/or control of blood pressure (BP) for hypertensive patients. This observation is made despite efforts to promote awareness, treatment, and the means available to aggressively manage high blood pressure. Over 65 million Americans have hypertension, which was listed as the primary cause of death for over 261,000 individuals in the United States in 2002.1 Hypertension is also a significant cause of end-stage renal disease and heart failure. National and international organizations continually refine their recommendations of how... 

NGOs remain(ed) critical of the list, however, because it represents a step back from the international consensus achieved with the WTO Decision. In the negotiations leading up to the Decision, several developed countries proposed to limit its scope to addressing specific diseases or just applying to specific pharmaceutical products. These efforts were roundly condemned by civil society activists as unethical and unsound health policy, and firmly rejected by developing countries. Ultimately, all WTO members agreed that there would be no such limitations. 

National and international cooperative efforts for sharing data are mandatory to achieve the large sample sizes required and allow metaanalyses of data (120,121), which can be very powerful. Study of genetic effects common to multiple diseases will also increasingly be of considerable interest (121,122). The most efficient scheme for completing a pooled association screen is for a large collaborative study of several diseases with division of microsatellites among laboratories (65). 

The purchase, transport, storage, use, and disposal of pesticides must be done according to international standards or those standards in accordance with the EPA. Basic environmental efforts can be taken to reduce the risk of vector-borne disease, such as establishing adequate shelters and a clean water supply and disposal of human and animal excreta and solid waste materials to reduce flies. 

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