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| Biography |
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Joel Breman, MD, DTPH, was educated at the University of California, Los Angeles (UCLA); Keck School of Medicine, University of Southern California (USC); and the London School of Hygiene and Tropical Medicine. He is trained in internal medicine (USC), infectious diseases (Harvard), and epidemiology (Centers for Disease Control and Prevention, CDC). Dr. Breman was advisor to the Guinean Smallpox Eradication-Measles Control Program from 1967-1969. From 1972-1976, he was responsible for disease surveillance and vaccine research with the Organization for Coordination and Cooperation in the Control of the Major Endemic Diseases in Burkina Faso. In 1976, in the Democratic Republic of the Congo, Dr. Breman investigated the first outbreak of Ebola Hemorrhagic Fever. He was in the Smallpox Eradication Unit, World Health Organization (WHO) from 1977-1980, responsible for orthopoxvirus research and the certification of global eradication. In 1980, Dr. Breman returned to the CDC where he began work on malaria, a continuing passion. Dr. Breman joined the Fogarty International Center of the U.S. National Institutes of Health (NIH) in 1995, and has been Deputy Director of the Division of International Training and Research and Senior Scientific Advisor. Dr. Breman has authored over 100 publications focused on infectious diseases and research capacity strengthening in developing countries. He is co-managing editor of the Disease Control Priorities Project.
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| Abstract |
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Infectious Diseases and the Disease Control Priorities Project (DCPP) |
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Infectious Diseases and DCPP: Infectious diseases are controlled in many rich countries yet continue to imperil poor nations. Sub-Saharan Africa, with 13% of the population of low- and middle-income countries (LMIC) contributes 25% of the Disability-Adjusted Life Years (DALYs) and 54% of infectious disease DALYs: 27% of the LMIC infectious diseases burden is in South Asia, 12% in East Asia, 3% in Latin America, and 2% each in the Middle East and Europe/Central Asia. Lower respiratory infections, HIV/AIDS, diarrheal diseases, tuberculosis and malaria are among the top ten causes of death in developing countries. Interventions against many infectious diseases have proven extremely cost effective, particularly childhood vaccinations. For malaria, intermittent preventive treatment of pregnant women to prevent low birth weight and maternal anemia, use of insecticide-treated bed nets, and switching to artemisinin combination therapy when parasite resistance prevails are very cost effective. For HIV/AIDS, peer education of those at risk, counseling and testing, diagnosis and treatment of sexually transmitted infections, condom promotion, blood safety, and prevention of mother-to-child transmission have attractive cost-effectiveness ratios. For low burden diseases, there are many cost effective
interventions: albendazole for geohelminths; case finding for leishmaniasis; ivermectin for onchocerciasis; and drugs and surgery for trachoma. The emergence of microbial resistance to drugs and insect resistance to insecticides has created a dangerous environment for patients and communities. Research is essential to understand the resurgent old and newly-emerging pathogens and to develop better diagnostics, drugs, vaccines, insecticides, and social approaches to combat them. |
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