Tuberculosis, the forgotten pandemic relying on a 100-year-old vaccine

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Justin Denholm, Melbourne HealthBy some estimates, 2 billion people are now infected worldwide, and in 2019, around 1.4 million people died from it.

It’s a pandemic infection, spread through the air — but it’s not COVID. It’s tuberculosis (or TB). Yet we’re not in lockdown for it. And we’re not queuing up for a vaccine.

Some people call TB “the forgotten pandemic”. But our knowledge of one pandemic is helping us manage the other.

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Read more:
Explainer: what is TB and am I at risk of getting it in Australia?

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They’re similar in some ways …

TB is caused by the bacterium Mycobacterium tuberculosis. And COVID is caused by SARS-CoV-2, a virus. They’re quite different microorganisms. But it’s easy for them to overlap in people’s minds.

Both TB and COVID are infectious diseases that generally affect the lungs. Both are passed between people mainly by aerosols, when infected people cough, sing or otherwise release them into the surrounding air.

TB is caused by Mycobacterium tuberculosis.
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So some of the things we’re used to doing for COVID-19 – like wearing masks and good ventilation – also work for preventing the spread of TB.

However, there are some important differences between them, which mean our public health responses can look quite different.

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Read more:
‘Kissing can be dangerous’: how old advice for TB seems strangely familiar today

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… but not in others

We are all so familiar with COVID. So when I’m talking with people about TB, I’ve started highlighting three key differences between the infections.

1. TB is less infectious

TB is much less infectious. While COVID (especially strains like the Delta variant) may be transmitted after brief or “fleeting” contact, this is rare for TB.

As a rule of thumb, TB programs around the world often suggest you need to be in close contact with an infectious person for more than eight hours before that risk builds up to the point where you need to be tested for it.

This means people are more likely to spread the infection within their household or immediate family rather than at the shops.

2. TB symptoms take longer to show up

With TB, the “window” between being exposed and becoming unwell, known as the incubation period, is much longer.

Infections can stay dormant (or “latent”) in the body for many months or years before people become unwell. But almost everyone who becomes unwell with COVID has been infected within the past two weeks.

We don’t ask contacts of TB to isolate at home as we can’t predict when they might become unwell. It certainly wouldn’t be ethical or realistic to isolate people for months or years, just in case. Fortunately, people who have dormant TB cannot pass infection on to others in the meantime.

3. We have TB treatments to help curb the spread

As we’re uncertain about how long it takes between someone becoming infected and becoming unwell with TB, you’d think that would be a big problem.

But we have effective treatments to give people with dormant TB. These help prevent them developing active disease.

These treatments, particularly antibiotics such as isoniazid or rifampicin, can greatly reduce the risk of contacts becoming sick.

For COVID, we don’t yet have any treatments for people who are infected but who are not showing symptoms (known as post-exposure treatments) to minimise the chance of them spreading the virus.

Some have been tried, but so far none have convincingly been shown to be effective.

How about vaccines?

Perhaps the biggest difference in our response to these pandemics is we have a variety of effective vaccines against COVID.

For TB, we are relying on a 100-year-old vaccine, known as BCG (short for Bacille Calmette-Guerin), which is still one of the most widely used vaccines globally.

While it protects young children from the most severe forms of TB, the vaccine seems to give much less protection for adults.

The BCG vaccine, unlike COVID vaccines, is a live vaccine, meaning it contains live (but weakened) bacteria. So it can’t be given safely to people with immune suppressing conditions, like HIV, because they could get infected from it. This means its use is limited in some people who most need protection.

TB vaccine may protect against COVID

Perhaps the BCG vaccine and COVID will come full circle. The BRACE trial, launched from Melbourne’s Murdoch Children’s Research Institute, is studying whether the BCG vaccine might protect against COVID infection.

This investigation has been prompted by a long history of research showing the vaccine also improves our immune responses to other conditions such as viral infections.

We don’t know yet whether this will work, as the study is ongoing. Almost 7,000 health-care workers around the world at risk of COVID exposure have been recruited to the trial.

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Read more:
Could BCG, a 100-year-old vaccine for tuberculosis, protect against coronavirus?

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Whether or not BCG turns out to prevent COVID, there’s no question we need new and more effective vaccines for TB.

While we have an increasing number of potential vaccine candidates, right now there is still no alternative to our 100-year-old BCG.

The massive amount of activity globally in developing COVID vaccines has also stimulated calls for greater efforts and funding to develop new TB vaccines.

We hope these will lead to more effective and safer options, and be powerful tools for eliminating TB. Let’s hope we’re not left waiting another 100 years.

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Read more:
Tuberculosis kills as many people each year as COVID-19. It’s time we found a better vaccine

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Justin Denholm, Associate Professor, Melbourne Health

This article is republished from The Conversation under a Creative Commons license. Read the original article.

The Forgotten People of Bhutan

Plinky Prompt: The Most Important Thing I Learned This Year

Interesting, 01

This will be a lesson I should have learnt some time ago, but seemingly forgot. It’s a really simple lesson really, though apparently easily forgotten. Simply put – don’t over commit at work. Certainly, work to the appropriate level, not denying that – just don’t over do it. What I mean is, putting in a heap of extra hours doesn’t do your health any good – physically, mentally, etc. So keep the job in perspective and in balance with the rest of life.

Police in Sudan Aid Muslim’s Effort to Take Over Church Plot

With possibility of secession by Southern Sudan, church leaders in north fear more land grabs.

NAIROBI, Kenya, October 25 (CDN) — Police in Sudan evicted the staff of a Presbyterian church from its events and office site in Khartoum earlier this month, aiding a Muslim businessman’s effort to seize the property.

Christians in Sudan’s capital city told Compass that police entered the compound of the Sudan Presbyterian Evangelical Church (SPEC) on Oct. 4 at around 2 p.m. and ordered workers to leave, claiming that the land belonged to Muslim businessman Osman al Tayeb. When asked to show evidence of Al Tayeb’s ownership, however, officers failed to produce any documentation, the sources said.

The church had signed a contract with al Tayeb stipulating the terms under which he could attain the property – including providing legal documents such as a construction permit and then obtaining final approval from SPEC – but those terms remained unmet, church officials said.

Church leader Deng Bol said that under terms of the unfulfilled contract, the SPEC would turn the property over to al Tayeb to construct a business center on the site, with the denomination to receive a share of the returns from the commercial enterprise and regain ownership of the plot after 80 years.

“But the investor failed to produce a single document from the concerned authorities” and therefore resorted to police action to secure the property, Bol said.

SPEC leaders had yet to approve the project because of the high risk of permanently losing the property, he said.

“The SPEC feared that they were going to lose the property after 80 years if they accepted the proposed contract,” Bol said.

SPEC leaders have undertaken legal action to recover the property, he said. The disputed plot of 2,232 square meters is located in a busy part of the heart of Khartoum, where it has been used for Christian rallies and related activities.

“The plot is registered in the name of the church and should not be sold or transfered for any other activities, only for church-related programs,” a church elder who requested anonymity said.

The Rev. Philip Akway, general secretary of the SPEC, told Compass that the government might be annoyed that Christian activities have taken place there for many decades.

“Muslim groups are not happy with the church in north Sudan, therefore they try to cause tension in the church,” Akway told Compass.

The policeman leading the officers in the eviction on Oct. 4 verbally threatened to shoot anyone who interfered, Christian sources said.

“We have orders from higher authorities,” the policeman shouted at the growing throng of irate Christians.

A Christian association called Living Water had planned an exhibit at the SPEC compound on Oct. 6, but an organization leader arrived to find the place fenced off and deserted except for four policemen at the gate, sources said.

SPEC leaders said Muslims have taken over many other Christian properties through similar ploys.

“We see this as a direct plot against their churches’ estates in Sudan,” Akway said.

The Rev. John Tau, vice-moderator for SPEC, said the site where Al Tayeb plans to erect three towers was not targeted accidentally.

“The Muslim businessman seems to be targeting strategic places of the church in order to stop the church from reaching Muslims in the North Sudan,” Tau said.

The unnamed elder said church leaders believe the property grab came in anticipation of the proposed north-south division of Sudan. With less than three months until a Jan. 9 referendum on splitting the country according to the Comprehensive Peace Agreement of 2005, SPEC leaders have taken a number of measures to guard against what it sees as government interference in church affairs.

Many southern Sudanese Christians fear losing citizenship if south Sudan votes for secession in the forthcoming referendum.

A top Sudanese official has said people in south Sudan will no longer be citizens of the north if their region votes for independence. Information Minister Kamal Obeid told state media last month that south Sudanese will be considered citizens of another state if they choose independence, which led many northern-based southern Sudanese to begin packing.

At the same time, President Omar al-Bashir promised full protection for southern Sudanese and their properties in a recent address. His speech was reinforced by Vice President Ali Osman Taha’s address during a political conference in Juba regarding the signing of a security agreement with First Vice President Salva Kiir Mayardit (also president of the semi-autonomous Government of Southern Sudan), but Obeid’s words have not been forgotten.

Akway of SPEC said it is difficult to know what will become of the property.

“Police continue to guard the compound, and nobody knows for sure what the coming days will bring,” Akway said. “With just less than three months left for the South to decide its fate, we are forced to see this move as a serious development against the church in Sudan.”

Report from Compass Direct News

Somalia’s militant group pursues Christians into Kenya

Somalia’s militant group al Shabaab is no longer confining its agenda to the country’s borders. They are now spreading into neighboring countries. There will not be a rescue coming from the Somali government, reports MNN.

Todd Nettleton with Voice of the Martyrs says the peacekeeping help that Somalia is getting is hampered by the internal anarchy. "How do you provide support to a country that is basically a failed state, where there is chaos on the ground? "

A "failed state" describes a country with a fractured social and political structure. Nettleton notes, "Really, there is no authority structure. There is no government body that really has power to enforce their will on the country." Sadly, Somalia has been leading the Failed States Index for three years’ running.

The conflict is now extending into Kenya. One reason might be al Shabaab’s intent to eradicate Christianity and create a Muslim state. Nettleton explains. "We heard a report that al Shabaab literally had a list of Christians that they were seeking."

Since al Shabaab is hunting believers, they are fleeing. "There are Christians who have had to leave Somalia who are in some of these refugee camps in surrounding nations. As the al Shabaab philosophy spreads into those camps, those Christians are put directly at risk." For example: Kenya.

Despite the oppression, Nettleton says the Gospel can’t be discounted. There is still a remnant church, albeit deep underground.

Voice of the Martyrs has found a way to let them know they’re not forgotten. "It’s a challenge to find Christians, it’s a challenge to support them. We have provided some help to the families of martyrs in Somalia."

While the situation seems hopeless, there is one avenue that surpasses the political venues. "The most significant thing that we can do is to pray for the country of Somalia, to pray especially for our Christian brothers and sisters there."

Somalia is ranked fourth on the Open Doors World Watch list of countries that are noted for their persecution of Christians.

Report from the Christian Telegraph

Tehran begins crackdown in advance of bloody anniversary

Iran is taking steps to quell protests as the anniversary of the disputed presidential election nears, reports MNN.

Multiple sources report they’re aggressively deploying paramilitary members, re-arresting activists, and enforcing certain bans on mingling of the sexes and un-Islamic women’s clothing.

The crackdown speaks to the oppressive nature of the government. It also means that everyone is under scrutiny, especially Christians.

In the best of times, the open witness of the Gospel is banned, and government spies monitor Christian groups. Believers face discrimination in education, employment, and property ownership.

However, with the increased scrutiny, discipling becomes dangerous work. Church leaders will continue to cultivate growth in the body of Christ, knowing that those who commit apostasy (turning away from Islam to another faith) face prison, abuse or the death penalty. Evangelist Sammy Tippit explains, "These are people who are from Muslim backgrounds who have come to know Christ. So the only thing they can get is from an outside source."

Believers are often isolated because they can’t worship together in a traditional church. That’s where Tippit’s teaching programs are extremely effective via satellite television. He says, "We need to pray that God will encourage them, will strengthen them, and give them the stamina in the face of great challenge."

Tippit recently met with a group of church leaders outside of Iran in order to encourage them and to let them know they’re not forgotten. "God met with us in an incredible way. Of course, they were hungry, and they were thirsty–these believers. And these were leaders."

Tippit says, "The only thing that the church can do is encourage them, pray for them, and try to give them some kind of biblical foundation that would enable them to claim the promises of God in the midst of suffering."

Report from the Christian Telegraph

Anglican leaders around globe decry ordination of lesbian bishop

In response to an openly gay woman being ordained a bishop in the Episcopal Church on Saturday, Anglican leaders from around the world decried the action as “gravely concerning and wrong,” with some adding that the move has “hurt and alienated” many within the Episcopal community, reports Catholic News Agency.

Fifty-five year-old Mary Glasspool, an openly parterned lesbian, was ordained a bishop at Long Beach arena on May 15. Some 3,000 people attended the ceremony which featured a procession with liturgical dancers in bright colored outfits, costumed dragons and drums, according to Virtue Online.

This recent move by the Episcopal church in the U.S. has caused tremendous controversy within the global Anglican church, prompting Archbishop of Canterbury Rowan Williams to issue a statement of caution when the announcement of Glasspool’s ordination was first made last year. He urged church leaders at the time to consider the “implications and consequences of this decision.” Archbishop Williams wrote in March that the Episcopal leaders’ later confirmation of Glasspool’s election as bishop-suffragen was “regrettable.”

Several world leaders within the Anglican community denounced Saturday’s ordination.

“The decision of the Episcopal Church of the United States of America to consecrate as a bishop a woman in a sexually active lesbian relationship is gravely concerning and wrong,” said Rev. Dr. H. William Godfrey, bishop of the the Anglican Church of Peru on May 15.

“It is impossible,” he added, “to know by what authority the Episcopal Church is taking this action. It is disobedient to the Word of God, to the teaching of the Church, and deeply hurtful and damaging to their Christian brothers and sisters.”

“It appears,” the bishop observed, “that their decision is being taken in accord with their instincts and feelings, and the ways of the liberal society in which they live, and that they have forgotten the moral values and teachings of the Holy Scriptures and their Church.”

A coalition of Evangelical Anglicans in Ireland issued a joint statement expressing support for those within the Episcopal community who feel “hurt and alienated” by Glasspool’s ordination.

“Many Christians of all traditions and denominations will share our sorrow and see Mary Glasspool’s consecration as a defiant rejection of pleas for restraint and, even more importantly, as a rejection of the pattern of holiness of life called for in Scripture and endorsed by believers over the centuries,” they wrote on Sunday.

Rev. Robinson Cavalcanti, Bishop of the Diocese of Recife in Brazil, said in a statement on May 15 that the ordination was “lamentable” and that it has caused “a de facto rupture” within the Anglican community.

The bishop of the Diocese of Caledonia, Rev. William Anderson, added that he “can only hope that the Archbishop of Canterbury will finally accept that bishops and national churches who choose to willfully ignore the teaching of the Anglican Communion and Holy Scripture, ought to suffer the natural consequence of choosing to go their own way – which is to say, that they ought to be considered to have left the Anglican Communion.”

Report from the Christian Telegraph 

Scholars: John Calvin was America’s ‘Founding Father’

More than a thousand attendees are expected to gather for a four-day conference to celebrate John Calvin’s 500th birthday, reports Michael Ireland, chief correspondent, ASSIST News Service.

As America prepares to celebrate Independence Day this July 4, Vision Forum Ministries will be hosting the national celebration to honor the 500th birthday of John Calvin, a man who many scholars recognize as America’s “Founding Father.”

The event — The Reformation 500 Celebration — will take place July 1-4 at the Park Plaza Hotel in downtown Boston, according to a media release about the event.

“Long before America declared its independence, John Calvin declared and defended principles that birthed liberty in the modern world,” noted Doug Phillips, president of Vision Forum Ministries.

“Scholars both critical and sympathetic of the life and theology of Calvin agree on one thing: that this reformer from Geneva was the father of modern liberty as well as the intellectual founding father of America,” he said.

Phillips pointed out: “Jean Jacques Rousseau, a fellow Genevan who was no friend to Christianity, observed: ‘Those who consider Calvin only as a theologian fail to recognize the breadth of his genius. The editing of our wise laws, in which he had a large share, does him as much credit as his Institutes. . . . [S]o long as the love of country and liberty is not extinct amongst us, the memory of this great man will be held in reverence.'”

He continued: “German historian Leopold von Ranke observed that ‘Calvin was virtually the founder of America.’ Harvard historian George Bancroft was no less direct with this remark: ‘He who will not honor the memory and respect the influence of Calvin knows but little of the origin of American liberty.’

“John Adams, America’s second president, agreed with this sentiment and issued this pointed charge: ‘Let not Geneva be forgotten or despised. Religious liberty owes it much respect.’

“As we celebrate America’s Independence this July 4, we would do well to heed John Adams’ admonition and show due respect to the memory of John Calvin whose 500th birthday fall six days later,” Phillips stated.

Calvin, a convert to Reformation Christianity born in Noyon, France, on July 10, 1509, is best known for his influence on the city of Geneva, the media release explains.

“It was there that he modeled many of the principles of liberty later embraced by America’s Founders, including anti-statism, the belief in transcendent principles of law as the foundation of an ethical legal system, free market economics, decentralized authority, an educated citizenry as a safeguard against tyranny, and republican representative government which was accountable to the people and a higher law,” the release states.

The Reformation 500 Celebration will honor Calvin’s legacy, along with other key Protestant reformers, and will feature more than thirty history messages on the impact of the Reformation, Faith & Freedom mini-tours of historic Boston, and a Children’s Parade.

The festivities will climax on America’s Independence Day as attendees join thousands of others for the world-renowned music and fireworks celebration on the Esplanade with the Boston Pops Orchestra.

Report from the Christian Telegraph 

Christian human rights group concerned for minorities in Iran

Christian Solidarity Worldwide (CSW), a UK-based Christian human rights group says that it is concerned for the safety and well-being of non-Muslim religious minorities in Iran as violent protests over recent Presidential elections continue, reports Dan Wooding, founder of ASSIST Ministries.

Alexa Papadouris, CSW’s Advocacy Director, said: “Recent comments by the Iranian Government and Ayatollah Khamenei apportioning blame on foreign elements for the mass demonstrations is a worrying development. The linking of national unrest with international interference has, in the past, been associated with increased targeting of non-Muslim religious minorities, deemed by the regime to be sympathizers with a Western agenda.”

CSW is concerned that the situation for non-Muslim religious minorities, particularly for Baha’is and certain Christian denominations, which worsened under Ahmadinejad’s previous term of presidency, will continue to deteriorate amidst the current political chaos. As the world’s attention is drawn to the unfolding events in Iran, CSW appeals that the situation for religious minorities is not forgotten.”

CSW is a human rights organization which specializes in religious freedom, works on behalf of those persecuted for their Christian beliefs and promotes religious liberty for all.

Report from the Christian Telegraph

COLOMBIA: FAMILY OF KIDNAPPED PASTOR FLEE HOME

Alarmed by threatening strangers, wife and children of William Reyes leave Maicao.

INDIANAPOLIS, Indiana, June 24 (Compass Direct News) – The wife and children of pastor William Reyes, who was kidnapped last September in Colombia and is still missing, have moved from their home to another city due to threatening strangers presumably linked to his kidnappers.

Compass learned that Idia Miranda Reyes, her son William, 19, and daughters Luz Nelly, 17, and Estefania, 9, suddenly left their home in Maicao in the department (state) of La Guajira two months ago and moved to an undisclosed location in the country.

The Rev. William Reyes disappeared on Sept. 25, 2008, en route to Maicao from the neighboring city of Valledupar. Since March 2008, the pastor of Light and Truth Inter-American Church and active member of the Fraternity of Evangelical Pastors of Maicao, had been receiving extortion threats from illegal armed groups operating in the La Guajira peninsula.

Family members have not heard from Pastor Reyes since, nor have his abductors contacted the family to demand ransom.

Two incidents earlier this year alerted his wife that she and her children were in danger from the kidnappers. On Jan. 15, an unidentified man appeared at the Inter-American Church in Maicao and asked for Idia Miranda Reyes. When he was told she was not there, the man asked for her address and cell phone number, which church workers refused to give him.

Before he left, the man said testily, “It is in [her] best interest to get in touch with me, than for me to have to find her.”

Six days later, Luz Nelly Reyes was approached by a stranger on the street (the family believes it was the same man), who told her that if she wanted to see her father again, she should come with him. The girl declined the invitation. When he attempted to grab her by the arm, Luz Nelly fled.

“I have not reported this to police, because I’m afraid,” her mother told Compass after the incident. “They could do something to me.”

Through sobs she added, “We never conceived of this happening to us. I just wish they would tell us if they have him or not.”

Idia Miranda Reyes waited to leave Maicao until Luz Nelly completed her senior year in high school; the 17-year-old graduated on March 28. According to sources, the Inter-American church is contributing a modest living allowance to the Reyes family.

Reyes is not alone in her fears; Colombia suffers the highest incidence of kidnapping in the Western Hemisphere and a homicide rate 11 times greater than in the United States.

Due to general lawlessness, Colombians often face harassment from the same criminals who kidnap or murder loved ones. Violent crime is so common in the country that half of the felonies are not reported to police, and only one in nine makes the newspapers.

Another Maicao kidnapping in February underscores the problem. Armed men abducted a woman from a church just a few blocks from the Light and Truth church – while worship was in progress. The pastor of that church later refused to disclose the victim’s identity or discuss the circumstances of her disappearance, citing concerns for the safety of his congregation.

Evangelical Christians are not always passive victims of crime, however. Justapaz, a Mennonite Church-affiliated organization based in Bogotá, and The Commission for Restoration, Life and Peace of the Evangelical Council of Churches of Colombia (CEDECOL) have organized an international prayer and action campaign in response to the Reyes family crisis.

The campaign mobilized concerned citizens to petition the office of Attorney General Dr. Mario Iguarán, asking that authorities conduct a thorough investigation into Pastor Reyes’ disappearance and report their findings to Commission Coordinator Ricardo Esquivia and Jenny Neme, director of Justapaz.

“Despite hundreds of letters from church members in the United States, Canada and across Europe, and repeated attempts to get a response from the Colombian Attorney General´s Office, we have yet to receive any information from them regarding progress in the case,” said Michael Joseph, who coordinates the Reyes case on behalf of CEDECOL and Justapaz. “We’re doing our best to make sure Pastor Reyes’ case is not forgotten.”

The Reyes family joins other “internal refugees” who live as exiles in their own country. Unchecked political and social violence have forced innocent victims – many of them widows and children – to abruptly abandon homes and careers. They must take up life in crowded, far-off cities in order to protect themselves and their children from further attack.

According to estimates, Colombia now has 3 million internal refugees, the second largest population of displaced persons in the world after Sudan.

Report from Compass Direct News