LAUSR

Dr. Tedros Adhanom Ghebreyesus has just been announced as the new Director-General of the World Health Organization (WHO). Starting on July 1st, 2017, he will be the first African to head up the UN agency. As an internationally recognized malaria researcher, former Ethiopian minister of health and foreign affairs, and chairman of the board for the Global Fund to Fight AIDS, tuberculosis (TB) and malaria, he has promised to stand up for the rights of the poor and respond rapidly and effectively to disease outbreaks and emergencies. This is an ambitious mandate. According to the Global Burden of Disease 2015 study, published in The Lancet in October 2016, infectious diseases (IDs) account for five of the top 12 causes of disease burden globally, as measured by years of life lost. Lower respiratory infections, diarrheal diseases, HIV/AIDS, malaria and TB together killed N7million individuals. Economically disadvantaged regions of the world bear the brunt of this burden as they are often ill-equipped to implement effective ID management strategies. Many of these countries are also afflicted by neglected tropical diseases (NTDs), accounting for an additional 112,600 deaths and significant morbidity. While the mortality rates of many NTDs have declined over the last decade, mortality from Chagas disease, leishmaniasis and dengue has risen. The re-emergence of Ebola and Zika viral outbreaks and the challenge of antimicrobial resistance have added further pressure to overstrained healthcare systems. Paradoxically, disasters can catalyze advances in control measures, driven by technological innovations and increasing investment from economically-developed countries. This was exemplified by the formulation of a highly protective Ebola vaccine, rVSV-ZEBOV, following the 2013–16West African outbreak. Final results of the cluster-randomized trial were published onDecember 22nd, 2016, demonstrating the expedited vaccine development timeline. Yet, post hocmechanisms to manage emergencies need to be complemented by robust ongoing efforts to combat endemic IDs. As part of the UN's Sustainable Development Goals, progress has been made in distributing preventative chemotherapy to tackle diseases that primarily affect developing countries. Nevertheless, the development of appropriate diagnostic tests—used for surveillance and to guide treatments—is sadly lagging, mainly due to a poorly defined market and little scope for commercial gains. Diagnostic tests are needed at different stages of ID management: early on to map the presence of disease and to interrupt transmission; at later stages to monitor the impact of therapy and to assess the extent of disease elimination; and finally for continued vector surveillance. The WHO has provided a framework for evaluating point-of-care (POC) devices for resource-limited settings using the ASSURED criteria (Affordable, Sensitive, Specific, User-friendly, Rapid and robust, Equipment-free and Deliverable to end users). Technological advances such as miniaturization of computer hardware