The Meningitis Vaccine Project, a so-called product development partnership, developed a new vaccine against bacterial meningitis, an inflammation of brain tissues that causes an estimated 10,000 deaths among African children and young people each year. The vaccine--known as MenAfriVac and specifically targeted for use in low-income countries in Africa--was designed to be made available to governments at a price of fifty cents per dose. The Meningitis Vaccine Project is an example of how product development partnerships have reinvigorated research on vaccines for neglected diseases. These partnerships disperse the multiple tasks of product development across a network of partners that are best suited for each task. The vaccine was rapidly embraced by African health officials, and in its first few weeks on the market, in late 2010, more than nineteen million people in Burkina Faso, Mali, and Niger were vaccinated.
Telemedicine has significant potential to extend nephrology consultation to rural and isolated communities. We describe a telenephrology clinic which has delivered ongoing consultative care from a nephrologist based at the National Institutes of Health in Bethesda Maryland to the Zuni Comprehensive Health Center in western New Mexico. Over the past nine years the clinic has conducted 1870 patient visits managing patients using a collaborative approach engaging a nurse case manager, nephrologist, primary clinicians, pharmacists, and community health nurses. A significant proportion of the care provided is directed towards patients with advanced kidney disease (eGFR< 30ml/min/1.73m2). While there are unique aspects to the Indian Health Service and to the Zuni community which is served by this clinic, it does serve as a demonstration that nephrologic consultative care can be delivered effectively and efficiently to rural high risk communities using a collaborative and integrated model of care.
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