Nebulized medication is used to treat a number of major respiratory diseases including asthma, chronic obstructive pulmonary disease, tuberculosis and lower respiratory tract infections — all of which disproportionately affect the poor.
World Mortality Rates, WHO 2002
Several of the drugs used to treat these conditions are inexpensive; the limiting factor in delivering them to those who need them has always been nebulizer access — until now.
COPD and Asthma: Nebulizers are the gold-standard treatment for deadly and debilitating respiratory diseases including asthma and chronic obstructive pulmonary disease (COPD). COPD currently ranks as the fifth leading killer in the world, just behind annual mortality from HIV/AIDS. Every year, three million people die from COPD—90% of these deaths occur in the developing world. Since one cause of COPD is cooking over wood fires, COPD disproportionately affects women. Another 180,000 people die annually from asthma, with the incidence of both asthma and COPD on the rise. The simplest treatment for COPD and asthma is to inhale a nebulized bronchodilator like albuterol during episodes of breathing difficulty. Access to nebulized bronchodilators would greatly reduce the number of deaths as well as the many burdens of these chronic conditions. Yet the cost of electric nebulizers and their need for electricity makes this approach almost impossible in the contexts where women still cook over wood stoves.
The HPN promises to provide a solution to this problem by making nebulized bronchodilators available to the world’s poorest communities. Our second clinical trial, conducted in summer 2012 in El Salvador, demonstrated that the HPN is as effective as electric nebulizers in treating asthma. The study confirms that the HPN is effective in treating reactive airway diseases.
Tuberculosis: Tuberculosis (TB) remains a challenge to global public health. It is a major cause of mortality and has proved particularly difficult to control in regions with high HIV prevalence. An estimated 1.3 million deaths occur annually among HIV-non-infected individuals and a further 0.5 million TB deaths occur among HIV-infected people. One key strategy for reducing these numbers is intensified TB diagnosis via more aggressive TB screening. This is done by sputum induction via nebulization and subsequent culture tests. Yet the cost of electric nebulizers and their need for electricity makes this approach almost impossible precisely in the contexts where it’s needed.
The HPN provides a solution to this problem by making nebulized sputum induction available to the world’s poorest communities. Our first clinical trial during summer 2010 compared the HPN to electric nebulizers for TB screening via sputum induction in South Africa. In partnership with the Desmond Tutu HIV Centre in Cape Town, we compared the quality of sputum obtained by nebulized hyptertonic saline, and demonstrated that the HPN was equivalent to an electric nebulizer on this important diagnostic measure. The results of this trial are available here.
Vaccine Delivery: The World Health Organization estimates that almost 2 million childhood deaths could be prevented each year using already existing vaccines. Recent studies suggest that nebulized vaccination may provide a new way to increase vaccine coverage. Certain aerosolized vaccinations have been shown to be equally or more effective for a number of diseases including measles, mumps, rubella and possible pneumonia. Nebulized vaccines also reduce the need for needles, which may transmit diseases if not used correctly. Yet the cost of electric nebulizers and their need for electricity again reduces the feasibility of this approach precisely in the contexts where it’s needed.
The HPN may provide a solution to this problem by making nebulized vaccines available to the world’s poorest communities.
Lower Respiratory Infection: Lower respiratory infections (LRIs) are the leading cause of death in low income countries, killing almost 3 million people per year. Recent studies suggest that nebulized hypertonic saline (salt water) might be effective in preventing and treating LRIs, especially in children. In the long term, we hope to treat lower respiratory infections with the HPN.