What to do if you develop Coronavirus (Covid-19) Symptoms

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If you or your neighbour/relative has cough, fever, throat pain or running nose, please do the following things frequently & regularly. Even if you don’t have those symptoms, you can follow these for prevention:

  1. Worm water with salt gargle several times a day
  2. Hot steam/vapour inhalation through nose & mouth at least 2-3 times daily
  3. Drink hot water with lemon several times daily
  4. Take ginger tea more (green tea better)
  5. Take more orange & malta daily
  6. Take some black seeds (kali jira) 2-3 times daily
  7. Take rice or bread as less as possible, avoid meat, take well-cooked fish, egg & chicken (occasional), drink milk (skimmed or fat-free)
  8. Take any type of fruits more (after washing thoroughly). Preferable fruits: orange, banana (diabetics should take less), pomegranate (anar), apple, kiwi etc,
  9. Eat all sorts of well-cooked or boiled vegetables. Preferable vegetables: tomatoes, carrots, capsicum, cauliflower, broccoli, cabbage, spinach, beans, lentils, legumes etc.
  10. For fever & pain, take Paracetamol tablet only (after food). For running nose or nose-block, take antihistamine only (ceitrizine/loratidine). For dry cough, take natural cough syrup or antitussive syrup only. For productive cough with sputum, take spectorant/mucolytic syrup only. (for appropriate drug & dose, better to consult with a registered doctor), and finally
  11. If you develop any sort of breathing difficulty/respiratory distress with the above symptoms, please immediately call the local control centre of health or call an ambulance to take you to any of the designated/assigned hospitals. Please don’t delay in case of breathing difficulty with fever & cough.

Thank you all….Stay home, stay safe & stay healthy……May Almighty protect all of us.

Writer:  Dr Mohammad Dewan, Ministry of Health, Saudi Arabia (Madinah Munawara)

COVID-19 Vaccine

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(Compiled by Dr. Md. Mozammel Hoq)

As the new coronavirus continues to spread, people around the world are anxious to know when we might have a vaccine to stop it.

What Would a COVID-19 Vaccine Do?

When you come into contact with a virus or bacteria, your body’s immune system makes antibodies to fight them off.

A vaccine forces your immune system to make antibodies against a specific disease, usually with a dead or weakened form of the germs. Then, if you come into contact with them again, your immune system knows what to do. The vaccine gives you immunity, so you don’t get sick or so your illness is much milder than it otherwise would have been.

A vaccine against COVID-19 would slow its spread around the world. Fewer people would get sick, and more lives could be saved.

How Are Vaccines Developed?

So how long could a COVID-19 vaccine take? Dozens of possible vaccines are in various stages of development around the world, according to the World Health Organization. Some have begun clinical trials. But certain things can’t be rushed, like how long it takes a person’s immune system to respond to a vaccine or the wait to check for side effects.

Even when researchers find a vaccine that works against the new coronavirus, it could be 12 to 18 months at best before it’s ready for the public. That’s only a fraction of the usual time.

Before any vaccine can be used widely, it must go through development and testing to make sure that it’s effective against the virus or bacteria and that it doesn’t cause other problems. The stages of development generally follow this timeline:

  • Exploratory stage. This is the start of lab research to find something that can treat or prevent a disease. It often lasts 2 to 4 years.
  • Pre-clinical stage. Scientists use lab tests and testing in animals, such as mice or monkeys, to learn whether a vaccine might work. This stage usually lasts 1 to 2 years. Many potential vaccines don’t make it past this point. But if the tests are successful and the FDA signs off, it’s on to clinical testing.
  • Clinical development. This is a three-phase process of testing in humans. Phase I usually lasts 1 to 2 years and involves fewer than 100 people. Phase II takes at least 2 years and includes several hundred people. Phase III lasts 3 or 4 years and involves thousands of people. Overall, the clinical trial process may stretch to 15 years or more. About a third of vaccines make it from phase I to final approval.
  • Regulatory review and approval. Scientists with the FDA and CDC go over the data from the clinical trials and sign off.
  • Manufacturing. The vaccine goes into production. The FDA inspects the factory and approves drug labels.
  • Quality control. Scientists and government agencies keep tabs on the drug-making process and on people who get the vaccine. They want to make sure it keeps working safely.

This version of the coronavirus only surfaced in late 2019, but scientists have gotten a boost from research on similar coronaviruses that cause severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS). Efforts to fight those diseases played a large role in the record speed of the first COVID-19 vaccine trial that’s now underway.

Some of the companies working on vaccines are also looking for ways to ramp up production quickly when the clinical trials find one that works safely. With more than 300 million people in the United States alone, mass vaccination will be a joint effort among several companies and government agencies.

Experts say the coronavirus could turn out to be seasonal, like colds and the flu. A vaccine might not be ready until after the current pandemic is over, but it may be vital if the cycle begins again.

(WebMD Medical Reference Reviewed on April 03, 2020)

করোনাভাইরাস সংক্রমণ ও প্রতিরোধ

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গত বছরের শেষভাগে চীনের হুবেই প্রদেশের ঊহান শহরে যে ভাইরাস-সংক্রমণ শুরু হয়েছিল, ক্রমে তা দেশ-মহাদেশ পেরিয়ে আজ সারা বিশ্বের ত্রাসে পরিণত হয়েছে। করোনাভাইরাস সংক্রমণ এর বিস্তার ঘটেছে অন্ততঃ ২০০টি দেশে, আক্রান্ত হয়েছে ১০

লক্ষাধিক মানবসন্তান, আর মাত্র কয়েক মাসে মৃত্যু হয়েছে ৪৬ সহস্রাধিক; এদের মধ্যে ৩ সহস্রাধিক চীনা, ৩০ সহস্রাধিক ইওরোপীয় আর প্রায় ৬ সহস্র আমেরিকান। এ এক অদৃশ্য শত্রু যা নিয়ন্ত্রনে একরকম ব্যর্থ হয়েছে যুক্তরাষ্ট্র ছাড়াও ইওরোপের প্রধান শিল্পোন্নত দেশগুলি।

হাম, জল-বসন্ত, হার্পেস, পোলিও, ফ্লু, হেপাটাইটিস এসব ভাইরাস-জনিত রোগের কথা আমরা কম-বেশি জানি; তবে কোভিড-১৯ রোগ এর মহামারীর কারণে করোনাভাইরাস এখন সবার জানা এক আতঙকের নাম। করোনা অর্থ মুকুট; ইলেকট্রন মাইক্রোস্কোপে এই ভাইরাসকে আমিষ-এর মুকুট-বলয় পরিবেষ্টিত দেখা যায়। করোনাভাইরাস পরিবারের অপর সদস্য সার্স (SARS) ভাইরাস ২০০৩ সালে ২৬ টি দেশে মারাত্মক নিউমোনিয়ার বিস্তার ঘটিয়েছিল; তবে কোভিড-১৯-এর তুলনায় তা ছিল কিছুটা নিয়ন্ত্রনযোগ্য।

অনেকের ধারণায় ভাইরাস অতি ছোট জীব; এ ধারণা ভ্রান্ত। ভাইরাসের কোন দেহ-কোষ বা প্রাণ না থাকলেও আছে আমিষ-বেষ্টিত প্রাণ-সঞ্চালক অনু ডিএনএ অথবা আরএনএ। এরা নিজেরা বংশবিস্তার করেনা, কিন্তু প্রাণী, উদ্ভিদ কিংবা ব্যাকটেরিয়ার কোষের নিউক্লিয়াসে ঢুকে, আশ্রয়দাতার জেনেটিক সরঞ্জামের সাথে সংযোজিত হয়ে ক্রমাগত বিভাজিত হতে পারে। একইভাবে অন্যান্য কোষকে আক্রমণ করে এরা পরজীবী ধবংসযজ্ঞ চালিয়ে যায়।

জীবাণু (microbe) না হলেও আচরণে মিল থাকায় এরা মাইক্রোবায়োলোজীতে অন্তর্ভুক্ত; আর রোগ সংক্রমণ-তত্ত্বও একইভাবে প্রযোজ্য। আন্তর্জাতিকভাবে ব্যবহৃত <Biohazard বা জৈব-বিপর্যয়>- চিহ্নটির সাথে যারা পরিচিত তারা জানেন- এতে পরস্পর-সম্পর্কিত চারটি বৃত্ত আছে; প্রথম তিনটি আশ্রয়দাতা (Host), রোগসূত্র (Agent) ও পরিবেশ (Environment), আর কেন্দ্রে অবস্থিত চতুর্থ বৃত্তটি সংক্রমণ (Infection) নির্দেশ করে। বলাবাহুল্য, আশ্রয়দাতার রোগ প্রতিরোধ ক্ষমতা ও  রোগসূত্রের রোগসৃষ্টি ক্ষমতার মধ্যে শক্তি পরীক্ষায় পরিবেশ বিশেষ ভূমিকা পালন করে।

আশ্রয়দাতা, যেমন মানুষ বা পশু-পাখির দেহে বিভিন্ন ধরনের জীবাণু থাকে যারা উপকারী কিংবা নিরপেক্ষ, সুস্থ প্রাণী স্বাভাবিক প্রতিরোধ ক্ষমতাবলে সহজে আক্রান্ত হয় না। কিন্তু রোগসৃষ্টিকারী জীবাণু আশ্রয়দাতার রোগ প্রতিরোধ ক্ষমতাকে পরাস্ত করে তাকে আক্রান্ত করতে পারে। বার্ধক্য কিংবা দীর্ঘমেয়াদী রোগ, অপুষ্টি, নেশা/মাদকাসক্তি, অ্যান্টিবায়োটিক, স্টেরয়েড, অ্যান্টিক্যান্সার- জাতীয় ওষুধ  ইত্যাদি আশ্রয়দাতার রোগ প্রতিরোধ ক্ষমতা কমায়। আবার দূর্বল হলেও রোগসূত্রের সংখ্যাধিক্য শক্তি অর্জনে সহায়ক হতে পারে। ক্ষতি ও ক্ষত বিবেচনায় তা রোগ লক্ষণ বা উপসর্গ সৃষ্টি করতে পারে, আবার আশ্রয়দাতাকে উপসর্গহীন বাহক (Carrier)-এ পরিণত করতে পারে। বাহকেরা নিজের অজান্তেই রোগ ছড়াতে পারেন। কোভিড-১৯ রোগ নিয়ন্ত্রিত হলেও অতি সম্প্রতি চীনে সহস্রাধিক উপসর্গহীন বাহক সনাক্ত হয়েছে যা দুশ্চিন্তার বিষয় বটে।

কোভিড-১৯ রোগ লক্ষণ বা উপসর্গ হতে পারে শুকনো কাশি, জ্বর, শীতবোধ, শ্বাসকষ্ট, এছাড়া শরীর-ব্যথা, গলাব্যথা, মাথাব্যথা ইত্যাদি, সাথে স্বাদ ও ঘ্রাণশক্তি লোপ কিংবা পেটের পীড়াও যোগ হতে পারে। ফ্লু বা ঠান্ডা-জ্বরের সাথে উপসর্গে মিল থাকলেও সাধারণতঃ সর্দি বা বদ্ধ নাসাপথ থাকেনা। কিন্তু এসব উপসর্গ রোগভিত্তিক না হওয়ায় পরীক্ষা-নিরীক্ষা ছাড়া শ্বাসতন্ত্রের এ রোগ নিরূপণ করা কঠিন। তাই উপসর্গ দেখা গেলে অবজ্ঞা না করে সতর্কতার সাথে কর্তব্য স্থির করতে হবে।

কোভিড-১৯ রোগের সুনিশ্চিত চিকিৎসা এখনো অজানা; এর প্রতিষেধক টীকাও আবিস্কৃত হয়নি। অত্যাধুনিক বিশেষায়িত হাসপাতালেই শুধু রোগ জটিলতার চিকিৎসা সম্ভব। কিন্তু স্বাস্থ্য সেবাদানকারী সঙ্কট ও অপ্রতুল ভেন্টিলেটর যন্ত্রের কারণে শিল্পোন্নত দেশেও এ রোগে মৃত্যুহার অনেক বেশী। অতএব প্রতিরোধই সর্বোৎকৃষ্ট উপায়। আর সেকারণেই প্রত্যেকে দায়িত্ব-সচেতন হয়ে, বিশ্ব স্বাস্থ্য সংস্থার নির্দেশাবলী ও নিজ নিজ দেশের (বা রাজ্যের) সরকারী বিধান মেনে চলাই বাঞ্ছনীয়।

জৈব-বিপর্যয়-চিহ্ন বা সংক্রমণ-তত্ত্ব অনুসরণ করে আমরা সহজেই বুঝতে পারি- করোনাভাইরাস এক শক্তিধর অদৃশ্য শত্রু; এ থেকে রক্ষা পেতে মাস্ক ও অন্যান্য পিপিই ব্যবহার করে এবং বাড়িতে থেকে, পরিচ্ছন্নতা রক্ষা করে, নিয়মিত সাবান দিয়ে হাত ধুয়ে, স্যানিটাইজার/ব্লীচ ব্যবহার করে, সামাজিক দূরত্ব বজায় রেখে আমরা আক্রান্ত ব্যক্তি ও বাহকের সান্নিধ্য এড়াতে পারি। সুস্থতা রক্ষায় আমাদের পুষ্টিকর খাবার গ্রহণ, পর্যাপ্ত জলপান, বিশ্রাম আর হালকা ব্যায়াম করাও প্রয়োজন। স্বাস্থ্য সেবাদানকারী ব্যক্তি যেমন চিকিৎসক, নার্স, ল্যাব স্টাফ এছাড়া যারা বয়স্ক, স্বাস্থ্য-ঝুঁকিতে আছেন, সংক্রমণ প্রতিরোধে তাদের আরো বেশী সতর্ক থাকতে হবে।

মোহাম্মদ আশরাফ হোসেন
ফ্লোরিডা, ইউএসএ
শিক্ষাঃ এমবিবিএস- বিএসএমএমইউ, ঢাকা; পিএইচডি (মেডিক্যাল মাইক্রোবায়োলোজী) ও স্নাতকোত্তর গবেষণা- নাগাসাকি
ইউনিভার্সিটি, জাপান;
ফেলোশিপ- কেস ওয়েস্টার্ণ রিযার্ভ ইউনিভার্সিটি, ক্লীভল্যান্ড ও ইউএস এফডিএ, সিল্ভার স্প্রিং (যুক্তরাষ্ট্র);
কর্ম অভিজ্ঞতা- স্বাস্থ্যসেবা, মেডিক্যাল প্রোডাক্টস ডেভেলপমেন্ট গবেষণা ও প্রকাশণা, গবেষণা প্রশাসন, রেগুলেটরী রিভিউ, মেডিক্যাল বেসিক সায়েন্স-এ শিক্ষকতা।
বর্তমান অবস্থান- নিউ ইয়র্কে অবস্থিত বহুজাতিক মেডিক্যাল ডিভাইস কোম্পানীতে রেগুলেটরী সায়েন্স প্রফেশনাল হিসাবে কর্মরত।

Combat Coronavirus (Covid-19) Pandemic

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Know Covid-19 (Novel Coronavirus) through question and answers and be safe.

Q.  What Is COVID-19?

Coronavirus disease 2019, or COVID-19, is a disease that can cause what doctors call a respiratory tract infection. It can affect your upper respiratory tract (sinuses, nose, and throat) or lower respiratory tract (windpipe and lungs).
The COVID-19 outbreak quickly spread around the world. It spreads the same way other coronaviruses do, mainly through person-to-person contact. Infections range from mild to serious.
COVID-19 is one of seven types of coronavirus, including the ones that cause severe diseases like Middle East Respiratory Syndrome (MERS) and Sudden Acute Respiratory Syndrome (SARS). The other coronaviruses cause most of the colds that affect us during the year but aren’t a serious threat for otherwise healthy people.

Q.  What Are the Symptoms of COVID-19?

Early symptoms include:

> Fever
> Dry Cough
> Fatigue
The virus can lead to pneumonia, respiratory failure, septic shock, and death. If you notice these severe symptoms in yourself or a loved one, get medical attention right away:
> Trouble breathing or shortness of breath
> Ongoing chest pain or pressure
> New confusion
> Can’t wake up
> Bluish lips or face
If you’re exposed and infected, symptoms can show up in as few as 2 days or as many as 14. It varies from person to person
The most common symptoms and the percentage of people who have them include:
> Fever: 88%
> Dry cough: 68%
> Fatigue: 38%
> Coughing up sputum, or thick phlegm, from the lungs: 33%
> Shortness of breath: 19%
> Bone or joint pain: 15%
> Sore throat: 14%
> Headache: 14%
> Chills: 11%
> Nausea or vomiting: 5%
> Stuffy nose: 5%
> Diarrhea: 4%
> Coughing up blood: 1%
> Swollen eyes: 1%

Q.  How Do You Know if It’s COVID-19, a Cold, or the Flu?

When you have symptoms, they can be similar to a bad cold or the flu. Your doctor will suspect COVID-19 if:
> You have a fever and breathing problems and you’ve travelled to places where the virus has spread.
> You’ve been exposed to people who have it within the last 14 days.

Q.  Testing for COVID-19

Call your doctor or IEDCR (through hotlines) if you think you’ve been exposed and have symptoms like:
> Fever of 100 F or higher
> Cough
> Trouble breathing
In most states, decisions about who gets tested are made at the IEDCR or your doctor of the hospital you visit.
The test looks for evidence of the virus in your upper respiratory tract. The person giving the test puts a swab up your nose to get a sample from the back of your nose and throat. That sample goes to a lab that looks for viral material or the presence of antibody in the serum against COVID-19.

Q.  What Is the Treatment for COVID-19?

There’s no specific treatment for COVID-19. People who get a mild case need the care to ease their symptoms, like rest, fluids, and fever control. You can take medicine for a sore throat, body aches, and fever upon advice by a physician. But don’t give aspirin to children or teens younger than 19. You might have heard that you shouldn’t take ibuprofen to treat COVID-19 symptoms — the
WHO made that statement in March 2020. But they reversed it soon after and said there’s no proof that taking it causes any harm.
Antibiotics won’t help because they treat bacteria, not viruses. If you hear about people with COVID-19 getting antibiotics, it’s for an infection that came along with the disease.
Those with severe symptoms need to be cared for in the hospital.
Numerous clinical trials are underway to explore treatments used for other conditions that could fight COVID-19 and to develop new ones. Several studies are focused on an antiviral medication called remdesivir, which was first created to fight Ebola. A study in China showed that hydroxychloroquine and chloroquine, which are used to treat malaria and autoimmune conditions like rheumatoid arthritis and lupus, helped people with COVID-19 pneumonia.

Q.  Is There a Vaccine?

Not yet, but clinical trials are underway in the U.S. and in China to test vaccines for SARS-CoV-2/COVID-19.
One vaccine called mRNA-1273 (which was developed by using messenger RNA) would tell your cells to pump out a protein that will kick-start your immune system to fight the virus. It’s worked well in animals and is ready to test in humans.

Q.  What Is Community Spread?

IEDCR, Doctors and health officials use this term when they don’t know the source of the infection. With COVID-19, it usually refers to someone who gets the virus even though they haven’t been out of the country or haven’t been exposed to someone who’s travelled abroad or who has COVID-19.

Q.  How Do You Prevent the Spread?

If you’re in an area where it’s spreading, take these steps:
> Wash your hands often with soap and water or clean them with an alcohol-based sanitizer. This kills viruses on your hands.
> Practice social distancing. Because you can have and spread the virus without knowing it, you should stay at home as much as possible. If you do have to go out, stay at least 6 feet away from others.
> Don’t touch your face. Coronaviruses can live on surfaces you touch for several hours. If they get on your hands and you touch your eyes, nose, or mouth, they can get into your body.
> Clean and disinfect. You can clean first with soap and water, but disinfect surfaces you touch often, like tables, doorknobs, light switches, toilets, faucets, and sinks. Use a mix of household bleach and water (1/3 cup bleach per gallon of water, or 4 teaspoons bleach per quart of water) or a household cleaner that’s approved to treat SARS-CoV-

Q.  What Caused the New Coronavirus?

Doctors aren’t sure. Coronaviruses can affect different species of animals, in addition to people. MERS and SARS were both linked to animals. Studies show COVID-10 has ties to snakes, bats, and pangolins. Many people who got the disease early on were linked to a large live seafood and animal market in China — you might hear it called a “wet market.” The first cases may have come from animals sold in the market, then spread from person to person.

Q.  How Does the New Coronavirus Spread?

SARS-CoV-2, the virus, mainly spreads from person to person.
Most of the time, it spreads when a sick person coughs or sneezes. They can spray droplets as far as 6 feet away. If you breathe them in or swallow them, the virus can get into your body. Some people who have the virus don’t have symptoms, but they can still spread the virus.
You can also get the virus from touching a surface or object the virus is on, then touching your mouth, nose, or possibly your eyes. Most viruses can live for several hours on a surface that they land on. A study shows that the COVID-19 coronavirus can last for several hours on various types of surfaces:
> Copper: 4 hours
> Cardboard up to 24 hours
> Plastic or stainless steel: 2 to 3 days
That’s why it’s important to disinfect surfaces to get rid of the virus.

Q.  Is There More Than One Strain of SARS-CoV-2?

It’s normal for a virus to change, or mutate, as it infects people. A Chinese study of 103 COVID-19 cases suggests the virus that causes it has done just that. They found two strains, which they named L and S. The S type is older, but the L type was more common in the early stages of the outbreak. They think one may cause more cases of the disease than the other, but they’re still working on what it all means.

Q.  Are Coronaviruses New?

Coronaviruses were first identified in the 1960s, but we don’t know where they come from.
Almost everyone gets a coronavirus infection at least once in their life, most likely as a young child. In our country Bangladesh, throughout the year especially during seasons change, typical flue attack many people but treatment and recording are not maintained. In the United States, regular coronaviruses are more common in the fall and winter, but anyone can come down with a coronavirus infection at any time.
The symptoms of most coronaviruses are similar to any other upper respiratory infection, including a runny nose, coughing, sore throat, and sometimes a fever. In most cases, you won’t know whether you have a coronavirus or a different cold-causing virus, such as rhinovirus. You treat this kind of coronavirus infection the same way you treat a cold.

Q.  Have There Been Other Serious Outbreaks?

Yes, coronaviruses have led to two serious outbreaks:
Middle East Respiratory Syndrome (MERS): About 858 people have died from MERS, which first appeared in Saudi Arabia and then in other countries in the Middle East, Africa, Asia, and Europe. In April 2014, the first American was hospitalized for MERS in Indiana, and another case was reported in Florida. Both had just returned from Saudi Arabia. In May 2015, there was an outbreak of MERS in South Korea, which was the largest outbreak outside of the Arabian Peninsula.
Severe acute respiratory syndrome ( SARS ): In 2003, 774 people died from an outbreak. As of 2015, there were no further reports of cases of SARS.

For any query:
General Secretary, CARES
Dr, Md. Mozammel Hoq, Professor (Retired)
Department of Microbiology, University of Dhaka

mhoq@du.ac.bd

Channel 24 interview of Dr Ruhul Abid, MD, Principal Investigator, Global Health Initiative

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Channel 24 interview of Dr Ruhul Abid, MD, Principal Investigator, Global Health Initiative and Assistant Professor in the Division of Cardiothoracic Surgery and Cardiovascular Research Center at Rhode Island Hospital and Brown University Alpert Medical School, USA regarding Coronavirus pandemic situation in the USA.

Fruit Crops

Diagnosis and management of nutrient constraints in mango

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Mango (Mangifera indica L.) is an evergreen tree fo the family Anacardiaceae, grown extensively for its edible fruit. Mango trees grow to 35-40m tall, with a crown radius of 10-15m. The trees are long lived, as some specimens still fruit after 300 years… READ MORE

Author and Co-Authors

Dr R.A. Ram (India), Dr M.A. Rahim (Bangladesh), Dr M.S. Alam (Bangladesh)

 

Affordable Biosimilar Medicine: A low-hanging fruit ready for picking

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Prof Ahmed A Azad, PhD

The pharmaceutical sector in Bangladesh has huge potential and opportunities for producing affordable modern medicines for the ordinary citizens as well as the developing world. The vibrant pharmaceutical industry produces 98 percent of all medicines used domestically, and exports high-quality drugs to about 130 countries. Almost all medicines made locally are generic (exact copies of the original drugs) produced by repackaging (“fill-finishing”) of imported active chemical ingredients (ACI). At a recent seminar organised by the Dhaka Chamber of Commerce and Industry (DCCI), it was claimed that local production of ACI could substantially decrease the production cost of generic medicines and increase export earnings from the current USD 130 million to over USD 1 billion within five years (The Daily Star, November 3, 2019). The pharmaceutical industry and university researchers have till now failed to join forces to develop generic API in Bangladesh, even though the required expertise and technologies are available.

To move with the times, and for long-term viability, the local pharmaceutical industry needs to think beyond generic medicines. In the last two decades, largely as a consequence of lifestyle, climate and environmental changes, non-communicable diseases (NCDs) and chronic ailments (such as diabetes, hypertension, asthma and various cancers) have rapidly proliferated in both developed and developing countries. Chemically synthesised small-molecule drugs, and their generic copies, have not proved to be sufficiently effective against these NCDs and chronic diseases.

Attention has largely shifted to a new class of drugs, Biologics, which are genetically-engineered versions of naturally occurring bioactive proteins and peptides present in the human body. Cheaper copies of Biologics, which retain their biological and therapeutic properties, are known as “Biosimilars” as they are structurally similar but not identical to the originator Biologics. Biologics and Biosimilars are produced by recombinant DNA technology where microscopic bacteria, fungi or mammalian cells are converted into living factories for the large-scale production of rare and high-value foreign proteins.

In more recent times, a new class of Biologics has entered the market and it constitutes the bulk of novel drugs in the pipeline of major multinational drug companies. In these new Biologics, proteins or peptides of medical importance are linked to, and resemble, human monoclonal antibody (mAb) molecules. These new mAb Biologics are unusually potent in treating and managing previously untreatable forms of NCDs and chronic diseases. These new wonder drugs are extremely expensive, costing in excess of USD 50,000 per person every year, and clearly out of reach for the common man. There is, therefore, huge demand for cheaper mAb Biosimilars. Producing these in developed countries is not effective in making them more affordable to the citizens of poorer countries.

This has created a great opportunity for any developing country, with reasonable technological proficiency and low labour and production costs, to step in to produce the new class of Biosimilars. The global market for Biosimilars, and particularly the mAb Biosimilars, was USD 2 billion in 2013, and has now surpassed USD 30 billion, and is projected to reach up to USD 0.5 trillion in 2026. Even if Bangladesh could capture 5 percent of the global market for Biosimilars, it could amount to USD 50 billion and its export could become the largest, and most stable, foreign exchange earner for the country. Compared to generic medicines, the development of the new Biosimilars, particularly the mAb Biosimilars, is technologically and conceptually complex. Because they are biologically produced, Biosimilars are not exact copies of the original Biologics, and as such they are subjected to very extensive and costly regulatory procedures to ascertain safety and effectiveness, resulting in increased production costs.

The overriding rationale for undertaking this ambitious project would be to develop affordable mAb Biosimilars for the common man in Bangladesh and the developing world. This could be possible if these wonder drugs were locally produced from scratch, including the development of the molecular seed clones. This would also provide a mechanism for competing with—and keeping ahead of—potential rivals like Korea, China, India and Brazil by making use of the WTO’s exemption of Bangladesh from patent restrictions till 2033. While all developed and developing countries have to wait till patent expiry to copy a novel Biologic into its cheaper Biosimilar, Bangladesh is legally free to copy any new Biologic, irrespective of its patent status, thus gaining valuable time over potential rivals in developing, selling and exporting new Biosimilars. It would be a pity if the pharmaceutical sector in Bangladesh failed to make the best use of this competitive advantage.

Does Bangladesh possess the competencies required for developing and commercialising new Biosimilars from scratch? At least one local company has invested heavily in establishing world-class large-scale fermentation and downstream processing facilities (under GMP conditions) to produce recombinant protein APIs of a number of first-generation Biosimilars (such as Insulin and Erythropoietin) from molecular clones obtained from overseas sources. Some other local companies are also developing similar facilities which would be available for the production of new recombinant Biosimilars. The local pharmaceutical industry also has extensive experience in manufacturing and marketing of high-quality generic medicines, and their export to developing countries. This could ease the way for entry of Bangladeshi-made Biosimilars into established overseas markets.

The only missing competency is in upstream technologies needed for the development of molecular clones of targeted Biosimilars. This involves intricate design and construction of genetic vehicles for biological production of Biosimilar proteins. It could be the most complex biotechnology project undertaken in Bangladesh thus far, but fortunately, trained human resources with the required advanced molecular and cell biology skills are already present in Bangladesh and within the NRB scientific community. The immediate requirement, to get the ball rolling, is for some start-up funds and access to a semi-automatic clone selector to complete the proof of concept studies needed to demonstrate that it is, indeed, possible to develop the seed molecular clones in Bangladesh.

This ambitious project would work best as a tripartite partnership between the research community, the industry and government. While productive collaboration between academic researchers and the industry should be the biggest strength of the pharmaceutical sector, in reality, lack of substantive university-industry links remains one of its major weaknesses. To encourage academia-industry collaborations, researchers could be offered a share of profits from the sale of products they help develop, and the industry could be granted tax concessions for supporting R&D. Government agencies could play important enabling roles. The Directorate General of Drug Administration could streamline and simplify guidelines to speed up the regulatory process, and the Bangladesh Medical Research Council could establish Contract Research Organisations (CROs) to support and expedite preclinical animal studies and human clinical trials.

Bangladesh has the technical capability to produce the latest Biosimilar medicines. Can a nation that aspires to become an advanced nation by 2041 afford not to take advantage of this opportunity to use home-grown technology and local talent for producing the latest and most effective high-tech medicines at an affordable price for its own citizens and those in developing countries, and in the process also create wealth for the nation? This would also be an opportunity for early investors to stake a claim for big rewards in the future. Political will, self-belief and a need for all stakeholders to work together are critical for the successful production of the latest Biosimilars in Bangladesh.

Prof Ahmed A Azad, PhD, is a retired academic and biomedical researcher. After retirement, he has been working with resident and NRB scientists to help develop molecular biosciences research capacity in Bangladesh. Email: aaazad1945@gmail.com

Source: https://www.thedailystar.net/opinion/perspective/news/low-hanging-fruit-ready-picking-1846837

Photo source:  POWERUP/SHUTTERSTOCK.COM