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The PLoS Medicine Debate

Which Single Intervention Would Do the Most to Improve the Health of Those Living on Less Than $1 Per Day?

  • Gavin Yamey mail,

    To whom correspondence should be addressed. E-mail: gyamey@plos.org

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  • on Behalf of the Interviewees
  • Published: October 23, 2007
  • DOI: 10.1371/journal.pmed.0040303
  • Published in PLOS Medicine

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"Immune milk farms" in developing countries: a low cost technology platform to combat acute diarrheal illness and associated malnutrition

Posted by plosmedicine on 31 Mar 2009 at 00:17 GMT

Author: Shawn J. Green
Position: Scientist
Institution: Origo Biosciences
E-mail: shawng@origobiosciences.com
Submitted Date: December 10, 2007
Published Date: December 10, 2007
This comment was originally posted as a “Reader Response” on the publication date indicated above. All Reader Responses are now available as comments.

Many of the poorest, sickest, and neediest people in the world live in rural areas of tropical developing countries and most keep ruminant animals, such as, cattle, buffalo, and goats. Ruminant animals are one of the most important assets of the poor in these regions and are the mainstay of their diet. By transforming existing dairy cows into producers of ‘immune milk’ to prevent and treat acute diarrheal illness and associated malnutrition, ruminants may prove to be a low cost technology platform to improve the health of those living on less than a $1 a day.

In many ways similar to Norman Borlaug’s introduction of high-yielding wheat varieties that staved off famine in the late-60s and achieved self-sufficiency in food gains for many developing nations, the localization of regional ‘immune milk farms’ may afford similar relief. It would not be unreasonable to vaccinate, collect, process, and deliver bioactively-rich ‘immune milk’ for several cents a day per individual. Aside from being inexpensive, safe, and nutrient-rich,‘immune milk’ exhibits antimicrobial and immunomodulatory properties that restores gut integrity, absorption, and mucosal immunity.

Diarrheal illness caused by the ingestion of enteric pathogens results in the death of millions annually with many more left critically dehydrated and malnourished. Unfortunately, current chemotherapeutic drugs and prophylactic vaccines can be expensive and logistically difficult to provide in the neediest and poorest regions of Sub-Sahara Africa and other developing nations. Despite good intentions and initial success, long term reliance on donated drugs by large pharmaceutical companies may perpetuate unnecessary dependence with no lasting solution. Safe drugs for young children and pregnant women, as well as, drug resistance remain an on-going concern. And the promise for clean water and affordable, durable vaccines will likely not be part of the near-term solution.

‘Immune milk’ addresses many of the challenges that exist for these new and costly solutions. Passive immunity afforded by ‘immune milk’ in pre-clinical models and clinical studies demonstrated broad spectrum protection against bacterial, viral, and fungal infections in the gut: reduces diarrhea caused by enteropathgenic E.coli in infants, prevents shigellosis after exposures to S. flexneri, reduces Rotavirus burden and shortens the duration of diarrhea frequency, reduces Cryptosporidium and diarrhea in AIDS patients with a stabilization of body weight, and reduces C. difficle burden and associated enterotoxin symptoms.

“Immune milk” may also provide relief in chronic HIV-infected individuals. Initial studies have shown that ingestion of colostrum alone alleviates refractory diarrhea in HIV patients with a corresponding increase in both body weight and peripheral blood CD4+ T cells. As we learn more about the gut microenvironment in HIV-infected individuals, ‘immune milk’ may prove to be a worthwhile approach to neutralize microbial endotoxin translocation in the gut and promote tissue repair and regeneration in the gut mucosa of AIDS patients.

The successful introduction of ‘immune milk’ would not only bridge the gap to the eventual introduction of affordable vaccines and new biologics/drugs that are under consideration, but it would also begin to establish a 'homegrown' infrastructure for building future bio-agricultural strategies to combat acute diarrheal illness and malnutrition in developing countries.

No competing interests declared.