In this Atlantic opinion piece, Amanda Glassman, director of Global Health Policy at the Center for Global Development (CGD), reports on how “lengthy, inefficient review processes” or “non-existent regulatory capacity” in some developing countries for drug and vaccine candidates waiting in the pipeline is keeping new medicines, vaccines, and diagnostic techniques from reaching millions in need. Glassman highlights a number of trials that were delayed due to regulatory and ethical approval processes, writing, “Not only do these delays prevent access to effective treatments by a growing number of patients,” but “they can lead to unnecessary costs that eat away at already small budgets to find new cures for neglected diseases.”
Access to Health Services
PlusNews examines Swaziland’s national shortages of antiretroviral (ARV) stocks, HIV tests, and lab tests necessary to initiate and manage HIV patients on treatment, and the country’s efforts to find funding to prevent stock-outs of these supplies. “Despite several bail-outs this year by international donors, neighboring countries and international NGOs, Swaziland remains in the grips of a months-long shortage of lab reagents needed for CD4 count testing, which measures the immune system’s strength and is needed to start patients on ARVs, as well as toxicity testing important in monitoring patients’ responses to treatment,” the news service writes, noting that funding received in April from PEPFAR will help supply first-line ARVs through April 2012 (11/15). According to BBC News, about 65,000 of the country’s 230,000 people living with HIV relies on state hospitals for ARVs (Simelane, 11/15).
South African Public Health Experts Urge Countries To Use TRIPS To Produce Generic Drugs, IPS Reports
South African public health experts from Medecins San Frontieres (MSF) South Africa and the Treatment Action Campaign (TAC) “are calling on governments to use legally available mechanisms to promote the production or import of generic drugs in their countries,” Inter Press Service reports. The article examines how countries can alter their patent acts under the Doha Declaration — a World Trade Organization declaration on the Agreement on Trade-related Aspects of Intellectual Property Rights (TRIPS) and Public Health that “exists to ensure that patents do not undermine the ability of countries to achieve the right to health” — “to access generic versions of otherwise patented medicines in cases where prices are prohibitively expensive, the organizations say.”
In this Huffington Post opinion piece, Nancy Birdsall, president of the Center for Global Development, reports on a World Bank- and USAID-sponsored debate she moderated last week as part of a series on HIV/AIDS issues, the topic of which was “Countries should spend a majority of what is likely to be a flat or even declining HIV prevention budget on ‘treatment as prevention.'” She notes several of her reactions to the debate and asks with regard to global health spending, “What about the pie? Even if it grows, there will be tradeoffs.”
The vision of an “AIDS-free generation” presented in a speech earlier this month by Secretary of State Hillary Rodham Clinton “is under threat in Congress,” as “[t]he House and the Senate are discussing significant cuts to the 2012 Obama administration request for global health funding,” Jeanie Yoon, a physician with Doctors Without Borders/Medecins Sans Frontieres (MSF), writes in a Baltimore Sun opinion piece. Yoon describes an MSF program in Zambia working to prevent mother-to-child HIV transmission (PMTCT), saying such programs “provide an opportunity for mothers be tested for HIV (as well as other dangerous conditions for pregnant women) and to take the steps needed for them and their babies to live healthy lives; as well as for communities to gain productive members instead of incurring yet more losses.”
Aid Targeting High Mortality Diseases ‘Lays The Groundwork’ For Improving Primary Health Care Services
“In recent years, initiatives such as the President’s Emergency Plan for AIDS Relief (PEPFAR) and the Global Fund to Fight AIDS, Tuberculosis, and Malaria have helped rein in some of the biggest scourges,” Paul Farmer, co-founder of Partners in Health and chair of the Department of Global Health and Social Medicine at Harvard Medical School, writes in a Washington Post opinion piece. “Scaling up PEPFAR, alongside other health initiatives, would bring a high return,” because “as we deepen the response to specific diseases such as AIDS or TB, we can broaden access to primary health services,” which “lays the groundwork for addressing health problems of all kinds,” he continues.
UNAIDS on Monday released its World AIDS Day Report 2011 (.pdf), “which shows more people than ever living with HIV, but deaths and new infections steadily dropping,” the Guardian reports (Boseley, 11/21). The number of AIDS-related deaths in 2010 was 21 percent lower than its peak in 2005, and the number of new HIV infections in 2010 also was down 21 percent from its peak in 1997, according to the report, BBC News notes (11/21). The report credits more widespread treatment, behavior change and male circumcision for significant drops in the number of new cases, according to the Guardian (11/21). “Of the 14.2 million people eligible for treatment in low- and middle-income countries, around 6.6 million, or 47 percent, are now receiving it, UNAIDS said, and 11 poor- and mid-income countries now have universal access to HIV treatment, with coverage of 80 percent or more,” Reuters notes, adding, “This compares with 36 percent of the 15 million people needing treatment in 2009 who got AIDS drugs” (Kelland, 11/21).
“More than 30 million children in seven countries in East Asia and the Pacific are deprived of at least one essential service such as basic health care, safe drinking water or access to education, according to a United Nations study (.pdf),” AlertNet reports. According to UNICEF’s “Child Poverty in East Asia and the Pacific: Deprivations and Disparities” report, “more than 13 million of the 93 million children in Cambodia, Laos, Mongolia, the Philippines, Thailand, Vanuatu and Vietnam suffer from two or more such deprivations.”
In this post in the Huffington Post’s “Impact” blog, Tido von Schoen-Angerer, executive director of the Doctors Without Borders/Medecins Sans Frontieres (MSF) Access to Essential Medicines Campaign, examines the interface between trade rules and public health, discussing the implications of the Doha Declaration on public health since its inception 10 years ago, and addresses the question of how “countries balance the need to protect public health against patent rights that lead to high medicine prices and limited access for people in need.” He notes that the winners of an MSF “ideas contest on the theme of ‘Revising TRIPS for Public Health'” will present their ideas at a conference in Geneva next month, concluding, “I hope the winning ideas can generate some discussion and look towards affecting change, so that the next decade sees us moving towards more access to medicines for those who need them most” (11/22).
In this Forbes opinion piece, journalist Sarika Bansal examines five ways in which pharmaceutical companies can address neglected tropical diseases (NTDs), including creating cross-sectorial research partnerships for neglected diseases; joining patent pools for neglected diseases; donating drugs for neglected diseases; creating facilities dedicated to neglected disease research; and allowing scientists to work on neglected disease, both formally and informally.