This report from the Center for Strategic & International Studies’ Global Health Policy Center, titled “Protection of Health Care in Armed and Civil Conflict,” examines how “action [last year] at the U.N. Security Council, the World Health Organization, and the U.S. Department of State, combined with a new campaign by the International Committee of the Red Cross and civil society mobilization, led to potential breakthroughs in three key dimensions of protection — documentation, prevention, and accountability.” The summary states, “The opportunity to better protect health services during conflict is palpable” (Rubenstein, 2/1).
Access to Health Services
The Guardian examines the future of the Global Fund to Fight AIDS, Tuberculosis and Malaria as it enters its second decade, writing, “Despite its staggering successes — including helping put 3.3 million people on AIDS treatment, 8.6 million on anti-tuberculosis treatment and providing 230 million insecticide-treated nets for the prevention of malaria — the fund’s recent troubles had threatened to overshadow its accomplishments as it prepared to mark a decade as the world’s main financier of programs to fight these three global epidemics.” The news service highlights a $750 million pledge to the Fund by Bill Gates, co-chair of the Bill & Melinda Gates Foundation, discusses recent managerial changes within the Fund, and quotes a number of experts about future challenges (Kelly, 2/2).
In this Global Health and Diplomacy opinion piece, Tanzanian President Jakaya Mrisho Kikwete examines efforts to meet Millennium Development Goal (MDG) targets on maternal and child mortality in Africa, noting, “Although Africa has just 12 percent of the global population, it accounts for half of all maternal deaths and half the deaths of children under five.” He writes, “Though global maternal deaths are in decline and women’s health has at last become a global priority, our goal of reducing maternal mortality by 75 percent in 2015 is still a long way off. … It is unacceptable to allow mothers and children to die when we have the knowledge and resources to save them.”
Approximately 85,000 HIV-positive people in Burma, also known as Myanmar, are in need of antiretroviral treatment (ART) and cannot access it “due to a lack of funding, despite renewed international engagement with the government amid a wave of political reform, according to a report released Wednesday” by the medical aid group Medecins Sans Frontieres (MSF), the Associated Press/CBS News reports (2/22). “At the launch of a new report called ‘Lives in the Balance,’ MSF said that only a quarter of the estimated 120,000 people living with HIV and AIDS were receiving treatment, and that it was turning people away from its clinics,” BBC News writes. While plans were made last year among MSF and its partners to scale up treatment for HIV and tuberculosis (TB), “those proposals were shelved after the Global Fund” to Fight AIDS, Tuberculosis and Malaria cancelled its Round 11 grants, according to the news agency. “The money was expected to provide HIV drugs for 46,500 people in Myanmar, along with treatment for another 10,000 people sicken[ed] by drug-resistant tuberculosis in the country, [the report] said,” BBC writes (Fisher, 2/22).
“While international attention focuses on Burma, [also known as Myanmar,] a health crisis in the country looms large,” Joe Billiveau, operations manager of Medecins Sans Frontieres’ (MSF) operational center in Amsterdam, writes in this opinion piece in Bangkok’s Nation. He continues, “An estimated 85,000 people infected with HIV in Burma are not receiving life-saving antiretroviral treatment (ART). This is an improvement on previous years, with new momentum in the country to tackle the crisis,” but the cancellation of the Global Fund to Fight AIDS, Tuberculosis and Malaria Round 11 grants “threatens to undo improvements” and prevent the planned scale-up of ART for an additional 46,500 patients and treatment for another 10,000 tuberculosis (TB) patients.
This post in the UHC Forward blog describes the second meeting of the Universal Health Coverage Roundtable Series, “Toward Sustainable Universal Health Coverage,” which was hosted by the Council on Foreign Relations in New York City on February 9. The panelists “examined the possibilities, challenges, and paths toward achieving Universal Health Coverage in different resource settings by exploring the methods for expanding and supporting coverage worldwide” and discussed issues such as how to define UHC, the importance of quality in health care, improving cost-effectiveness, and how to increase utilization of existing services, according to the blog (Wellington, 2/20).
The Associated Press on Saturday examined the HIV/AIDS epidemic in Uganda, where “[a] new government report says the prevalence of HIV in this East African nation increased from 6.4 percent in 2004 to 7.3 percent in 2011, a shocking statistic for a country once praised for its global leadership in controlling AIDS.” The news service highlights PEPFAR’s contributions to fighting the epidemic in Uganda, noting that “[a]t least half of the 600,000 Ugandans in need of AIDS treatment are able to access the drugs, mostly through PEPFAR.” According to the AP, “U.S. government officials have been pressing Uganda to devote more resources to AIDS and issues such as maternal health, saying dependency on foreign support is unsustainable in the long term.” On a recent trip to the country, Rep. Barbara Lee (D-Calif.) said meeting patients benefitting from PEPFAR-funded treatment “was confirmation of the fact that United States foreign aid works,” the AP writes (Muhumuza, 7/21).
Michael Merson, director of the Duke Global Health Institute, writes in The Hill’s “Congress Blog” that much of the progress in the fight against HIV/AIDS “has been made — and the lives of millions of people saved — because of PEPFAR, … [t]he largest ever global investment in health by the United States government.” With PEPFAR’s “aggressive new goals” — to provide antiretroviral drugs to six million people in low- and middle-income countries, “fund 4.7 million male circumcisions and provide antiretroviral therapy to 1.5 million HIV-infected pregnant women by 2013” — “[w]e need to ask: Are we setting ambitious goals that we’re not prepared to fund or meet? Are we setting up one of our country’s greatest successes for failure?” Merson asks. He notes that “PEPFAR funding has flatlined despite these new targets and is not nearly enough to maintain progress and continue reducing new HIV/AIDS cases and deaths” and that “uncertainty” surrounds the “commitment by Congress” and the outcome of the presidential election. Saying that “PEPFAR itself also needs to continue to adjust its priorities,” Merson states that “treatment, prevention, care, health system capacity and scientific research to develop an HIV vaccine require financial commitment, strong political will and investment in resources from all stakeholders. Let us not fall behind now and bring back the suffering of the past” (7/20).
The XIX International AIDS Conference opened in Washington, D.C., on Sunday and “is expected to draw 25,000 people, including politicians, scientists and activists, as well as some of the estimated 34 million people living with HIV who will tell their stories,” Agence France-Presse reports (Sheridan, 7/22). “Researchers, doctors and patients attending the world’s largest AIDS conference are urging the world’s governments not to cut back on the fight against the epidemic when it is at a turning point,” the Associated Press writes, adding, “There is no cure or vaccine yet, but scientists say they have the tools to finally stem the spread of this intractable virus — largely by using treatment not just to save patients but to make them less infectious, too” (Neergaard, 7/22). “New breakthroughs in research will be announced, as will new efforts by governments and organizations to reduce the spread of HIV, to treat those who have it, and to work, eventually, toward a vaccine and a cure,” the Seattle Times writes (Tate, 7/22). According to the Washington Post’s “Blog Post,” three remaining challenges to be addressed at the conference include: “More research into treatment and prevention, and more ways to deliver treatments”; reaching marginalized populations, such as men who have sex with men and sex workers; and “[i]ncreasing funding for PEPFAR and other anti-AIDS programs” (Khazan, 7/20).
Noting the 2010 reversal of the HIV travel and immigration ban allowing the International AIDS Conference (AIDS 2012) to be held in the U.S. for the first time in more than 20 years, Rep. Barbara Lee (D-Calif.) writes in a Huffington Post Blog opinion piece, “It is so exciting to host this conference at such a pivotal time in the history of the AIDS response,” and adds, “At no other time in history has our global leadership been more important than it is right now.” With nearly 25,000 people from about 200 countries expected to gather in Washington, D.C., for the conference July 22-27, “These leaders in the global HIV and AIDS fight will showcase their incredible efforts and achievements on our own soil” and “have the opportunity to develop new solutions in addressing the ongoing challenges posed by HIV/AIDS in our own country and around the world,” Lee writes.