In this post in BMJ’s “Yankee Doodling,” Douglas Kamerow, chief scientist at RTI International and an associate editor for the journal, reflects on the possibility of achieving an AIDS-free generation “if somehow we succeeded in getting all HIV positive people in the world identified and under long term treatment.” He writes that while there has been “astonishing progress against AIDS,” “two concerns immediately arise: the magnitude of the work remaining to find and continuously treat all those infected, and the confusion between that treatment (even if it is somehow universally successful) and actual eradication of the disease.” He concludes, “It is a rosy scenario, but even if it came true it still would not spell the end of the HIV story,” because “[w]e have no vaccine, and the virus keeps mutating” (8/14).
Access to Health Services
African Leaders, International Community Must Act On Commitments Made At London Family Planning Summit
In this UNFPA opinion piece, Babatunde Osotimehin, U.N. under-secretary-general and UNFPA executive director, and Sharon Camp, president and CEO of the Guttmacher Institute, reflect on last month’s London Summit on Family Planning, where “leaders from 18 African countries made unprecedented commitments — financially and politically — to strengthen their family planning programs,” and highlight “[a] new study by the Guttmacher Institute and UNFPA [that] shows there has been minimal progress in addressing the contraceptive needs of African women during the past four years.” They discuss uneven progress “in meeting the demand for contraceptive services” across the continent and write, “Now it is up to all of Africa’s leaders and the international community to do their part through a sustained commitment to improving the provision of contraceptive services” (8/7).
In this post in the New York Times’ “Opinionator” blog, journalist Sarika Bansal reports on a gap in surgical care in developing countries, writing, “It is conservatively estimated that 56 million people in sub-Saharan Africa — over twice the number living with HIV/AIDS — need a surgery today,” but, “across the developing world, surgical care often does not reach those who need it.” She says that a lack of access to surgical facilities and equipment, as well as a lack of trained health care workers, especially in rural areas, contributes to the problem. “Instead of finding ways to lure surgeons to rural areas” to fill this gap, many African countries, including Zambia, Tanzania, Malawi, Mozambique and Ethiopia, “have started experimenting with ‘task shifting’ — that is, training non-physicians to do the basic work of surgeons,” she notes. She highlights a medical licentiate program in Zambia that “trains clinical officers in basic surgeries like hernia repairs, bowel obstruction surgery, hysterectomies and more,” as well as “the donor-funded FlySpec (Flying Specialist) program, which charters planes to conduct orthopedic surgeries in remote parts of the country” (8/8).
“Methadone treatment is proving to be the most efficient way to wean people in Bangladesh from addiction to buprenorphine, a pharmaceutical drug, and health experts say it should be expanded to reach thousands more drug users to prevent the spread of HIV,” IRIN reports. The news service notes that “illegal use of pharmaceutical substances, mostly buprenorphine, is on the rise” in the country. “Buprenorphine was intended to be used to wean injecting drug users, also known as people who inject drugs (PWID), from narcotics like heroin, but has itself become a substance of addiction, with users injecting a liquid form of it,” the news service notes, adding, “Methadone, a pain reliever, suppresses withdrawal symptoms and blocks craving.”
In this post in Huffington Post’s “Healthy Living” blog, John-Manuel Andriote, a journalist and author living with HIV, writes, “For all of us living with HIV infection — Oct. 27 will mark seven years since my own diagnosis — the question we face daily, hopefully more consciously and deliberately than most, is how shall we live, knowing as we do that we will most assuredly die one day?” Reflecting on the XIX International AIDS Conference (AIDS 2012) that took place in Washington last month, he continues, “An AIDS-free generation is certainly a worthy goal,” but “even if tens of billions of additional dollars are allocated to address HIV/AIDS, even if the Republicans don’t succeed in inflicting their Darwinian ‘survival of the fittest’ upon the nation and the world, the question will continue to be what it has been for 31 years … Will we have the political will to end AIDS?”
“Ethiopia is preparing for a flood of medical doctors within ‘three to four years,’ an influx meant to save a public health system that has been losing doctors and specialists to internal and external migration,” IRIN reports. “‘We are now implementing strategies that intend to increase the current below-World Health Organization [WHO] standard number of medical doctors and retaining them in public hospitals,’ Tedros Adhanom, Ethiopia’s minister of health, told IRIN,” the news service writes. “‘We have now reached an enrollment rate of more than 3,100,’ [Adhanom] said,” adding, “The rate of enrollment in the country’s medical schools has increased tenfold from 2005, when it was below 300,” according to the news service.
In an opinion piece in the Guardian’s “Comment is Free” blog, Dean Baker, co-director of the Center for Economic and Policy Research, discusses potential policies contained within the “Trans-Pacific Partnership Agreement (TPP), a pact that the United States is negotiating with Australia, Canada, Japan and eight other countries in the Pacific region.” However, “[a]t this point, it’s not really possible to discuss the merits of the TPP since the governments are keeping the proposed text a secret from the public,” he says. Noting “[a] few items that have been leaked give us some insight as to the direction of this pact,” he discusses how the “pharmaceutical industry is … likely to be a big gainer” from the TPP if the pact includes “stronger and longer patent protection and also increased use of ‘data exclusivity.’”
Though many pregnant women are aware that treatment could save their lives and the lives of their infants if they test HIV-positive during prenatal care, a new study and literature review have found that a “[f]ear of being stigmatized as an AIDS patient is still a major barrier to good medical care for pregnant young women in many countries,” the New York Times reports. The study, published last week in PLoS Medicine, was “based on a survey of 1,777 women in rural Nyanza Province in Kenya,” according to the newspaper, which adds, “Only 44 percent of mothers in the province delivered in clinics, and the study found that a major obstacle was that they feared HIV tests.” The study’s author, Janet Turan, a professor of public health at the University of Alabama at Birmingham, in July also published “a review of multiple studies in many countries” that documented multiple accounts of “stigmatizing behavior,” the newspaper notes (McNeil, 8/27).
At the opening ceremony of World Water Week in Stockholm, Sweden, on Monday, the Food and Agriculture Organization (FAO) “launched a framework that will help combat food insecurity by providing methods to better manage water resources in agriculture and reduce waste,” the U.N. News Centre reports. “The initiative, entitled ‘Coping with water scarcity: An action framework for agriculture and food security’ [.pdf], seeks to encourage practices that will improve water management, such as modernizing irrigation schemes, recycling and re-using wastewater, implementing mechanisms to reduce water pollution, and storing rainwater at farms to reduce drought-related risks, among others,” the news service notes.
“Syrians are in urgent need of life-saving medicines following an escalation in fighting, which also threatens further food shortages, U.N. agencies warned on Tuesday,” Agence France-Presse reports (8/7). “Drugs for tuberculosis, hepatitis, hypertension, diabetes and cancer are urgently needed, as well as hemodialysis for kidney diseases, according to the WHO,” Reuters notes (8/7). “‘The recent escalation of clashes had resulted in substantial damages to the pharmaceutical plants located in rural Aleppo, Homs and Rural Damascus, where 90 percent of the country’s plants were located,’ a WHO spokesperson, Tarik Jasarevic, told reporters in Geneva today,” the U.N. News Centre writes. “Prior to the violence which has wracked the Middle Eastern country, Syria produced 90 percent of its medicines and drugs locally,” the news service notes (8/7).