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).
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).
“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.”
Advocacy Groups Warn Trans-Pacific Partnership Could Affect Access To Low-Cost Medications, Bloomberg Reports
Bloomberg Businessweek examines how ongoing trade negotiations related to the Trans-Pacific Partnership could affect access to quality low-cost medications, including antiretrovirals, in low- and middle-income countries. “Protecting the patents of drug makers … as part of the Trans-Pacific Partnership has drawn criticism from groups such as Doctors Without Borders and Public Citizen,” and “[t]he proposed accord has also spurred calls from U.S. lawmakers for greater transparency about the negotiations,” the news service writes. “The multilateral talks, the main accord being pursued by President Barack Obama’s administration, … began with Australia, Brunei, Chile, Malaysia, New Zealand, Peru, Singapore, the U.S. and Vietnam [and] may expand after the parties invited Canada and Mexico,” 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).
Diagnostics company Cepheid on Monday signed deals with PEPFAR, USAID, UNITAID, and the Bill & Melinda Gates Foundation to immediately reduce the price of its Xpert MTB/RIF test kit for its GeneXpert tuberculosis (TB) diagnostic system in 145 countries, Reuters reports. “The agreements will see the test sold for $9.98, down from its current price of $16.86 per test,” the news service writes, adding, “Cepheid said the Bill & Melinda Gates Foundation will make an initial payment of $3.5 million to make the test immediately available at the lower price” (Ail, 8/6).
In this post in the PLoS “Speaking of Medicine” blog, Judit Rius Sanjuan, a lawyer from Barcelona, Spain, and the U.S. manager of the Access Campaign at Medecins Sans Frontieres (MSF), says the Trans-Pacific Partnership (TPP), a regional trade agreement that currently involves 11 countries but could expand to include other countries in the Asia-Pacific region, “threatens to set a dangerous precedent with damaging implications for developing countries where MSF works, and beyond.” “Negotiations are being conducted in secret, but leaked drafts of the agreement outline U.S. aggressive intellectual property (IP) demands that that could severely restrict access to affordable, life-saving medicines for millions of people,” she writes, concluding, “At this pivotal moment in the fight against AIDS, when the scientific, medical and policy tools needed to reverse the epidemic are finally at hand, … the U.S. government’s demands in the TPP will threaten so much of what has been achieved so far, and will make the vision of an AIDS-free generation impossible, or at least much more expensive” (8/7).
Inter Press Service reports on the successful efforts of Tanzania’s Kigoma Region “to train assistant medical officers to conduct life-saving c-sections at its rural health centers,” allowing pregnant women with complications to deliver at more local facilities instead of having to travel to regional or district hospitals. Tanzania’s maternal mortality rate is high, at 578 deaths for every 100,000 live births, IPS notes. “[A]t one point the Kigoma Region had the highest rate in the country, at 933 per 100,000 live births in the early 1980s,” but “maternal mortality in this region [now] is considered to be lower than in the rest of the country,” according to the news service.
“The United Nations has urged the Philippines to pass a bill that will allow the government to provide free contraceptives,” BBC News reports (8/5). “UNFPA country coordinator Ugochi Florence Daniels said the [reproductive health (RH)] bill is important for the Philippines to achieve its health-related targets in the Millennium Development Goals (MDGs),” including maternal health, HIV/AIDS and infant mortality, the Philippine Star writes (Crisostomo, 8/4). “The House of Representatives plans to decide Tuesday whether to end debate on the bill and put it to a vote,” the Associated Press/Seattle Times notes (Gomez, 8/5).
Science looks back at the XIX International AIDS Conference (AIDS 2012), which ended last week in Washington, D.C., writing, “The battle against HIV is having more success than ever. … But several presentations made clear that a gulf separates aspirations from reality when it comes to ‘ending AIDS,’ which [Secretary of State Hillary] Clinton and many other prominent speakers at the conference emphasized was now possible.” Though more people are on antiretrovirals (ARVs) now than ever, low- and middle-income countries are spending more on HIV/AIDS, and “attempts to find a cure — long viewed as a fantasy — now lead the scientific agenda,” most “of the 34 million HIV-infected people in the world do not take ARVs, many receiving treatment have trouble staying on the medication, … new infection rates continue to climb in key populations,” “[n]o AIDS vaccine is on the horizon,” and “funding shortfalls loom for global programs,” Science writes, quoting several speakers at the conference and providing more detail on the successes and challenges in the response against HIV/AIDS (Cohen, 8/3).