The Associated Press examines access to antiretroviral treatment in Myanmar, which “ranks among the world’s hardest places to get HIV care, and health experts warn it will take years to prop up a broken health system hobbled by decades of neglect.” The country, also known as Burma, has been hindered by decades of rule by a military junta and economic sanctions imposed by developed countries, including the U.S., the AP notes, and writes, “Of the estimated 240,000 people living with HIV [in the country], half are going without treatment.” However, “as Myanmar wows the world with its reforms, the U.S. and other nations are easing sanctions,” the news agency writes, adding, “The Global Fund [to Fight AIDS, Tuberculosis and Malaria] recently urged Myanmar to apply for more assistance that would make up the shortfall and open the door for HIV drugs to reach more than 75 percent of those in need by the end of 2015,” as well as medications to fight tuberculosis (TB). The AP details one man’s efforts to obtain antiretrovirals, which are reserved for patients with CD4 cell counts below 150 cells, versus the WHO recommended 350 (Mason, 10/22).
Access to Health Services
Central African Republic Town Struggling To Provide Health Care Since Withdrawal Of Foreign Companies, VOA Reports
VOA News examines how the 2009 withdrawal of foreign diamond-mining companies from the small town of Carnot in the Central African Republic (CAR) affected the local economy and access to health care for residents. Initially, Medecins Sans Frontieres (MSF) “ran emergency nutrition programs for the first year, but then discovered deeper health problems in the region, including a child mortality rate that is three times above what is considered an emergency level, as well as elevated rates of HIV and tuberculosis,” the news service writes.
In the last of a series of posts on the U.K. Department for International Development’s (DfID) blog examining the department’s work in Malawi, Neil Squires, DfID head of profession for health, looks at the sustainability of the country’s HIV/AIDS program. “Malawi’s success in increasing access to antiretroviral drugs for HIV is highly dependent on donor funding for medicines,” he writes, adding, “Malawi has to actively consider its resource allocation in order to maximize the benefits and the health gained from the limited resources available.” He notes a report commissioned by UNAIDS on Malawi concluded that “unless Malawi can reduce the incidence of new infections, the scale up in access to antiretroviral drugs will not be sustainable in the medium to long term.” He concludes, “This is an important issue for the Government of Malawi, but also for the key donors who have supported the massive scale up in access to drugs, particularly the Global Fund. Malawi will need to maintain high levels of funding from the Global Fund if it is to maintain its supply of antiretroviral drugs” (10/23).
During a meeting with UNAIDS Executive Director Michel Sidibe on Tuesday, Indonesia Minister of Health Nafsiah Mboi “pledged to scale up HIV testing and treatment programs” with a “focus on 141 districts where key affected populations are the highest,” a UNAIDS feature story reports. “Indonesia also plans to become one of several countries in the region to offer universal health care by 2014,” with HIV treatment to be covered, according to the health ministry, UNAIDS notes. Sidibe said, “Indonesia is a key partner in the drive to end the AIDS epidemic. … Universal health coverage is a game changer for Indonesia. I am delighted to know that HIV treatment will be included in this national program. This sets the stage for sustainable funding of HIV programs,” the article states. “The Ministry of Health estimates that more than 600,000 people are living with HIV and that there are more than 76,000 new HIV infections each year,” according to UNAIDS, which adds, “Currently HIV treatment coverage is at less than 20 percent” (10/23).
India's Maternal Health Care Benefit Excludes Many Women Because Of Parity Requirement, Women's eNews Reports
Women’s eNews examines India’s Indira Gandhi Maternity Support Scheme, a health care benefit offering $80 cash assistance to pregnant women older than 18 years and who do not have more than two living children. “The benefit requires a pregnant woman to register her pregnancy at a health center, accept immunization of the mother and child and agree to exclusive breastfeeding and growth monitoring of children,” the news service writes. “One 2011 study, however, based on the latest national family health survey, indicated as many as 63 percent of poor women between ages 15 to 49 would be disqualified from the program because they had more than two children,” according to Women’s eNews. “With the scheme being piloted in four [high fertility] states, … health activists contend the government is promoting a coercive two-child policy in the name of population stabilization by offering incentives for only those women who have two children,” the news service writes, adding the program would benefit poor women who do not have access to adequate family planning or health services, income, or nutrition (Majumdar, 10/23).
In the Huffington Post’s “Politics” blog, Serra Sippel, president of the Center for Health and Gender Equity, notes that Secretary of State Hillary Rodham Clinton said at the XIX International AIDS Conference in July that all women should be able to decide “when and whether to have children” and that PEPFAR, in a guidance [.pdf] released last week, said, “Voluntary family planning should be part of comprehensive quality care for persons living with HIV,” and referred to family planning as a human right. “Then, in bold type, they punctuated it with, ‘PEPFAR funds may not be used to purchase family planning commodities,'” she writes. “They take it a step further with a caveat that before anyone decides they’d like their program to have anything to do with family planning, they had best consult relevant U.S. legal counsel first,” she adds. “To be fair, they do say that PEPFAR programs can just refer women to a different program that offers family planning,” but those programs are not always available, Sippel writes, adding, “So the suggestion is flawed from the start.”
“Last month, U.N. Secretary-General Ban Ki-moon convened a group of global leaders, including [Bill & Melinda Gates Foundation Co-Chair] Bill Gates and heads of state of polio-affected countries, to renew the commitment to eliminate polio,” William Keenan, executive director of the International Pediatric Association, and Robert Block, president of the American Academy of Pediatrics, note in the Huffington Post’s “Global Motherhood” blog. “This show of solidarity reminds us that the fight is not finished,” they write, and continue, “Armed with effective vaccines, pediatricians, partner organizations and front-line workers around the globe have eliminated 99 percent of all new polio cases.” They state, “We can’t afford to lose sight of this remaining one percent of polio cases.”
The Center for Global Health Policy’s “Science Speaks” blog on Friday published two posts reporting on ID Week, which concluded in San Diego on Sunday. “Wafaa El-Sadr of Columbia University offered an ID Week presentation Thursday about the impact of treatment on the global epidemic and the new promise of changing the trajectory of the epidemic by scaling up treatment both to save lives and reduce HIV incidence,” the blog writes in the first post, adding, “She reminded her audience that treatment has already had a major impact” (Lubinski, 10/19). “A trio of presentations on HIV, Women and Child Health [on Friday] morning told a story of success in preventing transmission of HIV from parents to children in the United States that has yet to be duplicated in developing countries, of options that could make a difference, and, in a look at the burdens children born with HIV will carry into adulthood, of some of the relatively rarely discussed consequences of gaps in efforts so far,” the blog writes in a second post (Barton, 10/19).
Writing in the Global Bioethics Blog, Stuart Rennie, a bioethics researcher and professor, notes another polio worker was killed in Pakistan last week and describes Taliban opposition to U.S.-supported polio vaccination efforts in Pakistan. “For its part, the Taliban argues that U.S. efforts to eradicate polio in Pakistan contradict U.S. efforts to combat terrorism in the region, more specifically its campaign of drone strikes,” he states, adding, “As Taliban officials argue, many more Pakistanis — including women and children not involved in terrorist activity — have died or been injured (psychologically and otherwise) from drone strikes than have died or are likely to die from polio.” He continues, “When you can see the point in a Taliban ethical argument, the world is a dark place.” Rennie concludes, “The eradication of polio is of global interest: it is important that it joins smallpox in the tiny category of eliminated infectious diseases, while we still have the chance” (10/21).
Briefly recapping a history of foreign aid policy since 1920, former Sen. Blanche Lincoln (D-Ark.) and former Arkansas Gov. Mike Huckabee (R) write in a Politico opinion piece, “Credit for America’s global leadership role belongs to both major political parties and Americans of all stripes” who “have always been guided by the notion that all lives have equal value, regardless of where someone was born.” Because of the current economic recession, “[w]e understand that there might be temptation to cut back on U.S. humanitarian programs and investments abroad,” they write, continuing, “However, the cost of cutting back on such programs is not worth it,” as such cuts would amount to less than one percent of the federal budget, “affect too many peoples’ lives and damage American economic and national security interests at a time our world is more interconnected than ever.”