Noting the progress made since the beginning of the HIV/AIDS epidemic and the upcoming recognition of World AIDS Day on December 1, Ronald Valdiserri, deputy assistant secretary for health, infectious diseases at the Department of Health and Human Services, writes in a Public Health Reports opinion piece (.pdf), “[W]e would do well to keep in mind the following caution. No matter the elegance of the controlled trial, the statistical significance of the results, or the superiority of the science, we must confront this inevitable reality: We will never be able to take full advantage of our progress in HIV clinical and prevention science until we develop and sustain the human, organizational, and structural capacities necessary to implement these new scientific breakthroughs.” He continues, “If we fail to attend to the ‘on-the-ground’ details of implementation, we risk dissipating the promise of new drugs, novel therapies, and enhanced interventions that could, in fact, lead us to an AIDS-free generation.”
Access to Health Services
According to a Pan American Health Organization (PAHO) and WHO joint press release, USAID “has tripled its financial support for the Pan American Health Organization/World Health Organization (PAHO/WHO) Regional Tuberculosis Program, which seeks to prevent 15,000 deaths from tuberculosis in Latin America and the Caribbean over the next five years and reduce the incidence of this disease.” The press release notes the commitment “increases a previous $5 million USAID/PAHO agreement, signed in November 2011 to strengthen programs for tuberculosis, maternal and neonatal health, and health systems in the region over the course of a three-year period, to a total of $8.9 million.” The press release states that $5.1 million is earmarked for the tuberculosis program, “up from an originally expected investment of $1.5 million” (10/31).
“Afghanistan is taking steps to improve its routine immunization coverage, after a drop in coverage led to a sharp increase in measles outbreaks last year, killing more than 300 children,” IRIN reports. “Experts say nearly 30 percent of the population has no or very poor access to primary health care, including immunization, and the percentage is estimated to be as high as 70 percent in areas of conflict in the south,” the news service writes, adding “decreasing vaccination coverage [is] due to rising insecurity, decreased access, difficult terrain and harsh winters,” as well as last year’s severe drought. “In the National Priority Programmes, which outline government priorities until 2015, the government admits many vaccinators lack initial training, and that budget shortages in past years prevented supervisory and monitoring visits by provincial level management teams,” IRIN states, adding that the WHO this year has implemented training programs and, along with UNICEF and the Ministry of Health, has combined the measles and polio vaccination campaigns to better utilize resources (11/1).
As part of its “Blueprint” series discussing the creation of a U.S. global AIDS blueprint called for by Secretary of State Hillary Clinton in July, the Center for Global Health Policy’s “Science Speaks” blog features an opinion piece by Salmaan Keshavjee of Harvard Medical School and Partners In Health. With an estimated 1,000 people with HIV dying of tuberculosis (TB) every day, “[i]t is clear that our current approaches to addressing the global tuberculosis pandemic are inadequate,” he writes. Keshavjee says, “First, bold targets for reducing tuberculosis incidence and zero TB-HIV deaths must be prioritized in the blueprint. … Second, known strategies for stopping the spread of tuberculosis have to be actively implemented. … Lastly, any effective strategy has to ensure that HIV advocates at the community level are educated about the threat of tuberculosis,” and he describes each of his points in detail. He concludes, “The United States has shown visionary leadership in the area of HIV treatment and changed the lives of countless people for the better. It is time to take on tuberculosis with the same moral and pragmatic vigor” (Barton, 10/31).
“An Indian government program to reduce the number of home births by giving expectant mothers cash grants has increased the number of hospital deliveries, but gaps in healthcare services are still causing avoidable maternal deaths, an alliance of health organizations has said,” BMJ reports, noting, “The health ministry’s Janani Suraksha Yojana (Mothers Protection Program) provides a cash incentive of 1400 rupees (Â£16; â‚¬20; $25) mainly to poor and underprivileged pregnant women to give birth in hospital.” According to the journal, “[t]he ministry said that the program had helped increase the proportion of hospital deliveries in India from less than 49 percent when it was launched in 2005 to more than 72 percent.” However, BMJ adds, “[t]he National Alliance for Maternal Health and Human Rights, a non-governmental coalition, has said that India’s health ministry has stirred demand and increased the number of hospital deliveries without paying enough attention to factors that determine maternal safety.”
The Associated Press examines the debate over the future of the Affordable Medicines Facility-malaria (AMFm), after the recent release of two papers evaluating the program’s effectiveness. AMFm was established in 2010 as “a pilot project to subsidize artemesinin combination drugs, the most effective malaria treatment,” the AP writes, noting the $460 million program is managed by the Global Fund to Fight AIDS, Tuberculosis and Malaria. “Last week, a report by Oxfam, an international charity, labeled the program a failure and said there was no proof it had saved lives because officials didn’t track who received the drugs,” the news service writes, adding, “But in another paper published Wednesday in the journal Lancet, experts insisted the program was ‘an effective mechanism’ to lower the price of preferred malaria drugs and make them widely available.” The Global Fund is scheduled to discuss the future of the program at a meeting next month, according to the AP (Cheng, 10/31).
“Scientists have come up with a test for the virus that causes AIDS that is 10 times more sensitive and a fraction of the cost of existing methods, offering the promise of better diagnosis and treatment in the developing world,” Reuters reports. “The test uses nanotechnology to give a result that can be seen with the naked eye by turning a sample red or blue, according to research from scientists at Imperial College in London published in the journal Nature Nanotechnology,” the news agency writes (Wickham, 10/28). “The test can be configured to a unique signature of a disease or virus — such as a protein found on the surface of HIV,” and if the marker is present, a chemical reaction causes a blue result and a red result if the marker is not present, according to BBC News. “Early testing showed the presence of markers of HIV and prostate cancer could be detected,” BBC News notes, adding, “However, trials on a much larger scale will be needed before it could be used clinically” (Gallagher, 10/28).
Deutsche Welle examines the widespread lack of access to medical supplies and drugs in developing countries and efforts by the pharmaceutical industry and others to bring new and lower-cost drugs into these emerging markets. Christian Wagner-Ahlfs of the Federal Coordination of Internationalism, or BUKO, which brings together 130 German activist groups to examine the work of the pharmaceutical industry in developing nations, said new drug prices in particular are “totally exorbitant,” adding, “It is a major problem that the companies do not reveal their actual research costs, so the prices are difficult to control,” according to DW. However, Norbert Gerbsch, deputy managing director of the Federation of German Industry (BPI), said those nations also have a responsibility to improve their health care infrastructure and food security, the news agency reports.
U.N. Refugee Agency Prepared To Send Emergency Aid Into Previously Unreachable Syrian Communities If Cease Fire Holds
The U.N. refugee agency “said Thursday it is ready to send emergency aid to thousands of Syrian families in previously unreachable areas” if a four-day U.N. Security Council-backed ceasefire set to begin Friday holds, Agence France-Presse reports. In an press release, the U.N. High Commissioner for Refugees said, “In all, some 550 tons of supplies are being made available for distribution to up to 13,000 affected families — some 65,000 people — in several previously inaccessible areas,” the news agency notes (10/25). “UNHCR, which currently has more than 350 staff in three offices across Syria, said it has been working closely with the Syrian Arab Red Crescent and other partners to provide aid,” the U.N. News Centre reports.
“I’ve always believed that bringing together the world’s brightest minds to help solve the significant and complex crises we face as a global society is the best way to effect change in the world and that is how I envision re-imagining the future of Global Health,” entrepreneur Naveen Jain, founder of World Innovation Institute, Moon Express, inome, and InfoSpace, writes in a Forbes opinion piece. He says he will address this issue in a talk in San Francisco at TEDxSF, which “will explore crucial questions addressing the cutting-edge intersection of technology, medicine, scientific research, and industry at UCSF on November 10, 2012.”