The Canadian Medical Association Journal (CMAJ) reports on HIV in the Kingdom of Swaziland, writing the country “now has the dubious distinction of having the world’s highest rate of both HIV and tuberculosis (TB).” The journal notes “[a]bout 26 percent of adults aged 15-49, or about 202,000 of all the citizens of Africa’s last absolute monarchy, are HIV-positive, according to the Swaziland government,” and asks, “Why are the 1.2 million people of this landlocked kingdom … in such dire straits?” CMAJ writes, “A host of underlying factors appear to be at the root of its woes: politics, history, culture, economics, poverty, gender inequity, and much more.”
Access to Health Services
India’s National Food Security Bill, “expected to be discussed in Parliament later this year, … holds out hope of addressing some of the nation’s most persistent and pervasive problems,” Ashwin Parulkar, a research scholar at the Centre for Equity Studies, writes in the Wall Street Journal’s “India Real Time” blog. “Unfortunately, in my view, the draft in its current form will be a major let down,” he states and provides some background on the bill. “Lawmakers have drafted this legislation but it appears that the bill will do little to tackle the critical areas of India’s hunger crisis so widely acknowledged by this country’s own policymakers,” he writes.
“Uruguay’s Congress voted narrowly on Wednesday to legalize abortions during the first 12 weeks of pregnancy, a rare move in largely Catholic Latin America that underscores the country’s liberal leanings,” Reuters reports. “President Jose Mujica, a former leftist guerrilla fighter, has said he would sign the bill into law,” the news service notes (Castaldi, 10/17). “[T]he bill approved by Uruguay’s Senate came after a pointed debate among legislators, producing a compromise that disappointed both abortion-rights groups and opponents, who have vowed to carry out a referendum to overturn the legislation,” the New York Times writes, adding, “Legislators carefully worded the bill, describing it not as legalization of abortion but as a decriminalization measure.” The newspaper writes, “The bill effectively legalizes abortion in the first trimester, permits abortion through 14 weeks of pregnancy in cases of rape and allows later-term abortions when a woman’s health is at risk” (Romero et al., 10/17).
Aissata Sall Yade, a communications assistant for the Senegal Urban Reproductive Health Initiative, part of IntraHealth International, writes in the Bill & Melinda Gates Foundation’s “Impatient Optimists” blog about Aissatou Dia Fall, a head midwife at Senegal’s Gallo Dia Health Center in Yeumbeul, and her efforts to improve access to health care for women in the community. She has reached out to different organizations for monetary assistance for her clients, Yade notes, adding, “Strategies like Aissatou Dia Fall’s will help improve Senegal’s national contraceptive prevalence rate, which is currently only 12 percent. It will also help reduce one of the world’s highest maternal mortality rates (410 deaths per 100,000 live births) and reduce the fertility rate (an average of five children per woman)” (10/17).
“Chelsea Clinton is taking on the discomforting issue of diarrhea, throwing her family’s philanthropic heft behind a sweeping effort in Nigeria to prevent the deaths of one million mothers and children each year from preventable causes, including 100,000 deaths from diarrhea,” Reuters reports. “The 32-year-old daughter of President Bill Clinton and Secretary of State Hillary Rodham Clinton joined Nigerian officials, the prime minister of Norway and other leaders on Tuesday in promoting expanded access to zinc and oral rehydration solutions or ORS, a treatment that could prevent more than 90 percent of diarrhea-related deaths in the country,” the news agency writes (Steenhuysen, 10/17).
PlusNews examines challenges and concerns over an announcement by the Zimbabwean government that it plans to train nurses to prescribe and administer antiretroviral drugs (ARVs) to people living with HIV in the country. “Previously, nurses were allowed only to administer the drugs after a doctor had prescribed them,” the news service writes, adding, “Now, changes made in the job descriptions of nurses by the Nurses’ Council of Zimbabwe will see them prescribing the medication.” Owen Mugurungi, director of the HIV/AIDS and TB unit in the Ministry of Health and Child Welfare, said, “I need to point out that it’s not enough that a professional council allow nurses to administer drugs; this should be followed up with measures to capacitate nurses to do this work correctly,” according to PlusNews. The news agency looks at how the possibility of work overload for nurses, a government hiring freeze on nurses, and ARV availability could affect the country’s plan to reach 85 percent of the population in need of HIV treatment by the end of this year (10/16).
Using data from cancer registries worldwide, researchers from the International Agency for Cancer Research (IACR) found that 169.3 million years of healthy life were lost to cancer in 2008, according to a study published on Tuesday in the Lancet, HealthDay News reports. Using “a measure called disability-adjusted life-years (DALYs) to assess not only the impact of fatal cancer, but also the effects of disabilities among cancer survivors,” the researchers also found men in Eastern Europe and women in sub-Saharan Africa had the largest cancer burden worldwide; increased access to treatment has not improved survival outcomes for several common cancers; and lower-income countries have higher average levels of premature death due to cancer, while higher-income countries have higher average levels of cancer-related disability and impairment, according to the news service. Study co-author Freddie Bray, deputy head of the IARC Cancer Information Section, said in a Lancet press release, “Our findings illustrate quite starkly how cancer is already a barrier to sustainable development in many of the poorest countries across the world and this will only be exacerbated in the coming years if cancer control is neglected,” the news service notes (10/15).
“During the first presidential debate, neither President [Barack] Obama nor [Republican presidential nominee Gov. Mitt] Romney addressed the issue that affects half the world’s population: women’s reproductive rights,” Musimbi Kanyoro, president and CEO of the Global Fund for Women, writes in the Huffington Post’s “Politics” blog. “As the two square off on foreign policy, women’s reproductive rights must be addressed because whomever becomes president will not only determine U.S. women’s personal, economic and educational choices, but also those of women worldwide,” she writes, adding, “The candidates’ positions on women’s reproductive rights couldn’t be starker.”
Offering Methadone Treatment To Drug Users Significantly Reduces HIV Infection, Transmission Risk, Study Shows
Offering methadone treatment to people who use injection drugs “substantially reduces the risk that they will get HIV or give it to anyone else,” according to a BMJ study published this month that pools data from studies done in nine countries, the New York Times reports. “Methadone itself does not affect the virus; scientists believe it works because [drug users] on treatment become better able to stop sharing needles and selling sex for drugs,” the newspaper writes, noting “the risk of catching HIV is one in 125 from a syringe, about one in 122 from anal sex, and less than one in 2,000 from vaginal sex, according to an editorial published with the study.” The newspaper adds, “Many countries, including Russia, have large HIV epidemics among addicts but nonetheless outlaw methadone and buprenorphine treatment for political, religious, or other reasons” (McNeil, 10/15).
“Health workers in Myanmar are confident that efforts to narrow the country’s huge gap between access to, and need for, life-saving medicines to treat HIV/AIDS are back on track after the Global Fund to Fight AIDS, Tuberculosis and Malaria invited the country to apply for additional funding,” IRIN reports. “The agency’s coordinator for Myanmar, Eamonn Murphy, said new funds will allow the country to close a ‘treatment gap’ where only one-third of the 120,000 people nationwide who need [antiretrovirals (ARVs)] receive them,” the news service notes. “A spokesman for the Global Fund said it ‘had encouraged an application by the country for more money’ following an August visit to Myanmar by its general director,” IRIN writes. “Health officials drafted a ‘concept note’ outlining how additional funding might be used, which will be reviewed by the Global Fund’s board, Murphy said,” according to the news service, which notes, “It offers two scenarios: the first ensures 85 percent of those who need ARVs receive them by 2015; while with the second, 76 percent of people would be covered, he said.” The news service adds, “Based on feedback from the board, the government will choose a strategy for the proposal to be submitted early next year” (10/12).