In this opinion piece in the Atlantic, Mark Harrington, co-founder and executive director of the Treatment Action Group (TAG), says that stronger leadership from the U.S. is needed in order to end the AIDS epidemic. Harrington notes that “earlier this year, [President Obama] proposed a shocking cut of $550 million to [PEPFAR], the most successful U.S.-funded global health program in history,” and highlights his absence from “the first International AIDS Conference to be held on American soil since … 1990.” He provides “a to do list the president should consider if he wants to walk the walk,” which includes “[f]ully fund[ing] PEPFAR and support[ing] its reauthorization in 2013,” “[f]ully support[ing] the Global Fund to Fight AIDS, Tuberculosis and Malaria,” “[r]eject[ing] the congressional ban on federal funding for needle exchange,” “[r]evis[ing] and revitaliz[ing] the National HIV/AIDS Strategy,” increasing funding for NIH, and “fully funding the research, prevention, care, and treatment” needed to end the epidemic (7/24).
Access to Health Services
In a round-up of events from the XIX International AIDS Conference on the Bill & Melinda Gates Foundation’s “Impatient Optimists” blog, Trevor DeWitt, new media communications officer for the foundation, notes that the Global Fund to Fight AIDS, Tuberculosis and Malaria on Monday released results “showing broad gains in the number of people receiving HIV treatment” (7/23). According to a Global Fund press release, “The results show that 3.6 million people living with HIV are now receiving antiretroviral treatment under programs backed by the Global Fund, an increase of 600,000 since the end of 2010.” In addition, “Overall, 8.7 million lives have been saved by programs supported by the Global Fund since the organization was formed in 2002. The results include data through June 2012,” the press release states (7/23).
Jonathan Klein, board chair of Friends of the Global Fight Against AIDS, Tuberculosis and Malaria and co-founder and CEO of Getty Images, writes in a guest post on Forbes, “The U.S. government has long been the world’s most stalwart Global Fund supporter, and U.S. leadership continues to be the most effective tool in leveraging additional resources for the fight against AIDS, tuberculosis and malaria, particularly at a time when budgets are universally tight.” He notes that “[f]or every $1 invested by U.S. taxpayers, the Global Fund leverages at least $2 more from international donors. And that money translates directly into lifesaving prevention and treatment.” Klein says, “Continued U.S. leadership is essential to maintain these gains and reach our health goals. … With sustained strong support, policymakers in Washington can continue to be responsible … for the uptick in people living healthy, productive lives.” Noting that U.S. foreign aid accounts for less than one percent of the federal budget, he concludes, “But it reaps enormous rewards in generating global good will, boosting national security, saving lives and creating a safer, more stable world for all of us” (7/23).
“Resistance to AIDS drugs, a problem that has been widely feared over the last decade, is growing in parts of Africa but should not hamper the life-saving drug rollout, researchers reported on Monday” in a study published in the Lancet, Agence France-Presse reports. “Over eight years, prevalence of resistant virus in untreated people soared from around one percent to 7.3 percent in eastern Africa, and from one percent to 3.7 percent in southern Africa,” the news agency writes, adding that while “[s]imilar rates of 3.5-7.6 percent were also found in western and central Africa, Latin America and the Caribbean,” those rates remained fairly stable over the study period (7/23). “The authors of the new report suggested strengthening pharmacy supply chains to prevent shortages — a chronic problem in poor countries. They also called for better tracking of patients for whom drugs are prescribed,” the New York Times notes (McNeil, 7/23).
“Results from a groundbreaking trial of three drugs given in combination — one of them completely new and one not yet licensed for this use — killed more than 99 percent of patients’ [tuberculosis (TB)] bacteria after two weeks of treatment,” and the combination “appears to be equally effective on drug-resistant TB,” the Guardian reports (Boseley, 7/23). The combination “comprises a candidate TB drug called PA-824, the antibiotic moxifloxacin not yet approved for TB therapy, and an existing TB drug, pyrazinamide,” Agence France-Presse writes, noting the combination is called PaMZ (7/23). “Because the combination doesn’t contain isoniazid or rifampicin, the two main medicines used against TB, it also may provide a much-needed weapon against strains that fail to succumb to those drugs and are spreading, the researchers wrote,” Bloomberg Businessweek reports (Bennett, 7/23). The Phase II study, which was presented on Monday at the International AIDS Conference in Washington and published in the Lancet, “needs to be confirmed in larger and longer trials,” according to Reuters (Steenhuysen, 7/23).
In this post in the Results for Development Institute’s “Center for Global Health R&D Policy Assessment” blog, Aarthi Rao, a program officer at the institute, examines whether corporate social responsibility (CSR) programs within Indian pharmaceutical companies can help fight neglected diseases. “Corporate giving amongst Indian pharmaceutical firms is still in its infancy and will likely evolve in the coming years as the industry continues to grow,” the she writes, adding, “As the breadth of social initiatives increases, it will be interesting to watch whether the social arms of firms will join their business counterparts in increasing the availability of neglected disease technologies” (7/23).
Secretary Clinton Reaffirms U.S. Commitment To 'AIDS-Free Generation,' Pledges More Than $150M For Global Efforts
In a speech delivered at the XIX International AIDS Conference in Washington, D.C. on Monday, U.S. Secretary of State Hillary Clinton “underscored the United States’ commitment to achieving an ‘AIDS-free generation’ and announced more than $150 million in additional funding,” Politico reports (Norman, 7/23). “‘Iâ€™ve heard a few voices from people raising questions about America’s commitment,’ she said, adding, ‘We will not back off. We will not back down,'” according to The Hill’s “Healthwatch” (Viebeck, 7/23). Of the $150 million pledged, “$80 million will be dedicated towards preventing mother-to-child transmission abroad, with the goal of eliminating it by the year 2015”; “[a]nother $40 million is allotted for voluntary male circumcision in Africa to decrease risk of transmission of the virus”; “an additional $15 million [will] fund research on interventions”; “$20 million [is] to bolster country-led efforts to expand HIV-related services”; and “$2 million [will go] towards civil society groups to reach key populations affected by HIV,” ABC News writes (Duwell, 7/23). “Clinton said she had commissioned [U.S. Global AIDS Coordinator Ambassador Eric Goosby] to produce a blueprint for the way ahead,” the Guardian notes (Boseley, 7/23). “Goosbyâ€™s deadline is the upcoming World AIDS Day, Dec. 1,” Inter Press Service adds (Biron, 7/23).
Michael Merson, director of the Duke Global Health Institute, writes in The Hill’s “Congress Blog” that much of the progress in the fight against HIV/AIDS “has been made — and the lives of millions of people saved — because of PEPFAR, … [t]he largest ever global investment in health by the United States government.” With PEPFAR’s “aggressive new goals” — to provide antiretroviral drugs to six million people in low- and middle-income countries, “fund 4.7 million male circumcisions and provide antiretroviral therapy to 1.5 million HIV-infected pregnant women by 2013” — “[w]e need to ask: Are we setting ambitious goals that we’re not prepared to fund or meet? Are we setting up one of our country’s greatest successes for failure?” Merson asks. He notes that “PEPFAR funding has flatlined despite these new targets and is not nearly enough to maintain progress and continue reducing new HIV/AIDS cases and deaths” and that “uncertainty” surrounds the “commitment by Congress” and the outcome of the presidential election. Saying that “PEPFAR itself also needs to continue to adjust its priorities,” Merson states that “treatment, prevention, care, health system capacity and scientific research to develop an HIV vaccine require financial commitment, strong political will and investment in resources from all stakeholders. Let us not fall behind now and bring back the suffering of the past” (7/20).
Noting the successes of PEPFAR and the Global Fund to Fight AIDS, Tuberculosis and Malaria, former President George W. Bush writes in a Washington Post opinion piece that “[a]n important byproduct of this massive effort on HIV/AIDS has been the improvement of African health systems,” which “has raised an exciting prospect: to extend the gains on AIDS to other diseases.” Bush also discusses his work with the Pink Ribbon Red Ribbon, a public-private partnership initiative spearheaded by the Bush Institute to save women from breast and cervical cancer. Over the past decade a “global effort” has saved millions of lives, he says, adding, “It would be a sad and terrible thing if the world chose this moment to lose its focus and will.” Bush concludes, “Other countries and local governments in Africa can do more in providing resources and increasing funding … [b]ut to continue the momentum in the fight against AIDS, America must continue to lead” (7/22).
The Associated Press on Saturday examined the HIV/AIDS epidemic in Uganda, where “[a] new government report says the prevalence of HIV in this East African nation increased from 6.4 percent in 2004 to 7.3 percent in 2011, a shocking statistic for a country once praised for its global leadership in controlling AIDS.” The news service highlights PEPFAR’s contributions to fighting the epidemic in Uganda, noting that “[a]t least half of the 600,000 Ugandans in need of AIDS treatment are able to access the drugs, mostly through PEPFAR.” According to the AP, “U.S. government officials have been pressing Uganda to devote more resources to AIDS and issues such as maternal health, saying dependency on foreign support is unsustainable in the long term.” On a recent trip to the country, Rep. Barbara Lee (D-Calif.) said meeting patients benefitting from PEPFAR-funded treatment “was confirmation of the fact that United States foreign aid works,” the AP writes (Muhumuza, 7/21).