In this post on the Center for Global Development’s (CGD) “Global Health Policy” blog, Mead Over, economist and senior fellow at CGD, previews his participation in a panel that took place Monday evening at the XIX International AIDS Conference. Participants discussed whether AIDS spending is a sound investment in a resource-constrained environment (7/23). Additional information regarding the debate, which was held at World Bank headquarters and included several high-level speakers, is available on the World Bank website (7/23).
Global Health Conferences and Meetings
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).
In an opinion piece in The Hill’s “Congress Blog,” international health consultant Taufiqur Rahman argues that funding for the HIV/AIDS response is sufficient. He says countries should pay for their own first-line antiretroviral treatment, integrate programs to include HIV prevention activities and apply pressure to bring down the cost of second-line drugs. “We are not using technology and best practices sufficiently to accelerate and sustain our gains to save more lives quickly and build country systems,” Rahman states, adding, “We do not need more funds. We need to be smarter about investing existing resources of $8 billion with careful planning, economic analysis, proper prioritization, and lots of coordinated as well as collaborative efforts.” He continues, “We now need to focus on a ‘Transition Strategy’ with countries and this requires serious rethinking and refocusing. Let us have one global strategy of transition, critical investment, and country capacity building. Focus on collaboration, integration, revised national strategy and national financing to win this battle” (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).
In a feature analysis, Devex examines the history of PEPFAR, the program’s sustainability, its use of public-private partnerships, and the potential impact of the closure earlier this month of the Global Health Initiative (GHI) office. Noting that next year marks the 10-year anniversary of PEPFAR, Devex concludes, “The Obama administration’s apparent about-face on components of GHI is but one reminder that in Washington — especially as administrations come and go — ideas, initiatives, and funding often fade away all too quickly. The U.S. foreign aid industry is no exception. If PEPFAR can continue its commitment to innovation and partnership, however, visitors to the U.S. capital this week [for the International AIDS Conference] can still be hopeful over America’s leadership role in the fight against HIV/AIDS” (Troilo/Piccio, 7/23).
Bill Gates Stresses Importance Of Investment In Both HIV Treatment And Research For Vaccines, Microbicides
In a symposium session on Monday at the XIX International AIDS Conference in Washington, D.C., politicians and public health experts joined Bill & Melinda Gates Foundation Co-Chair Bill Gates for a discussion about improving effectiveness and efficiency in the HIV/AIDS response, the Washington Post reports (Brown/Botelho, 7/23). “Gates … reiterated the importance for nations and donors to support research, but also expressed support for ongoing treatment initiatives in the meantime,” according to Agence France-Presse. “No one should think that we have got the tools yet. We will get the tools but only if we stay the course in terms of the scientific investments,” Gates said, AFP notes (Sheridan, 7/23). The Washington Post adds that “[t]he main one lacking is a vaccine, but also important and missing are woman-controlled means to prevent infection, such as a vaginal microbicide” (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).
RECENT RELEASE: CSIS Blog Posts Highlight Panel Discussions On PEPFAR, Examine Challenges To Administering Treatment-As-Prevention
“In advance of the XIX International AIDS Conference — AIDS 2012 — CSIS celebrated the release of the special supplement of the Journal of AIDS focused on PEPFAR” with an event organized in cooperation with the Office of the Global AIDS Coordinator (OGAC),” the Center for Strategic & International Studies’ (CSIS) “Smart Global Health” blog reports. According to the blog, the event “featured contributing authors and guest editors who are leading figures in PEPFAR and the international HIV/AIDS community” participating “in wide-ranging discussions of the successes and challenges of PEPFAR, from its inception to its future” (Fisher/Kramer, 7/23). In a related post in the blog, Phillip Nieburg, a senior associate at the CSIS Global Health Policy Center, examines the challenges of adopting treatment-as-prevention as a strategy to achieve an “AIDS-free generation” (7/23).
Susan Blumenthal, public health editor at Huffington Post and former U.S. assistant surgeon general, and Michelle Moses-Eisenstein, an Allan Rosenfield Health Policy Fellow with amfAR, the Foundation for AIDS Research in Washington, write in the Huffington Post Blog that the International AIDS Conference, held in Washinton this week, “will highlight opportunities for achieving an AIDS-free generation.” They add, “Of great concern right now is that the remarkable progress toward ending AIDS that has been made over the past decades is being threatened by a decline in resources and the threat of budget cuts to support HIV research and services worldwide.” They conclude, “If we are going to eradicate AIDS in America and worldwide, then a global strategic plan for achieving an HIV-free generation is needed that mobilizes all sectors of society across countries, scales up interventions that work to reach more people, makes programs more efficient and accountable, and invests in research to accelerate progress in ending HIV/AIDS, including intensifying efforts to discover both a cure and a vaccine” (7/23).