“Health care, taxes, energy, favorite flavor of ice cream — it seems our elected leaders must disagree at every turn. But one issue that has so far repulsed the partisan pressures of the times was highlighted [at the XIX International AIDS Conference (AIDS 2012)] in our nation’s capital last week: the fight against HIV/AIDS,” former Senate Majority Leader Bill Frist (R-Tenn.) writes in an opinion piece in “The Week.” He says, “The conference was a celebration of the remarkable success made because of this leadership, and a call for continued support” in the response against HIV/AIDS. Noting he moderated a panel discussion with Rep. Barbara Lee (D-Calif.) and Sens. Chris Coons (D-Del.), Marco Rubio (R-Fla.) and Mike Enzi (R-Wyo.) on congressional bipartisanship at the conference, Frist continues, “I witnessed what I felt to be an accurate portrayal of how we got to the point where we could celebrate so many successes. Fundamental to the progress has been bipartisanship.”
U.S. Secretary of State Hillary Clinton “expressed concern” over Uganda’s increasing number of HIV infections on a visit to the country last week, part of an 11-day trip to eight African nations, Uganda’s New Vision reports (Mukasa, 8/4). According to the Observer, Clinton “said while America recognizes the strides Uganda made in the 1990s when HIV prevalence dropped from 20 percent to seven percent, prevalence is now rising.” PEPFAR is the largest donor for HIV programs in the country, the newspaper notes, adding that “[t]he U.S. government recently committed $25 million to help Uganda eliminate mother-to-child HIV transmission and … [m]ore than 300,000 Ugandans are receiving treatment through PEPFAR” (Mwesigye, 8/5). “The reversal is particularly disappointing to health experts given the time and attention that have been focused on AIDS here, and the billions of dollars spent,” the New York Times writes (Kron, 8/2). “I am hoping that we can work together to make prevention the focus again. We are going to review our strategy because we want to emphasize what will work,” Clinton said, according to the Observer (8/5).
“For nearly two years, not a single child with HIV has been born at the public hospital in the Cite-Verte district of Yaounde, the capital of Cameroon,” Inter Press Service reports, adding, “Emilien Fouda, the hospital’s director, says this proud record is the result of combined effort by his staff and community support groups.” The news service discusses efforts to prevent mother-to-child transmission at the hospital, highlighting a program run by a community group called the No Limit for Women Project (NOLFOWOP). “‘The [program] includes awareness-raising, voluntary — and confidential — screening for HIV, testing for other sexually transmitted infections, and birthing practices that minimize the risk of HIV transmission,’ Fouda told IPS,” the news service writes. However, IPS notes, “Community support groups like NOLFOWOP are only present at some of the country’s hospitals, and not all public health centers systematically test women giving birth for HIV” (Nzouankeu, 8/3).
In this post on the Center for Global Development’s (CGD) “Global Health Policy” blog, CGD’s Victoria Fan, Rachel Silverman, and Amanda Glassman examine “the preliminary report [.pdf] on the pilot of PEPFAR’s Expenditure Analysis Initiative, an important and exciting move by PEPFAR towards evidence-based decision making and greater transparency.” Expenditure analysis (EA) “provides an account of where money gets spent and on what,” they continue, adding, “Here’s why it could be a game changer: This seemingly simple tool is essential for realizing huge potential gains in both technical and allocative efficiency, two core components of value for money.” After describing some of the report’s shortcomings, they write that “the report demonstrates the wide range of potential applications for using EA to improve value for money, which is particularly encouraging given PEPFAR’s plans to institutionalize EA into its routine annual reporting” (8/1).
The XIX International AIDS Conference (AIDS 2012) that took place last week in Washington, D.C., “ignited momentum to shift from ‘fighting AIDS’ to ‘ending AIDS,’” Mohga Kamal-Yanni, senior health adviser at Oxfam International, and Urvarshi Rajcoomer, policy and advocacy adviser at Oxfam in South Africa, write in a Mail & Guardian opinion piece. “Oxfam believes investing in health systems such as infrastructure and health worker, drug supply chain and health information systems, is a critical prerequisite to ending AIDS,” they write. However, “to make this a reality,” pharmaceutical companies, donor governments, the Global Fund to Fight AIDS, Tuberculosis and Malaria, and the World Bank “must now do their part,” they continue.
Noting the United Nations last week “announced the appointment of Dr. Michel Kazatchkine, the former head of the Global Fund to Fight AIDS, Tuberculosis and Malaria, as the U.N. Secretary-General’s new special envoy for HIV/AIDS in Eastern Europe and Central Asia,” Kasia Malinowska-Sempruch, director of the Open Society Foundations’ global drug policy program, writes in this Huffington Post opinion piece, “[W]hile Dr. Kazatchkine’s skills will be principally devoted to a handful of E.U. Member States and some neighbors, all of Europe would be wise to heed his guidance on the importance of sensible drug policies in the HIV response.” She continues, “As a member of the Global Commission on Drug Policy — a body of experts from politics, health, academia and business — Dr. Kazatchkine reminded leaders that ‘the war on drugs has fueled the HIV epidemic.’”
“PrePex, a bloodless circumcision device for adults, will be tested in at least nine African countries in the next year, according to the backers of the tests,” the New York Times reports. PEPFAR “will pay for PrePex circumcisions for about 2,500 men in Lesotho, Malawi, South Africa, Tanzania and Uganda, said Dr. Jason B. Reed, a technical adviser to the plan,” the newspaper writes. “The Bill & Melinda Gates Foundation will pay for similar studies in Kenya, Mozambique, South Africa, Zambia and Zimbabwe,” it adds. According to the New York Times, the device “was approved by the Food and Drug Administration in January, and World Health Organization approval is expected soon.” The newspaper notes, “No surgeon is needed for the procedure; a two-nurse team slides a grooved ring inside the foreskin and guides a rubber band to compress the foreskin in the groove,” and adds, “After a week, the dead foreskin falls off like the stump of a baby’s umbilical cord or can be painlessly clipped off, said Tzameret Fuerst, chief executive of PrePex” (McNeil, 8/13).
In this post in Huffington Post’s “Impact” blog, Deborah Derrick, president of Friends of the Global Fight Against AIDS, Tuberculosis and Malaria, examines “the success of U.S. efforts to promote better global health through support for [PEPFAR] and the Global Fund to Fight AIDS, Tuberculosis and Malaria.” She highlights U.S. Secretary of State Hillary Clinton’s recent trip to Africa, writing that Clinton’s “encouraging words” at the Reach Out Mbuya health center in Uganda reinforced U.S. commitment to an AIDS-free generation. She notes both PEPFAR and the Global Fund have supported the center and adds that “through hundreds of similar local programs all over the world, the Global Fund provides treatment to 3.6 million people who are HIV-positive.”
In this post in BMJ’s “Yankee Doodling,” Douglas Kamerow, chief scientist at RTI International and an associate editor for the journal, reflects on the possibility of achieving an AIDS-free generation “if somehow we succeeded in getting all HIV positive people in the world identified and under long term treatment.” He writes that while there has been “astonishing progress against AIDS,” “two concerns immediately arise: the magnitude of the work remaining to find and continuously treat all those infected, and the confusion between that treatment (even if it is somehow universally successful) and actual eradication of the disease.” He concludes, “It is a rosy scenario, but even if it came true it still would not spell the end of the HIV story,” because “[w]e have no vaccine, and the virus keeps mutating” (8/14).
The Center for Global Health Policy’s “Science Speaks” blog examines how the “U.S. travel bans on people involved in sex work and people who have used illegal drugs … kept many of the people at highest risk from coming to the [XIX International AIDS Conference (AIDS 2012)]” in Washington, D.C., last month. “The result, observers said afterward, was a larger conference with fewer sex workers than had brought their first-hand experiences and concerns to Vienna and Mexico City,” according to the blog. Carlos Laudari, senior technical adviser for HIV AIDS prevention at Pathfinder, “and others said those in absentia were not the only ones disempowered; the loss of sex worker and drug user input on how to realize the goals of treatment as prevention, on barriers to funding, testing, health care access, and for that matter, on the difference between sex work and sex trafficking — commonly, and erroneously equated — weakened the dialogue and the action they were intended to inform,” the blog writes and quotes several other advocates (Barton, 8/8).