In a study published online in the Proceedings of the National Academy of Sciences, Till Barnighausen, David Bloom, and Salal Humair of the Harvard School of Public Health examine “whether [HIV treatment as prevention (TasP)] is indeed a game changer or if comparable benefits are obtainable at similar or lower cost by increasing coverage of medical male circumcision (MMC) and antiretroviral treatment (ART).” They write, “The most cost-effective HIV prevention strategy is to expand MMC coverage and then scale up ART, but the most cost-effective HIV-mortality reduction strategy is to scale up MMC and ART jointly. TasP is cost effective by commonly used absolute benchmarks but it is far less cost effective than MMC and ART” (12/6).
In its continuing series titled “The State of AIDS,” GlobalPost examines the HIV/AIDS epidemic in Latin America and the Caribbean, where “[m]ajor gains have been made in the fight against the spread of HIV” over the past decade, particularly in stopping mother-to-child transmission (MTCT). However, some countries in the region have some of the highest HIV/AIDS prevalence rates outside of sub-Saharan Africa; “the disease continues to spread among certain at-risk populations,” such as men who have sex with men; and “nearly one-third of those infected in Latin America are still not getting treated,” the news service reports.
IRIN examines the WHO’s ongoing efforts to synthesize and communicate guidance about the risk of HIV infection and transmission for women taking injectable hormonal contraception, including a meeting scheduled for this week in Geneva. The news service looks at the history of the issue, including “a February 2012 [WHO] statement standing by current guidelines allowing women living with or at high risk of HIV to use hormonal contraception” and advising women on injectable contraception to use condoms concurrently; reaction from representatives of non-governmental organizations and WHO officials; and efforts by researchers to “formulat[e] a concept note on a clinical trial that could be the world’s first to examine whether hormonal contraception does indeed increase HIV risk” (12/5).
Al Jazeera examines HIV/AIDS in the Persian Gulf, writing, “For much of the past two decades, there has been an information vacuum in the Gulf for epidemiological data on HIV and AIDS. According to a study by the World Bank, the Middle East and North Africa remains ‘the only region where knowledge of the HIV epidemic continues to be limited and subject to much controversy.'” The news service notes, “Much of this has to do with cultural objection to some of the means of transmission, particularly in cases of men who have sex with other men (MSM),” and the article discusses how “Qatar and other [Gulf Cooperation Council] countries are making progress tackling these taboos” (Chappelle, 12/5).
IRIN examines exclusive breastfeeding practices in Kenya, writing, “The country’s push for exclusive breastfeeding appears to be working; according to the 2009 Kenya Demographic and Health Survey, 32 percent of babies are exclusively breastfed up to the age of six months, up from just 13 percent in 2003.” Kenya hopes “a new law (.doc) banning the promotion of infant formula … will contribute to the government’s push to encourage all mothers to breastfeed exclusively for at least six months,” the news service writes. IRIN continues, “Kenya has adopted the [WHO] recommendation that HIV-positive mothers should exclusively breastfeed their infants for the first six months of life, introducing appropriate complementary foods thereafter, and continue breastfeeding for the first 24 months of life.”
Through travel to Africa and “[a]s chairman and ranking member of the Senate Foreign Relations Subcommittee on African Affairs, we’ve seen firsthand the enormous toll of HIV/AIDS on families, communities and economies,” Sen. Chris Coons (D-Del.) and Sen. Johnny Isakson (R-Ga.) write in the Huffington Post’s “Politics” blog. “On December 1st, we marked World AIDS Day by honoring the lives lost to the scourge of AIDS and by recommitting ourselves to building an AIDS-free generation and ending this pandemic once and for all,” they write, adding, “Although we come from different political parties, we stand together in our belief that the United States should remain a global leader in the fight against HIV/AIDS.”
The Skoll World Forum and the Bill & Melinda Gates Foundation’s “Impatient Optimists” blog have co-produced a blog series highlighting key challenges in the global response moving forward and examining how the international community can overcome these challenges. The following summarizes three posts included in the series.
Last week, the U.S. government announced up to $7.5 million in grants over the next two years to fund “implementation science projects exploring how to achieve the goal of eliminating new pediatric HIV infections while keeping mothers alive,” the Center for Global Health Policy’s “Science Speaks” blog reports (Barton, 12/5). According to a State Department press release, “Implementation science is critical to ensure that evidence-based and scalable interventions address current barriers to effective PMTCT programs. The results from successful operational and implementation science research are essential to improved program and health system performance” (11/28).
Devex’s “Pennsylvania Ave.” blog reports on reaction from the international development community to the release last week of the “President’s Emergency Plan for AIDS Relief (PEPFAR) Blueprint: Creating an AIDS-free Generation” (.pdf). “In general, aid groups welcomed the release of the blueprint and urged other donors to follow the United States’ lead,” the news service writes, adding, “There are, however, some groups that were disappointed with the lack of concrete funding commitments, among other details.” Devex provides reaction from DAI, Management Sciences for Health, and World Vision and quotes representatives of Save the Children, Abt Associates, and UNAIDS (Mungcal/Valdez, 12/4).
Global Post examines how “many [HIV] patients around the world continue to turn to more affordable but far less reliable treatments” instead of proven — but more expensive — therapies, such as antiretroviral (ARV) drugs. “These interventions, founded in belief rather than biology, can in fact worsen the spread of HIV,” the news service writes. As researchers search for a scientific-based cure or vaccine, “[h]ealth workers hope increased awareness and further research into the virus will help eradicate the spread of HIV,” GlobalPost writes, noting it “is encouraging is that funding is being provided to help scientists in their groundbreaking work” (Connolly, 12/4).