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).
“Methadone treatment is proving to be the most efficient way to wean people in Bangladesh from addiction to buprenorphine, a pharmaceutical drug, and health experts say it should be expanded to reach thousands more drug users to prevent the spread of HIV,” IRIN reports. The news service notes that “illegal use of pharmaceutical substances, mostly buprenorphine, is on the rise” in the country. “Buprenorphine was intended to be used to wean injecting drug users, also known as people who inject drugs (PWID), from narcotics like heroin, but has itself become a substance of addiction, with users injecting a liquid form of it,” the news service notes, adding, “Methadone, a pain reliever, suppresses withdrawal symptoms and blocks craving.”
In this post in Huffington Post’s “Healthy Living” blog, John-Manuel Andriote, a journalist and author living with HIV, writes, “For all of us living with HIV infection — Oct. 27 will mark seven years since my own diagnosis — the question we face daily, hopefully more consciously and deliberately than most, is how shall we live, knowing as we do that we will most assuredly die one day?” Reflecting on the XIX International AIDS Conference (AIDS 2012) that took place in Washington last month, he continues, “An AIDS-free generation is certainly a worthy goal,” but “even if tens of billions of additional dollars are allocated to address HIV/AIDS, even if the Republicans don’t succeed in inflicting their Darwinian ‘survival of the fittest’ upon the nation and the world, the question will continue to be what it has been for 31 years … Will we have the political will to end AIDS?”
India on Monday “opened a $12 million, government-backed laboratory whose mission is to create a new vaccine against HIV,” Science Insider reports. “The HIV Vaccine Translational Research Laboratory, which aims to recruit about 30 scientists, is embedded within the Translational Health Science and Technology Institute, a $200 million facility under development on the outskirts of New Delhi” and “will work in collaboration with the New York based-International AIDS Vaccine Initiative (IAVI),” the news service writes, noting “operating costs will be shared equally” (Bagla, 8/14). “Former president A.P.J. Abdul Kalam launched the [laboratory] in New Delhi on Monday at a symposium on accelerating India’s search for an HIV vaccine,” the Wall Street Journal’s livemint.com writes. “Promising ‘strong political will’ at the highest level, health minister Ghulam Nabi Azad said, ‘A preventive vaccine for HIV/AIDS is the best hope to end this epidemic,'” and “added that the step was an initiative to reinforce a national response in the global fight against disease,” the news service notes (Krishnan, 8/13).