“Data presented from the FEM-PrEP trial by Dr. Lut Van Damme Tuesday [at the 19th Conference on Retroviruses and Opportunistic Infections in Seattle] highlighted the challenge that adherence plays in successfully deploying effective Pre-Exposure Prophylaxis (PrEP) interventions,” HIV Medicine Association Executive Director Andrea Weddle writes in this guest post in the Center for Global Health Policy’s “Science Speaks” blog. “The FEM-PrEP study was conducted to evaluate the protective effect of a daily oral dose of emtricitabine/tenofovir disoproxil fumerate (FTC/TDF) among African women, but was halted early, in April 2011,” because of “interim data analysis showing similar rates of new HIV infections among women taking daily FTC/TDF and the placebo arm,” Weddle notes. Van Damme said blood monitoring did not show levels of the drug consistent with self-reported adherence rates, according to Weddle (3/6).
“Global health programs now teeter on the edge of disaster,” Foreign Affairs writes in this feature article, adding, “The world economic crisis and the politics of debt reduction are threatening everything from malaria control and AIDS treatment to well-baby programs and health care worker training efforts.” The article provides a historical overview of global health programming and funding. “Like it or not, the burden of reducing suffering and increasing the health of the world’s poor now falls largely on the backs of the two Washingtons,” Foreign Affairs writes, referring to politicians in Washington and the Washington state-based Bill & Melinda Gates Foundation. The article concludes, “It would be a catastrophe were the ‘age of generosity’ to end so soon after it began, leaving millions without life-sparing medicines and tools they have come to rely upon” (Garrett, 5/6).
Nature examines how funding shortfalls are hampering global efforts to use drugs to curb the spread of HIV, writing, “[A]t this week’s annual Conference on RetroÂviruses and Opportunistic Infections in Seattle, Washington, there was growing concern that financial austerity in the United States and elsewhere is eating away at the funding needed for a worldwide prevention effort.” The journal cites proposed reductions “to direct international aid for HIV programs under the President’s Emergency Plan for AIDS Relief (PEPFAR)” in President Barack Obama’s FY 2013 budget request and an announcement by the Global Fund to Fight AIDS, Tuberculosis and Malaria last November that it had cancelled Round 11 grants “until 2014 because of tightening budgets in donor countries.”
The Wall Street Journal examines how many HIV-positive Ethiopians coming to a “squatter’s camp” at Ethiopia’s Entoto Mountain in the hopes that a spring believed to contain holy water would cure HIV instead begin treatment with antiretrovirals (ARVs). “The country’s traditional and often superstitious views toward AIDS commonly lead to exile for the disease’s sufferers,” the newspaper writes, adding, “But modern methods are gaining more purchase, in recent years resulting in a greater number of Ethiopians on antiretroviral therapy and a decline in AIDS-related deaths.”
Ukraine Security Secretary Says HIV, TB Remain Threat To Nation’s Security, Encourages Cooperation With Global Fund
Speaking about two bills concerning Ukraine’s cooperation with the Global Fund to Fight AIDS, Tuberculosis and Malaria, Ukraine Secretary of National Security and Defense Council Andriy Kliuyev said “[t]he epidemics of AIDS and tuberculosis [TB] remain a threat to national security in Ukraine and require redoubled efforts to treat and prevent these diseases,” Interfax reports. Submitted to Ukraine’s parliament by the Cabinet of Ministers, the two bills “propos[e] to exempt from taxes and duties all transactions connected with the use of grants from the Global Fund to Fight AIDS, Tuberculosis and Malaria in Ukraine,” the news agency notes. “The NSDC secretary said the state should explore every avenue to minimize the sickness rate and create conditions for the treatment and prevention of dangerous diseases, adding that the grants of the Global Fund to Fight AIDS, Tuberculosis and Malaria are valuable support for Ukraine,” Interfax writes (3/3).
Russia Should Abandon ‘Zero-Tolerance’ Approach To Drug Use And Implement Proven Prevention Strategies
Why have effective, “simple tools such as Medication Assisted Therapy (methadone, buprenorphine) and clean needle-exchange services” — methods that are “very effective in decreasing drug abuse and reducing risk of infection with HIV, hepatitis C and other diseases” â€“ “had so little impact on the policies and programs of the Russian Federation?” Bertrand Audoin, executive director of the International AIDS Society, and Chris Beyrer, a professor at the Johns Hopkins Bloomberg School of Public Health, write in this New York Times opinion piece. With an “estimated number of injecting drug users [at] 1.8 million, and the estimated number of opiate users exceed[ing] 1.6 million,” and more than one million people living with HIV, “Russia now accounts for two thirds of the Eastern Europe and Central Asian HIV epidemic, the fastest growing in the world,” they write.
“Nine global HIV/AIDS advocacy organizations sent a letter [.pdf] to President Obama Thursday asking him to rethink his fiscal year (FY) 2013 budget recommendation to slash $546 million in funding from the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) program,” the Center for Global Health Policy’s “Science Speaks” blog reports. The groups, which include AVAC: Global Advocacy for HIV Prevention, the HIV Medicine Association, and POZ Magazine, noted the request “recommended funding the Global Fund to Fight AIDS, Tuberculosis and Malaria at $1.65 billion — keeping the U.S. on track to reach its three-year commitment of $4 billion by 2013,” but in the letter stated, “[W]e must and we do strongly object to the apparent shoring up of the Global Fund budget request at the expense of the PEPFAR program. … These two programs are synergistic and often provide complementary services to the same communities,” the blog notes (Mazzotta, 3/2).
Zimbabwe Parliamentarians Lauded For Undergoing Voluntary HIV Counseling, Testing And Male Circumcision
“More than 170 [of Zimbabwe’s] parliamentarians from across the political divide have resolved to undergo voluntary counseling and HIV testing in a bid to encourage the grassroots to follow suit,” and “the 150 male members in the 175-member group have also resolved to be circumcised,” a Herald editorial states. “Members of Parliament are regarded as role models whose power of influence in society is immense,” the editorial writes, adding, “And as leaders, their message is readily received particularly if it is coupled by exemplary behavior in the communities they serve.”
Will McKitterick, a research assistant with the Center for Global Development (CGD), in this “Rethinking U.S. Foreign Assistance” blog post summarizes Secretary of State Hillary Clinton’s “grueling marathon of Congressional committee hearings in defense of the FY2013 international affairs budget request.” The nine hours of hearings “ran the gamut of U.S. priorities in national security and foreign policy,” McKitterick writes, adding, “Congressional leaders seemed alarmed by reductions in global health spending and raised specific concerns over the administration’s ability to meet its commitments to its PEPFAR goal of placing six million people on life-sustaining treatment by 2013. Secretary Clinton assured the committees that cuts would be balanced by consolidating programs, finding efficiencies, improving partners’ capacity, and shifting more responsibilities to host countries” (3/2).
“Kenya’s most recent male circumcision rapid results initiative failed to meet its target, and officials are stepping up efforts to identify and fix the problems that could foil the government’s campaign to circumcise more than one million men by 2013,” PlusNews reports. “Conducted between November and December 2011, the initiative aimed to circumcise 70,000 men over a 30-day period, but results released in February show that only 40,000 men were circumcised,” the news service writes, adding, “This is the first time the annual initiative — which began in 2008 — has failed to reach its target.”