KPLU 88.5’s “Humanosphere” blog reports on a meeting of the HIV Vaccine Trials Network (HVTN), “the world’s largest HIV vaccine research network,” held in Seattle this week. “We actually don’t know what the agenda is,” HVTN Executive Director Jim Kublin said during a lecture, titled “Scientific Agenda, the Next Seven Years,” according to the blog. “But what makes it easier to laugh about not knowing where you’re going, he added, is that researchers today have a lot more tantalizing clues — beginning with the ground-breaking Thai vaccine trial known to this bunch as RV144,” the blog writes and describes the study (Paulson, 10/31).
As part of its “Blueprint” series discussing the creation of a U.S. global AIDS blueprint called for by Secretary of State Hillary Clinton in July, the Center for Global Health Policy’s “Science Speaks” blog features an opinion piece by Salmaan Keshavjee of Harvard Medical School and Partners In Health. With an estimated 1,000 people with HIV dying of tuberculosis (TB) every day, “[i]t is clear that our current approaches to addressing the global tuberculosis pandemic are inadequate,” he writes. Keshavjee says, “First, bold targets for reducing tuberculosis incidence and zero TB-HIV deaths must be prioritized in the blueprint. … Second, known strategies for stopping the spread of tuberculosis have to be actively implemented. … Lastly, any effective strategy has to ensure that HIV advocates at the community level are educated about the threat of tuberculosis,” and he describes each of his points in detail. He concludes, “The United States has shown visionary leadership in the area of HIV treatment and changed the lives of countless people for the better. It is time to take on tuberculosis with the same moral and pragmatic vigor” (Barton, 10/31).
The International HIV/AIDS Alliance has been providing technical support for UNAIDS since 2011 to assist policymakers in integrating human rights programs into National Strategic Plans for HIV (NSPs), the organization’s blog states and notes, “As part of the project, three regional workshops were held for: East and Southern Africa; the Middle East and North Africa; and the Asia/Pacific regions.” The blog continues, “The workshops aimed to increase participantsâ€™ knowledge of why human rights and HIV programs must be connected, and how a lack of integration is undermining the effectiveness of the HIV response.” A report, co-published by UNAIDS and the Alliance and titled “Making it Work,” provides “some short-term outcomes and lessons learnt from this initiative,” according to the blog (10/24).
The Associated Press examines access to antiretroviral treatment in Myanmar, which “ranks among the world’s hardest places to get HIV care, and health experts warn it will take years to prop up a broken health system hobbled by decades of neglect.” The country, also known as Burma, has been hindered by decades of rule by a military junta and economic sanctions imposed by developed countries, including the U.S., the AP notes, and writes, “Of the estimated 240,000 people living with HIV [in the country], half are going without treatment.” However, “as Myanmar wows the world with its reforms, the U.S. and other nations are easing sanctions,” the news agency writes, adding, “The Global Fund [to Fight AIDS, Tuberculosis and Malaria] recently urged Myanmar to apply for more assistance that would make up the shortfall and open the door for HIV drugs to reach more than 75 percent of those in need by the end of 2015,” as well as medications to fight tuberculosis (TB). The AP details one man’s efforts to obtain antiretrovirals, which are reserved for patients with CD4 cell counts below 150 cells, versus the WHO recommended 350 (Mason, 10/22).
In the last of a series of posts on the U.K. Department for International Development’s (DfID) blog examining the department’s work in Malawi, Neil Squires, DfID head of profession for health, looks at the sustainability of the country’s HIV/AIDS program. “Malawi’s success in increasing access to antiretroviral drugs for HIV is highly dependent on donor funding for medicines,” he writes, adding, “Malawi has to actively consider its resource allocation in order to maximize the benefits and the health gained from the limited resources available.” He notes a report commissioned by UNAIDS on Malawi concluded that “unless Malawi can reduce the incidence of new infections, the scale up in access to antiretroviral drugs will not be sustainable in the medium to long term.” He concludes, “This is an important issue for the Government of Malawi, but also for the key donors who have supported the massive scale up in access to drugs, particularly the Global Fund. Malawi will need to maintain high levels of funding from the Global Fund if it is to maintain its supply of antiretroviral drugs” (10/23).
Speaking on Monday in Luanda, Angola, at the opening session of the inaugural meeting on Medical Education, sponsored by the Faculty of Medicine of Agostinho Neto University, WHO Regional Director for Africa Luis Gomes Sambo said communicable diseases account for 63 percent of deaths in Africa, with HIV and tuberculosis (TB) responsible for the majority of those, the Angola Press reports. Nonetheless, Africa has made significant progress against HIV/AIDS and malaria, as well as in improving child and maternal mortality, he said, according to the news service (10/22). Sambo also “said on Monday in Luanda that the population’s health depends on the provision of health care for those [in] need, as well as the efforts made by the society to protect, promote and re-establish the people’s well-being,” another article from Angola Press notes (10/23).
In a post in the Center for Global Health Policy’s “Science Speaks” blog, Lucica Ditiu, executive secretary of the Stop TB Partnership, examines the need to include tuberculosis (TB) in the global AIDS response blueprint that Secretary of State Hillary Clinton announced at the XIX International AIDS Conference (AIDS 2012), writing, “At present one in four AIDS-related deaths is precipitated by TB. … All people living with HIV need to get tested for TB and receive TB treatment if they have the disease.” She continues, “We urge PEPFAR to include in the blueprint explicit TB/HIV indicators and activities,” and she provides five examples (10/23).
During a meeting with UNAIDS Executive Director Michel Sidibe on Tuesday, Indonesia Minister of Health Nafsiah Mboi “pledged to scale up HIV testing and treatment programs” with a “focus on 141 districts where key affected populations are the highest,” a UNAIDS feature story reports. “Indonesia also plans to become one of several countries in the region to offer universal health care by 2014,” with HIV treatment to be covered, according to the health ministry, UNAIDS notes. Sidibe said, “Indonesia is a key partner in the drive to end the AIDS epidemic. … Universal health coverage is a game changer for Indonesia. I am delighted to know that HIV treatment will be included in this national program. This sets the stage for sustainable funding of HIV programs,” the article states. “The Ministry of Health estimates that more than 600,000 people are living with HIV and that there are more than 76,000 new HIV infections each year,” according to UNAIDS, which adds, “Currently HIV treatment coverage is at less than 20 percent” (10/23).
Oxfam Says 'No Evidence' AMFm Has Saved Lives; Global Fund Says Claims Are 'Untrue,' Guardian Reports
Noting “[t]he U.K. government has contributed Â£70 million [$112 million] to the Affordable Medicines Facility for malaria (AMFm),” the Guardian reports, “The charity Oxfam has cast doubt on [the] international scheme that aims to boost the provision of the most effective treatment for malaria.” According to the newspaper, “Oxfam says there is no evidence the program has saved the lives of the most vulnerable people” and “has criticized it as ‘risky and dangerous.'” But “[t]he body behind the AMFm says an independent study shows it has improved access and reduced drug prices,” and “[t]he Global Fund said Oxfam’s claims were ‘simply untrue,'” the Guardian writes, adding, “A DfID spokesman said: … ‘Studies have shown that quality drugs have got through to remote areas — and that more vulnerable groups, including children under five in rural areas and from the poorest backgrounds, are now being reached'” (Dreaper, 10/24).
In the Huffington Post’s “Politics” blog, Serra Sippel, president of the Center for Health and Gender Equity, notes that Secretary of State Hillary Rodham Clinton said at the XIX International AIDS Conference in July that all women should be able to decide “when and whether to have children” and that PEPFAR, in a guidance [.pdf] released last week, said, “Voluntary family planning should be part of comprehensive quality care for persons living with HIV,” and referred to family planning as a human right. “Then, in bold type, they punctuated it with, ‘PEPFAR funds may not be used to purchase family planning commodities,'” she writes. “They take it a step further with a caveat that before anyone decides they’d like their program to have anything to do with family planning, they had best consult relevant U.S. legal counsel first,” she adds. “To be fair, they do say that PEPFAR programs can just refer women to a different program that offers family planning,” but those programs are not always available, Sippel writes, adding, “So the suggestion is flawed from the start.”