In this interview in World Politics Review’s “Trend Lines,” Peter Navario, an adjunct associate professor of public policy at New York University and a former global health fellow at the Council on Foreign Relations, discusses the evolution South Africa’s HIV/AIDS policy over the last decade, the country’s current relationship with pharmaceutical companies, and how South African President Jacob Zuma’s HIV/AIDS policy is received in the region and by international donors. “South Africa has gone from global laggard to playing a leading role in the global HIV response,” Navario said, adding that the country’s “policies are in lockstep with World Health Organization guidelines, and an aggressive new strategic plan aims to tackle HIV-related stigma, meet 80 percent of treatment need and cut new infections in half by 2016” (3/7).
In a plenary presentation at the 19th Conference on Retroviruses and Opportunistic Infections (CROI) in Seattle on Wednesday, Dorothy Mbori-Ngacha of UNICEF examined the challenges to reaching the goal of an AIDS-free generation, by “eliminat[ing] 90 percent of HIV infections among children by 2015,” and “outlined the four pillars of achieving that goal,” including preventing HIV among women, preventing unintended pregnancies, preventing mother-to-child transmission (PMTCT), and supporting HIV-positive women and their families, the Center for Global Health Policy’s “Science Speaks” reports. She called for strengthening family planning programs in the context of PMTCT, prioritizing “pregnant women for access to pre-exposure prophylaxis (PrEP) or microbicides,” implementing strategies to initiate and care for women in treatment programs, and intervening early in pregnancy, according to the blog (Lubinski, 3/7).
Odds Of Adult Mortality Lower In PEPFAR Focus Countries Compared With Non-Focus Countries, Study Shows
“In an attempt to assess the impact of U.S. international assistance for AIDS, researchers from Stanford University carried out a review of the relationship between U.S. support provided through the President’s Emergency Plan for AIDS Relief (PEPFAR) and adult mortality in PEPFAR focus countries in sub-Saharan Africa, and whether there were differences in outcome between these countries and other African countries which did not receive PEPFAR support,” NAM’s Aidsmap reports (Alcorn, 3/8). Presenting the results at the 19th Conference on Retroviruses and Opportunistic Infections (CROI) in Seattle on Wednesday, Eran Bendavid said “[s]tatistical analysis found that adults living in focus countries between 2004 and 2008 had about a 20 percent lower odds of mortality compared to adults in non-focus countries,” the Center for Global Health Policy’s “Science Speaks” writes, adding, “Evidence for unintended health effects with respect to adult mortality is inconclusive, Bendavid said, but the likelihood of PEPFAR interventions eliciting unintended harms is low” (Mazzotta, 3/7).
At the 19th Conference on Retroviruses and Opportunistic Infections (CROI) on Wednesday, Gabriel Chamie of the University of California, San Francisco “discussed outcomes in a routine linkage-to-care strategy versus and an enhanced strategy for accelerated antiretroviral therapy (ART) start in rural Uganda,” the Center for Global Health Policy’s “Science Speaks” blog reports. In the study, a higher percentage of people who were offered the enhanced strategy received follow-up care, began ART, and remained in care, and “Chamie highlighted the need for enhanced linkage to care efforts for patients at all CD4 cell counts,” according to the blog (Mazzotta, 3/7).
“Women who are at risk of unplanned pregnancy are also at risk of HIV, and vice-versa so separation of these services no longer makes sense. The global health community must work to bring family planning and HIV services together — and quickly — to save women’s lives,” by Dana Hovig, chief executive of Marie Stopes International, and Alvaro Bermejo, executive director of the International HIV/AIDS Alliance, write in this RH Reality Check blog post marking International Women’s Day. The authors conclude, “We call on the public to urge leaders to support integration of services in the developing world. We encourage organizations working with us to support the integration of family planning and HIV services” (3/7).
“HIV incidence among non-Muslim men has decreased with greater uptake of voluntary medical male circumcision (MMC) in Uganda, according to data presented Tuesday” by Ronald Gray of the Johns Hopkins Bloomberg School of Public Health at the 19th Conference on Retroviruses and Opportunistic Infections (CROI) in Seattle, HIV Medicine Association Executive Director Andrea Weddle writes in this guest post on the Center for Global Health Policy’s “Science Speaks” blog. In the same session, Bertran Auvert of the University of Versailles “reported on a trial on MMC in the Orange Farm Township in South Africa among 110,000 adults” that found MMC prevalence has risen from about 11 percent among males ages 15 to 49 in 2008 to about 59 percent now, according to the blog (Mazzotta, 3/7).
“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.”