U.S. Global AIDS Coordinator Ambassador Eric Goosby “discussed lessons learned from the U.S. response to the global HIV/AIDS epidemic over the past decade at an event hosted by the Brookings Institute Monday morning,” the Center for Global Health Policy’s “Science Speaks” blog reports. “While calling recent scientific advances in HIV prevention ‘game changers’ that have offered hope of an AIDS-free generation, [Goosby said] that the successful fight against the epidemic relies on recognizing AIDS-specific efforts so far as a foundation for further health gains, on country ownership, and on continuing to build ‘the shared responsibility’ of a multi-donor response,” the blog adds.
“Government assurances that the scaling back of the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) program in South Africa (SA) will be carefully managed to protect patients are welcome, but … [t]he reality is that the Department of Health is struggling to cope with severe medical staff shortages, financial resources that never seem to stretch far enough, inadequate infrastructure and maintenance programs, and administrative bottlenecks,” a Business Day editorial states. Though the reworking of PEPFAR funding will take place over five years “and does not entail the complete loss” of funding, “the shortfall will have to come from somewhere,” the editorial says, adding, “It will be tragic if, just as we are starting to see light at the end of the long, dark tunnel of the HIV/AIDS epidemic in SA, the gains of the past few years were to be reversed due to the loss of critical foreign funding and the government’s lack of capacity to plug the gap.”
The U.S. Government Accountability Office (GAO) recently released two reports on issues related to global health. In “Ensuring Drug Quality in Global Health Programs,” the agency writes, “Concerns have been raised about the potential for substandard drugs to enter the supply chains of global health programs,” and notes that it concluded, “U.S.-funded global health programs have put regulatory and policy requirements in place to help prevent procurement of substandard drugs” (8/1). In another report looking at the WHO, titled “Reform Agenda Developed, but U.S. Actions to Monitor Progress Could be Enhanced,” GAO found, “The United States has provided input into WHO’s reform agenda, particularly in the areas of transparency and accountability, but the Department of State’s (State) tool for assessing progress in the area of management reform could be enhanced” (7/23).
Diagnostics company Cepheid on Monday signed deals with PEPFAR, USAID, UNITAID, and the Bill & Melinda Gates Foundation to immediately reduce the price of its Xpert MTB/RIF test kit for its GeneXpert tuberculosis (TB) diagnostic system in 145 countries, Reuters reports. “The agreements will see the test sold for $9.98, down from its current price of $16.86 per test,” the news service writes, adding, “Cepheid said the Bill & Melinda Gates Foundation will make an initial payment of $3.5 million to make the test immediately available at the lower price” (Ail, 8/6).
U.S. Secretary of State Hillary Clinton on Tuesday visited officials in South Africa and discussed the response to HIV/AIDS, the Associated Press/Huffington Post reports. Speaking with Foreign Minister Maite Nkoana-Mashabane “in the second cabinet-level strategic dialogue between the two nations,” Clinton said “that global efforts to stop the virus ‘have saved hundreds of thousands of lives,'” the news service writes. “In South Africa, 5.7 million people — 17.8 percent of the population — have tested positive for HIV,” and PEPFAR “has spent $3.2 billion on antiretroviral drugs and HIV prevention programs in [the country] since 2004,” according to the AP.
“With Congress adjourned until after Labor Day and not a single funding bill for the federal fiscal year beginning October signed into law before the recess even began, the virtual standstill of legislative action could have a mixed impact on global health funding,” the Center for Global Health Policy’s “Science Speaks” blog reports. “It appears that House and Senate leaders have reached a tentative agreement to fund most government programs under a so-called ‘continuing resolution’ that would essentially continue funding for most programs at current levels through March 30, 2013,” the blog writes, adding, “PEPFAR is likely to see at least a modest cut from current funding so that resolution could delay or potentially reduce the overall hit to the program” (Lubinski , 8/10).
“Health care, taxes, energy, favorite flavor of ice cream — it seems our elected leaders must disagree at every turn. But one issue that has so far repulsed the partisan pressures of the times was highlighted [at the XIX International AIDS Conference (AIDS 2012)] in our nation’s capital last week: the fight against HIV/AIDS,” former Senate Majority Leader Bill Frist (R-Tenn.) writes in an opinion piece in “The Week.” He says, “The conference was a celebration of the remarkable success made because of this leadership, and a call for continued support” in the response against HIV/AIDS. Noting he moderated a panel discussion with Rep. Barbara Lee (D-Calif.) and Sens. Chris Coons (D-Del.), Marco Rubio (R-Fla.) and Mike Enzi (R-Wyo.) on congressional bipartisanship at the conference, Frist continues, “I witnessed what I felt to be an accurate portrayal of how we got to the point where we could celebrate so many successes. Fundamental to the progress has been bipartisanship.”
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).
PEPFAR on Wednesday “announced awards for a $60 million initiative, with potential for additional funding in year three, to support implementation science research and the evaluation of programs established under PEPFAR,” according to a U.S. State Department media note. “These evaluations, funded through collaboration with the Centers for Disease Control and Prevention (CDC), the National Institutes of Health (NIH), and the U.S. Agency for International Development (USAID), will contribute to the evidence base for HIV programs and maximize the impact of its investments in programs around the world. Data gathered will help partner countries to strengthen their efforts to prevent new HIV infections and save lives,” the media note states, adding, “More than 35 evaluations in over 12 countries will be funded in 2012” (8/1).
“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).