In the Center for Strategic & International Studies’ (CSIS) “Smart Global Health” blog, Todd Summers, senior adviser at the CSIS Global Health Policy Center, reviews the Global Fund to Fight AIDS, Tuberculosis and Malaria’s old rounds-based grant system that the Global Fund Board recently agreed to replace with a new funding model “that’s designed to be flexible, focused, and fast,” he says. Summers describes some of the shortcomings of the old model, outlines the “[c]ore attributes” of the new model, and writes, “Many other important aspects of the new funding model remain to be worked out, and some larger questions remain. I’ll try to highlight some of these in upcoming blogs” (11/26).
Programs, Funding & Financing
“As World AIDS Day 2012 approaches, it is a timely opportunity to reflect on what we learned at this year’s International AIDS Conference” and recognize “[t]he United States, through the President’s Emergency Plan for AIDS Relief (PEPFAR), has been a remarkable vehicle in this fight, employing sound science to offer the highest quality interventions and treatment,” Nils Daulaire, director of the Office of Global Affairs at the Department of Health and Human Services (HHS), writes in the AIDS.gov blog. Daulaire discusses how “[t]o ensure long-term sustainability, PEPFAR country programs and its implementing agencies are transforming their partnerships so that countries direct, implement, and evaluate their own responses with strong U.S. support,” and elaborates on the “four key dimensions of country ownership.” He concludes, “HHS is committed to continue implementing PEPFAR programs in partnership with countries and civil society as they build a sustainable response to global AIDS and work towards achieving an AIDS-free generation” (11/26).
Writing in the Diplomatic Courier Blog, Jaclyn Schiff, communications director for the American Society of Tropical Medicine and Hygiene, examines how “an Obama administration effort to curb reckless spending on events” is “making it harder for American researchers to collaborate effectively with their counterparts in other countries.” She says the policy, issued through a September 2011 memo asking all departments to cut travel spending by 30 percent, prevented Stephen Thomas, director of Walter Reed’s Viral Diseases Branch, from traveling to Atlanta for the American Society of Tropical Medicine and Hygiene’s annual conference to present his research on dengue vaccine efficiency (11/23).
“In October 1987, Roy Vagelos, then the chief executive of [pharmaceutical company] Merck, launched the largest pharmaco-philanthropic venture ever,” William Foege, an epidemiologist and former director of the CDC, writes in a Washington Post opinion piece highlighting the company’s efforts to combat onchocerciasis in the developing world through the free distribution of its drug Mectizan. Initially developed to protect dogs against heartworms, Merck found a human version of the drug “could inhibit the microfilaria of onchocerciasis for a year with a single dose,” Foege continues, adding, “Merck said that it would supply the drug as long as it was needed. Extended surveillance has shown this to be one of the safest drugs ever developed.”
“More than one-quarter of people diagnosed with tuberculosis [TB] at a clinic in India’s largest city of 18 million have a strain that doesn’t respond to the main treatment against the disease, according to preliminary data from a new diagnostic being tested,” the Wall Street Journal reports. The newspaper obtained “preliminary and not peer reviewed” data from TB clinics in Mumbai, and Puneet Dewan with the Bill & Melinda Gates Foundation TB program in India “said the WHO and Indian authorities are taking the data seriously because it appears to confirm other studies in recent years of similarly high rates of multi-drug-resistance, in which patients don’t respond to the two most powerful TB medicines.” According to the newspaper, “The WHO and India currently estimate India has about 100,000 of the 650,000 people in the world with multi-drug-resistance” (Anand/McKay, 11/23).
“Cellphones, those tiny gateways to modernity, have recently allowed prostitutes [in India] to shed the shackles of brothel madams and strike out on their own,” the New York Times reports, adding, “But that independence has made prostitutes far harder for government and safe-sex counselors to trace. And without the advice and free condoms those counselors provide, prostitutes and their customers are returning to dangerous ways.” According to studies, “prostitutes who rely on cellphones are more susceptible to HIV because they are far less likely than their brothel-based peers to require their clients to wear condoms,” the newspaper writes. The New York Times says a government program that provided condom advocacy posters in an area traditionally known for its concentration of brothels worked, “[b]ut now that mobile phones are untethering prostitution from brothels, those targeted measures are threatened” (Harris, 11/24).
In this post in the Bill & Melinda Gates Foundation’s “Impatient Optimists” blog, Joe Cerrell, director of the foundation’s Europe office, examines “the international conversation about aid to developing countries,” noting, “This week the 27 European heads of government will decide whether or not to protect the â‚¬51 billion [$66.1 billion] development aid budget from cuts over the next seven years, as part of the overall European Union (E.U.) budget for the next seven years.” Development aid is effective and can help grow recipient countries’ economies, he says, concluding, “As the economic situation continues to be felt throughout the world, we can’t forget that millions of lives hang in the balance. Maintaining our commitment and increasing the quality of aid towards programs that we know work is simply the right thing to do” (11/21).
UNAIDS’ World AIDS Day report: Results, released on Tuesday, said the goal of eventually ending the global AIDS epidemic “is more than merely visionary” and “is entirely feasible,” primarily because of “historic success” in scaling up HIV programs and improving access to antiretroviral drugs to treat and prevent HIV, Reuters reports (Kelland, 11/20). According to the report, “[t]wenty-five countries, many in hard-hit Africa, have at least halved new HIV infections in the past decade, with particular progress made toward protecting children from the deadly virus,” Agence France-Presse writes (11/20). “UNAIDS says that half the global reductions in new HIV infections in the last two years have been among newborn children,” PlusNews writes. “But the epidemic is not over in any part of the world, and is gaining pace in some,” the news service continues, noting the number of new infections has increased in the Middle East and North Africa (11/20). The report “stresses that countries must dramatically ramp up both [prevention and treatment efforts] if the world hopes to meet the ambitious goals agreed upon last year at a special session of the United Nations,” ScienceInsider writes (Cohen, 11/20).
AVAC and amfAR, the Foundation for AIDS Research, on Tuesday released the first (.pdf) in a series of quarterly reports following up on the release of the Action Agenda to End AIDS (.pdf), which was launched in July at the XIX International AIDS Conference (AIDS 2012), according to a joint press release. “New infections and AIDS deaths continue to decline, but not at a pace sufficient to meet the global goals of halving new infections among adults and eliminating new infections in children by 2015,” the report states and looks at data in the areas of strategy, investment, accountability, research, and efficiency (11/20).
The “grand experiment” of the Affordable Medicines Facility-malaria (AMFm) — a pilot program that aims to get artemisinin-based combination therapies (ACTs) into rural areas of several African nations — “seems likely to end, its successes underrated and potential improvements not yet explored,” a Nature editorial says. In October, “an independent evaluation found that it had performed remarkably well on the main benchmarks of success, increasing the number of outlets stocking ACTs and lowering prices,” but last week “the Global Fund to Fight AIDS, Tuberculosis and Malaria decided to end the AMFm as a stand-alone program, by integrating it into the fund’s core system for awarding malaria-control grants to countries,” the editorial notes, adding, “This integration probably spells the end for AMFm, because there will be no new money for the program after the end of next year.”