In this PLoS “Speaking of Medicine” blog post, Julien Potet and Katy Athersuch of Medecins Sans Frontieres’ (MSF) Access Campaign say that the WHO’s decision last week to “simply continue monitoring” the medical research and development (R&D) industry’s ability to address the needs of people living in developing countries “by creating a global R&D ‘observatory'” is “a deeply disappointing outcome that will not help re-shape priorities, increase funding or catalyze development of urgently needed new medical tools; at best it will only underscore further how badly these actions are needed.” They discuss how access to new tools, technologies, and treatments “can save lives” and some of the progress made in expanding R&D. Advocates’ “pressure will be critical for engaging governments and mobilizing the public leadership needed to support the research for cures that millions of neglected patients await,” they conclude (12/6).
Programs, Funding & Financing
In a study published online in the Proceedings of the National Academy of Sciences, Till Barnighausen, David Bloom, and Salal Humair of the Harvard School of Public Health examine “whether [HIV treatment as prevention (TasP)] is indeed a game changer or if comparable benefits are obtainable at similar or lower cost by increasing coverage of medical male circumcision (MMC) and antiretroviral treatment (ART).” They write, “The most cost-effective HIV prevention strategy is to expand MMC coverage and then scale up ART, but the most cost-effective HIV-mortality reduction strategy is to scale up MMC and ART jointly. TasP is cost effective by commonly used absolute benchmarks but it is far less cost effective than MMC and ART” (12/6).
Noting that the WHO’s Global Tuberculosis Report shows “that access to care and treatment for tuberculosis [TB] has expanded substantially in the past two decades,” Deborah Derrick, president of Friends of the Global Fight Against AIDS, Tuberculosis and Malaria, writes in an AlertNet opinion piece, “Not only is this good news for those countries that are most vulnerable to tuberculosis; it is also good news for the global community,” as TB can be passed through the air. Derrick describes some of the interventions against TB instituted internationally, and she notes the Global Fund to Fight AIDS, Tuberculosis and Malaria “is the largest global donor to tuberculosis programs, providing 82 percent of international funding to fight the disease,” as well as “91 percent of international financing” to fight multidrug-resistant TB (MDR-TB).
Through travel to Africa and “[a]s chairman and ranking member of the Senate Foreign Relations Subcommittee on African Affairs, we’ve seen firsthand the enormous toll of HIV/AIDS on families, communities and economies,” Sen. Chris Coons (D-Del.) and Sen. Johnny Isakson (R-Ga.) write in the Huffington Post’s “Politics” blog. “On December 1st, we marked World AIDS Day by honoring the lives lost to the scourge of AIDS and by recommitting ourselves to building an AIDS-free generation and ending this pandemic once and for all,” they write, adding, “Although we come from different political parties, we stand together in our belief that the United States should remain a global leader in the fight against HIV/AIDS.”
PEPFAR will purchase up to 150 rapid tuberculosis (TB) Xpert testing devices and cartridges to test about 450,000 people for TB, “addressing a need to improve diagnoses of drug-resistant strains of disease, and to identify the disease in HIV-positive people in sub-Saharan Africa and Myanmar, the Office of the Global AIDS Coordinator announced” Tuesday, the Center for Global Health Policy’s “Science Speaks” blog reports. “The investment is part of an ongoing effort,” according to the blog, which notes, “The announcement of the program’s added investment in the Cepheid Xpert tests, following the pre-World AIDS Day release last week of PEPFAR’s blueprint for creating an AIDS-free generation backs the plan’s stated purpose of applying evidence-based approaches and scientific advances to confront the global HIV epidemic” (Barton, 12/4).
“This week, the Global Alliance for Vaccines and Immunization (GAVI) is holding a forum in Dar es Salaam, Tanzania,” Guardian health editor Sarah Boseley writes in her “Global Health Blog,” noting, “Invited are 700 experts from all the organizations and countries GAVI works with, funding immunization programs across the globe and in some of the poorest places on the planet.” One of the groups, Medecins Sans Frontieres/Doctors Without Borders (MSF), “says it is deeply concerned that the current vaccination strategy is not paying enough attention to the one in five babies who go without the most basic immunization, such as DTP (diphtheria, tetanus and whooping cough) from two months and then measles vaccine, which babies should have at the age of nine months,” Boseley writes, noting the group also says vaccines need to be better designed for use in Africa (12/4). In a press release, MSF notes that three new issue briefs outlining the organization’s “main concerns” are available online (12/4). The first discusses vaccine pricing; the second discusses the development of “easier-to-use” vaccines, and the third discusses vaccine supply and procurement practices (12/4).
In the New York Times’ “Scientist At Work” blog, Alexander Kumar, a physician and researcher at Concordia Station in Antarctica, examines the question of “why humans should venture out to other planets, and perhaps in the process create new problems, when we have so many problems on our own planet,” including HIV, malaria, tuberculosis and other “largely preventable and treatable” conditions. Kumar, who is “investigat[ing] the possibility of one day sending humans to Mars” for the European Space Agency, says he is “repeatedly asked … why the human race would invest its precious and finite resources (money) into space exploration?” He continues, “People have presented valid arguments both ways: those against, about depriving the bottom billion of our planet by diverting much-needed funding; and those in favor, for furthering mankind’s now-desperate need for discoveries and new life-saving technology through exploration in space.
This report (.pdf) from the Center for Strategic & International Studies (CSIS), titled “Competing Pressures for U.S. PEPFAR In Botswana: Rising Ambitions, Declining Resources,” examines how the “partnership will be tested as the United States and Botswana negotiate a complex, multiyear handoff of PEPFAR-supported HIV/AIDS activities and as U.S. financial assistance is reduced,” the report summary states. The summary continues, “Botswana is a good setting in which to see whether an AIDS-free Generation is achievable and to better understand what success might require in terms of policy and programmatic innovations, health planning and management capacity, and costs” (Stash et al., 11/30).
PRI’s “The World” this week features a series examining the challenges of addressing cancer in the developing world. The series, produced in collaboration with the Pulitzer Center on Crisis Reporting, includes radio stories, multimedia features, an interactive map, and infographics, according to the main page. The radio stories examine cancer prevention, control, and research efforts in Uganda, Haiti, India, and the U.S. (12/3). In an interview with the series’ principal reporter, Joanne Silberner, Lancet editor Richard Horton said, “Cancer is certainly being under-recognized and neglected in low- and middle-income countries. … I think cancer is slowly becoming more recognized but there is a long way to go before it gets the attention it so urgently needs (12/3). On December 5, PRI will host a Facebook chat from 10am-4pm EST that will feature Silberner and cancer researchers and advocates (12/4).
“Many currently believe that U.S. domestic entitlements are too large, but disregard the fact that the PEPFAR program has created a new class of moral entitlements overseas — in the form of four million and counting people receiving U.S.-supported life-sustaining AIDS treatment in low- and middle-income countries around the world,” Mead Over, a senior fellow at the CGD, writes in the Center for Global Development’s (CGD) “Global Health Policy” blog. He continues, “But I think the U.S. has just as much fiduciary and moral responsibility to anticipate and plan for its current and future AIDS treatment entitlements overseas as it does for its much larger Social Security and Medicare entitlements at home,” and adds, “Moving forward, I suggest that the U.S. should figure out how to convert the moral entitlements it has already granted into credible long-term enforceable commitments which are more analogous to the commitments it makes to Social Security beneficiaries in the U.S.” (11/30).