The Canadian Medical Association Journal (CMAJ) reports on HIV in the Kingdom of Swaziland, writing the country “now has the dubious distinction of having the world’s highest rate of both HIV and tuberculosis (TB).” The journal notes “[a]bout 26 percent of adults aged 15-49, or about 202,000 of all the citizens of Africa’s last absolute monarchy, are HIV-positive, according to the Swaziland government,” and asks, “Why are the 1.2 million people of this landlocked kingdom … in such dire straits?” CMAJ writes, “A host of underlying factors appear to be at the root of its woes: politics, history, culture, economics, poverty, gender inequity, and much more.”
Programs, Funding & Financing
Contradictions Among Member State, Donor Priorities Must Be Resolved For Current WHO Reform To Be Successful
In a BMJ analysis examining the future of the WHO, David Legge, scholar emeritus at Australia’s La Trobe University, notes “[a] substantial shortfall in the funds available for basic administrative functions led WHO’s director general, Margaret Chan, to initiate another reform of the WHO in 2010,” and “outlines the problems and what the reforms are trying to achieve.” He writes, “Success of the current reform program depends on resolving the contradiction between member state priorities and donor control and requires the freeze on assessed contributions to be lifted,” adding, “To achieve this, member states must be persuaded to prioritize global health over parochial interests.”
“Though the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) has been touted as one of our nation’s most successful initiatives in global health (and certainly one of President George W. Bush’s most positive legacies) it continues to miss the mark” when it comes to family planning, global gender specialist and freelance writer Jessica Mack writes in KPLU 88.5’s “Humanosphere” blog. “The essential role of contraception, especially barrier methods, in preventing the spread of HIV/AIDS is intuitive, obvious, and also well documented,” she writes. “While earlier PEPFAR rules did not specifically dictate whether or not funding could be used for contraceptive supplies, the language over the last few years has become increasingly restrictive on this point,” she continues, noting that PEPFAR’s recently released 2013 country operational plan (COP) forbids the use of PEPFAR funds to purchase family planning commodities. Mack concludes, “PEPFAR is simply flying directly in the face of the Global Health Initiative’s vision and the stated objectives of the Obama Administration” (10/25).
Negative Effects Of Global Health Initiatives On Developing Countries' Health Systems Exaggerated, Review Shows
“An evaluation of the scientific evidence on the effects of global health initiatives on the health systems of developing countries concludes that the harmful effects have been exaggerated,” according to a press release from the Royal Society of Medicine. The systematic review, published on Wednesday in JRSM Short Reports, “found that much of the research literature did not fulfill the requirements of rigorous scientific evidence,” according to the press release. “The systematic review identified 24 studies published in peer-reviewed scientific journals between 2002 and 2009 that have commented on adverse effects on health systems arising from investments by the Global Fund,” the press release states, adding, “All the studies evaluated contained only seemingly anecdotal evidence or authors’ perceptions or interpretations of circumstances” (10/24).
Researchers from Imperial College London, the Harvard Global Equity Initiative, and Harvard School of Public Health “have identified three global organizations that new funding initiatives should emulate in order to meet health priorities in poorer countries, in research published [Thursday] in the journal the Lancet,” Imperial College London reports in an article on its webpage. The study, “a comprehensive review of new funding methods that raised money for health in developing countries between 1990 and 2010 … found that the GAVI Alliance, … the Global Fund [to Fight AIDS, Tuberculosis and Malaria], and UNITAID, … were the sole organizations whose innovative financing methods had raised and distributed funds on a global scale,” the article notes, adding, “The authors concluded that innovative financing is essential to reduce dependence on contributions from donor governments. These innovative instruments provide a different way of raising money from new sources and making it available to address global health problems” (10/25).
“[T]he latest calculations show that U.S. ethanol policies have increased the food bills of poor food-importing countries by more than $9 billion (Â£5.6 billion) since 2006,” Olivier De Schutter, U.N. special rapporteur on the right to food, writes in the Guardian’s “Poverty Matters” blog. He asks, “But where to next? Should we disavow biofuels altogether?” He writes, “The new starting point should be to put food security first,” noting, “Globally, 25 percent of land is already degraded, and the remaining productive areas are subject to ever-greater competition from industrial and urban uses.”
“An HIV/AIDS report by advocacy organizations in Uganda indicates that new transmissions are on the rise amidst troubling trends of increasing prevalence and incidence,” Uganda’s New Vision reports. “The findings are contained in a report titled: ‘The Change We Need to End AIDS in Uganda,’ which describes a 10-point plan to halt the trend,” the newspaper notes. “Some of the 10 points include ending harmful policies that further marginalize vulnerable groups; endorsing and expanding safe medical circumcision; and tackling health challenges that hold back the response to AIDS,” according to the newspaper.
Number Of New TB Infections Fall, But Drug Resistance, Lack Of Funding Could Slow Progress, WHO Reports
“New tuberculosis [TB] infections dropped 2.2 percent worldwide last year, but with nearly nine million new infections, the World Health Organization said TB remains a massive problem that could worsen if countries shortchange funding to fight it,” Reuters reports (Steenhuysen, 10/17). “In a new report issued Wednesday, the U.N. agency estimated there were about 8.7 million new cases of TB last year, down from about 8.8 million in 2010,” and “[t]he number of deaths was unchanged at about 1.4 million — making it the second-leading killer among infectious diseases after AIDS,” the Associated Press writes (Cheng, 10/17). “The number of people becoming ill with tuberculosis has been falling steadily for roughly a decade after a surge in the 1990s,” but “those numbers are still huge, and only 19 percent of those infected with forms of the disease that are resistant to multiple tuberculosis drugs are being diagnosed, the WHO estimated,” according to the Wall Street Journal (McKay, 10/18). BBC News notes the report “warned of ‘persistently slow progress’ in treating tuberculosis which is resistant to antibiotics” (Gallagher, 10/17).
On its website, the International HIV/AIDS Alliance describes a new publication, titled “Of Spices and Silk: Sharing Stories of Technical Support to Global Fund Grants in Asia,” which presents 11 case stories showing how the Alliance’s regional Technical Support Hubs have provided assistance to Global Fund grant recipients (9/27). “The case stories were written during a writeshop held in Bangkok in August 2012 where participants were invited to use a narrative structure to reflect on and draw out their experiences working as consultants providing technical support for Global Fund grants,” the report homepage states (9/25).
“The implementation of an ambitious bill that guarantees cheap food grains for India’s poor could be pushed back to the next fiscal year, a top government adviser said,” the Wall Street Journal reports. “[I]mplementing the bill in the fiscal year starting April 2013 would make financial and political sense for the government, which is facing a yawning budget gap and federal elections before May 2014,” according to the newspaper, which adds the bill is “likely to be introduced in the budget session, which is due late February, C. Rangarajan, chairman of the Prime Minister’s Economic Advisory Council, said in an interview.” After a general debate, parliament would have to approve the bill, which “aims to provide subsidized grains to more than 60 percent of India’s 1.2 billion people, with special provisions for pregnant women, destitute children and others,” for it to become law, the newspaper writes, adding, “A government spokesman declined to comment on the matter Friday” (Sahu/Guha, 10/27).