“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).
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.”
Differing Opinions About AMFm 'Unlikely To Be Resolved' After Global Fund Decision On Program's Future
In her “Global Health Blog,” Guardian health editor Sarah Boseley examines the Affordable Medicines Facility-malaria (AMFm), “which aims to enable countries to increase the provision of affordable artemisinin combination therapies (ACTs) through not only the public sector but also the private sector and [non-governmental organizations (NGOs)].” Following pilot projects in seven African countries and an independent evaluation by the London School of Hygiene and Tropical Medicine, the Global Fund to Fight AIDS, Tuberculosis and Malaria, which hosts AMFm, is set to decide the future of the scheme at a board meeting in November. She notes Oxfam recently released a report criticizing the mechanism, saying the evaluation was flawed because it looked at the number of ACTs sold and not lives saved.
The Associated Press examines access to antiretroviral treatment in Myanmar, which “ranks among the world’s hardest places to get HIV care, and health experts warn it will take years to prop up a broken health system hobbled by decades of neglect.” The country, also known as Burma, has been hindered by decades of rule by a military junta and economic sanctions imposed by developed countries, including the U.S., the AP notes, and writes, “Of the estimated 240,000 people living with HIV [in the country], half are going without treatment.” However, “as Myanmar wows the world with its reforms, the U.S. and other nations are easing sanctions,” the news agency writes, adding, “The Global Fund [to Fight AIDS, Tuberculosis and Malaria] recently urged Myanmar to apply for more assistance that would make up the shortfall and open the door for HIV drugs to reach more than 75 percent of those in need by the end of 2015,” as well as medications to fight tuberculosis (TB). The AP details one man’s efforts to obtain antiretrovirals, which are reserved for patients with CD4 cell counts below 150 cells, versus the WHO recommended 350 (Mason, 10/22).
Central African Republic Town Struggling To Provide Health Care Since Withdrawal Of Foreign Companies, VOA Reports
VOA News examines how the 2009 withdrawal of foreign diamond-mining companies from the small town of Carnot in the Central African Republic (CAR) affected the local economy and access to health care for residents. Initially, Medecins Sans Frontieres (MSF) “ran emergency nutrition programs for the first year, but then discovered deeper health problems in the region, including a child mortality rate that is three times above what is considered an emergency level, as well as elevated rates of HIV and tuberculosis,” the news service writes.
The U.N. World Food Programme (WFP) on Tuesday posted an infographic that answers such questions as “how many people does WFP feed each year?” and “[h]ow much does that cost and where does it get the money?” According to the infographic, WFP provided 3.6 million tons of food aid in 2011, which is equivalent to the weight of 36 cruise ships, and 71 percent of the food bought came from developing countries (10/23).
In the last of a series of posts on the U.K. Department for International Development’s (DfID) blog examining the department’s work in Malawi, Neil Squires, DfID head of profession for health, looks at the sustainability of the country’s HIV/AIDS program. “Malawi’s success in increasing access to antiretroviral drugs for HIV is highly dependent on donor funding for medicines,” he writes, adding, “Malawi has to actively consider its resource allocation in order to maximize the benefits and the health gained from the limited resources available.” He notes a report commissioned by UNAIDS on Malawi concluded that “unless Malawi can reduce the incidence of new infections, the scale up in access to antiretroviral drugs will not be sustainable in the medium to long term.” He concludes, “This is an important issue for the Government of Malawi, but also for the key donors who have supported the massive scale up in access to drugs, particularly the Global Fund. Malawi will need to maintain high levels of funding from the Global Fund if it is to maintain its supply of antiretroviral drugs” (10/23).
“It’s not much of a surprise that Monday night’s presidential debate, which focused on foreign policy, was consumed by a discussion of defense spending, and security and trade policies,” but “it’s still disappointing that both [President] Barack Obama and [Republican presidential nominee Gov.] Mitt Romney were relatively silent on issues like global health, research, and international aid,” Global Health Technologies Coalition (GHTC) Communications Officer Kim Lufkin writes in the GHTC’s “Breakthroughs” blog. She summarizes some “brief mentions during the debate season of the role of science and technology,” including some media coverage of the lack of mention of global health. “With the election now less than two weeks away … it seems increasingly unrealistic that either candidate will offer up much on global health, research, or other development topics soon,” she writes, concluding, “But no matter what the outcome is in two weeks, the next president must demonstrate more support for global health and foreign aid than the candidates displayed during Monday night’s debate” (10/24).
Writing in GlobalPost’s “Global Pulse” blog, Claire Panosian Dunavan, a professor of medicine and infectious diseases at the University of California, Los Angeles, reflects on the Global Health Service Partnership, a new public-private partnership launched by Vanessa Kerry, daughter of Sen. John Kerry (D-Mass.) “to boost the education of doctors and nurses in sub-Saharan Africa.” She asks, “Will it fly? Or — to put it more bluntly — is global health still tugging at American heartstrings?” She highlights the Global Citizen Festival in Central Park last month, a five-hour concert sponsored by the Global Poverty Project that “drew 60,000 attendees and millions of dollars for health issues ranging from maternal care to mosquito nets to wiping out polio” and draws comparison to Bob Geldof’s 1985 “Live Aid” concert, which she says “reached nearly two billion people in 150 countries via broadcasts and satellite links” and “marked a milestone in global health awareness.”
Noting a recent U.N. study (.pdf) showed that, despite progress on tackling child mortality globally, sub-Saharan Africa “is trailing far behind,” David Dominic, a consultant for non-governmental organizations, writes in this Huffington Post U.K. opinion piece, “[T]he more we look, the more it seems that the U.K. aid system, with regards to sub-Saharan Africa, is carefully designed to control and exploit the region, with scant regard for the impacts upon the poor. That is, aid seems to be used as a tool of modern imperialism.” He continues, “This is significant to us in the U.K. because sub-Saharan Africa is the region which has received most aid from the U.K. over the last few decades and is also where the U.K. has had the most influence.”