“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 The newspaper obtained “preliminary and not peer reviewed” data from TB clinics in Mumbai, and Puneet Dewan with the Bill & Melinda Gates Foundation TB program in India “said the WHO and Indian authorities are taking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).
Programs, Funding & Financing
“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.”
The Global Fund to Fight AIDS, Tuberculosis and Malaria Board recently made several decisions that will affect the future of the organization, including appointing former U.S. Global AIDS Coordinator Ambassador Mark Dybul as executive director and adopting a new funding model, Nature reports in an article examining the history and future of the Fund. “It has been a rough couple of years for the Global Fund,” but “[l]ast week’s appointment of Mark Dybul as executive director could signal a fresh start, and has been broadly welcomed,” Nature writes (Butler, 11/22). “As [Dybul] begins his four-year term in early February 2013, current Fund General Manager Gabriel Jaramillo will transition out of his position,” PlusNews reports, noting, “That position, created to guide the Fund through reforms proposed by a 2011 high-level review panel at a time of low donor confidence, will disappear.”
UNAIDS’ new World AIDS Day report: Results, released on Tuesday, “shows that unprecedented acceleration in the AIDS response is producing results for people,” according to a UNAIDS press release. Between 2001 and 2011, “a more than 50 percent reduction in the rate of new HIV infections has been achieved across 25 low- and middle-income countries — more than half in Africa, the region most affected by HIV,” the press release states, adding, “In addition to welcome results in HIV prevention, sub-Saharan Africa has reduced AIDS-related deaths by one third in the last six years and increased the number of people on antiretroviral treatment by 59 percent in the last two years alone.” According to the press release, “The area where perhaps most progress is being made is in reducing new HIV infections in children,” and the number of AIDS-related deaths has dropped because of increased access to antiretroviral treatment.
Emergency Obstetric Care Reduced Maternal Mortality Rates Up To 74% In Two African Projects, MSF Reports
According to a new briefing paper (.pdf) from Medecins Sans Frontieres (MSF), access to emergency obstetric care, including ambulance service, could help save the lives of up to three quarters of women who might otherwise die in childbirth, AlertNet reports (Batha, 11/19). In two projects, one in Kabezi, Burundi, and the other in Bo, Sierra Leone, MSF showed “that the introduction of an ambulance referral system together with the provision of emergency obstetric services can significantly reduce the risk of women dying from pregnancy related complications,” according to an MSF press release. The services, which cost between $2 and $4 per person annually, are offered 24 hours a day, seven days a week, and are free of charge, the press release notes (11/19). The projects “cut maternal mortality rates by an estimated 74 percent in Kabezi and 61 percent in Bo,” Reuters writes, adding, “The charity hopes its model could serve as an example for donors, governments and other aid agencies considering investing in emergency obstetric care in countries with high maternal mortality rates” (11/19).
In a statement released on Monday, WHO Director-General Margaret Chan said “[s]everal recent media articles are creating misinformation and confusion in the public health arena” by “erroneously suggesting that, in working to reduce non-communicable diseases (NCDs) such as cardiovascular diseases, cancers, chronic respiratory diseases and diabetes, WHO receives funding from the food and beverage industry,” the U.N. News Centre reports. Referring to an October 19 article by Reuters suggesting the Pan American Health Organization (PAHO) had accepted money from the industry and a similar November 1 piece by Mother Jones, Chan said, “The allegations in these articles are wrong,” and she added, “When WHO works with the private sector, the organization takes all possible measures to ensure its work to develop policy and guidelines is protected from industry influence,” the news service notes (11/19).