The Associated Press on Saturday examined the HIV/AIDS epidemic in Uganda, where “[a] new government report says the prevalence of HIV in this East African nation increased from 6.4 percent in 2004 to 7.3 percent in 2011, a shocking statistic for a country once praised for its global leadership in controlling AIDS.” The news service highlights PEPFAR’s contributions to fighting the epidemic in Uganda, noting that “[a]t least half of the 600,000 Ugandans in need of AIDS treatment are able to access the drugs, mostly through PEPFAR.” According to the AP, “U.S. government officials have been pressing Uganda to devote more resources to AIDS and issues such as maternal health, saying dependency on foreign support is unsustainable in the long term.” On a recent trip to the country, Rep. Barbara Lee (D-Calif.) said meeting patients benefitting from PEPFAR-funded treatment “was confirmation of the fact that United States foreign aid works,” the AP writes (Muhumuza, 7/21).
Quality of Care
More widespread use of antiretroviral drugs (ARVs) to treat HIV infection has led to drug resistance in low- and middle-income countries, but the level “is not steep enough to cause alarm, said a survey released by the World Health Organization on Wednesday,” Agence France-Presse reports. “In low- and middle-income countries, drug resistance stood at 6.8 percent in 2010, the WHO said in its first-ever report on the matter,” the news agency writes, adding, “High-income countries, many of which began widescale treatment for HIV years earlier and used single or dual therapies that can also encourage resistance, face higher rates of resistance, from eight to 14 percent, said the study” (Sheridan, 7/18).
The WHO “says comprehensive HIV treatment strategies are needed in developing countries to overcome stigma and discrimination,” because “often those in need of HIV treatment and prevention are unable to receive [the services] because of their social status,” VOA News reports. Certain populations, such as sex workers, men who have sex with men (MSM), and people who inject drugs, sometimes face “barriers … to access services,” Gottfried Hirnschall, director of the WHO HIV/AIDS Department, said, adding, “And we obviously see that as a consequence in many places these groups have higher infection rates. They have higher mortality, etcetera,â€ according to the news service.
Though Indonesia is “widely seen as a development success story — indeed, it is sometimes referred to as one of Asia’s ‘rising powers’ … in the area of maternal health, the successes have been modest and much remains to be done,” Andrew Rosser, associate director of the Indo-Pacific Governance Research Centre at the University of Adelaide, writes in an Inside Indonesia opinion piece. “Indonesia is on track to meet many of these goals,” including those related to poverty, child nutrition and mortality, education, and tuberculosis and malaria, “[b]ut it is well off track when it comes to goals related to maternal health,” he states. The country also is “failing to meet its targets on the use of modern methods of contraception and reducing the ‘unmet need’ for family planning — that is, the proportion of couples who want to limit the number of children they have but do not have access to contraception,” Rosser notes.
New UNICEF Publications Show Universal Health Coverage Achievable Through Social Protection Measures
“Two newly released UNICEF publications demonstrate that while reaching universal health coverage (UHC) is possible in most countries, this requires a comprehensive social protection system of which health insurance is a crucial component,” according to this post on the UHC Forward blog. A recent UNICEF study “finds that even in middle and low-income countries that have adopted a formal policy of universal health coverage … many socio-economic barriers to access persist,” the blog reports, adding, “It is for this reason that the study has been framed in the broader approach recommended by UNICEF’s first global Social Protection Strategic Framework, which stresses the importance of developing and strengthening integrated social protection systems” (O’Connell, 6/4).
Al Jazeera examines Afghanistan’s health care system since the fall of the Taliban, writing, “Standards of health care in Afghanistan have improved significantly since the fall of the Taliban, but security continues to play a large role in determining access to and quality of care provided.” According to the video report, Afghanistan’s constitution mandates that health services be provided free of charge, which “leaves many small clinics reliant on foreign aid.” The news service notes, “There’s a big difference in the type of care you can get [in] rural areas and in urban areas,” adding, “Many procedures still require patients to travel to city hospitals, putting them at risk from violence and grueling journeys on poorly maintained roads” (Smith, 6/3).
“Counterfeit, falsified, and substandard drugs are a dangerous threat to people around the world, including Americans,” therefore “we have a vital interest in ensuring the safety of an ever more complex global drug supply chain,” Jennifer White, a foreign service officer in the Office of International Health and Biodefense in the Bureau of Oceans and International Environmental and Scientific Affairs, writes in a post in the State Department’s “DipNote” blog. She notes that the “Department of State engages in the fight against counterfeit medicines using a multi-faceted approach,” including training foreign drug regulators; funding consumer outreach to raise awareness of the problem; being active in international bodies that address counterfeiting, such as the WHO; and “work[ing] in partnership with other U.S. government agencies, the health care community, patients, civil society, and the pharmaceutical industry to ensure that patients receive safe medicines and that those who put patients’ lives at risk can be prosecuted” (5/22).
More Research Needed Into How Transgender Persons In Asia, Pacific Affected By HIV, Stigma, Report Says
A report released Thursday in Bangkok by the United Nations Development Programme (UNDP) and the Asia Pacific Transgender Network (APTN) says more research needs to be conducted to determine the extent to which transgender persons in Asia and the Pacific are affected by HIV, are socially ostracized, and lack fundamental rights, including access to basic health care, a UNDP press release reports. The report, released to mark the International Day Against Homophobia and Transphobia, is “a comprehensive review of material gathered from across the region over the past 12 years” and “emphasizes that inclusive research, designed and implemented in partnership with the transgender community, is critical to enable governments, community-based organizations and supporting organizations to enhance HIV and sexual health care services specific to the needs of transgender people, and foster action by governments to adopt more socially equitable policies and practices to protect their rights,” according to the press release (5/17).
“The worldwide counterfeit drug market is huge and growing,” Tim Mackey and Brian Liang of the Institute of Health Law Studies at the California Western School of Law and Thomas Kubic of the Pharmaceutical Security Institute write in a Foreign Policy opinion piece, noting such “drugs occupy a wide spectrum of medications, and their quality is suspect; they can be mislabeled, tainted, adulterated, ineffective, or, in the worst cases, all of the above.” They argue for a new framework for fighting the illegal drug trade because “[g]lobal policy has not kept up with the burgeoning counterfeit drug trade.” The authors say that although initial results of the WHO IMPACT (International Medical Products Anti-Counterfeit Taskforce) are “encouraging,” they note that “[s]ome WHO member states, including India and Brazil (both top producers of generic drugs) and other developing countries, have questioned whether WHO can rightly take on enforcement operations” because it “is not a global law enforcement agency.”
In a joint statement (.pdf), UNFPA Executive Director Babatunde Osotimehin and Agneta Bridges, secretary-general of the International Confederation of Midwives (ICM), recognize the International Day of the Midwife on May 5. “The right to health is a basic human right that every woman should enjoy. Yet, every day, almost 1,000 women die in pregnancy and childbirth â€¦ One of the main causes for these tragedies is lack of access to maternity services, including the care of midwives or others with midwifery skills at childbirth,” they write, continuing, “Urgent action is needed to achieve the Millennium Development Goals 4 and 5 on child and maternal health before the target year of 2015, and investing in human resources for health, especially midwifery, is one the soundest investments a country can make to accelerate progress” (5/4).