“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 The newspaper obtained “preliminary and not peer reviewed” data from TB clinics in Mumbai, and Puneet Dewan with the Bill & Melinda Gates Foundation TB program in India “said the WHO and Indian authorities are taking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).
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.
According to a new report (.pdf) released by Medecins Sans Frontieres (MSF) at the Union World Conference on Lung Health in Kuala Lumpur, many tuberculosis (TB) programs “under-diagnose, under-treat or completely leave children with TB out, despite the increase in pediatric TB, and rising numbers of children who are infected with drug-resistant forms of TB strains,” PlusNews reports. The report, based on “data collected over three years from over 2,000 children with TB in 13 MSF projects across six countries,” found that diagnosis of children using the most commonly used TB test is inaccurate and pediatric TB drug formulations and treatment guidelines are inadequate, the news service notes. MSF called for the development of new TB tests that do not require sputum samples or laboratory infrastructure and “urged WHO to provide clear guidance to drug manufacturers on needed fixed-dose combinations of first-line drugs to support implementation of the new WHO-recommended dosages,” PlusNews writes (11/16).
Noting the Global Fund to Fight AIDS, Tuberculosis and Malaria met last week to discuss progress in fighting the three diseases, Lucy Chesire, executive director and secretary to the board of the TB ACTION Group, interviews Lucica Ditiu, executive secretary of the Stop TB Partnership, about the global response to tuberculosis (TB) in the Huffington Post’s “The Big Push” blog. In the blog, Ditiu summarizes the state of the global TB response, discusses the emergence of multidrug-resistant TB (MDR-TB), and addresses the Global Fund’s role in the response to TB and the future of these efforts. “The Global Fund has an ambitious strategy that includes important milestones for anti-TB efforts,” Ditiu said, adding, “The international community must find a way to fund that strategy and to ensure that resources are allocated in a way that achieves the greatest good for the greatest number of people,” according to the blog (11/16).
“In a bid to ensure the global fight against three of the world’s most devastating diseases remains efficient, the Board of the … Global Fund to Fight AIDS, Tuberculosis and Malaria voted [Thursday] to begin an immediate transition” to a new grant-funding approach, the U.N. News Centre reports (11/15). The new funding model “is designed to be simpler, more flexible, and have greater impact in conquering the diseases,” according to Reuters. “The new system relies upon closer discussions with the recipient countries, along with other donor groups and experts, over the design of their disease-fighting programs”; “will focus on addressing the needs of the poorest countries with the highest number of infections”; and will allow flexible grant cycles “instead of falling in set time periods, so that they can be coordinated better with a country’s budgetary cycle, [the Board] said,” the news agency writes (Dawson, 11/15).
The Wall Street Journal examines how “Greece has seen decades of advances in public health rolled back, as a flood of illegal immigrants, a dysfunctional government and budget cuts ravage a once proud health-care system.” Noting “[o]ver the past two years, more than 50 endemic cases of [malaria] and more than 100 imported cases have been identified in Greece,” the newspaper writes, “The return of malaria, a scourge in developing countries, to Greece is a disturbing indicator of the nation’s decline since it crashed in 2009 under the weight of a debt binge.” The Wall Street Journal examines the history of malaria’s return to the country and how the government is responding. “In addition to malaria, public health officials say they are worried about rises in everything from infectious respiratory-tract diseases and skin conditions to tuberculosis and HIV,” the newspaper notes (Granitsas, 11/14).
In a guest post on the Global Health Technology Coalition’s “Breakthroughs” blog, Mandy Slutsker, senior project associate with the ACTION Partnership, describes a new report that calls for increased efforts to fight tuberculosis (TB) among children worldwide (Lufkin, 11/13). The report, titled “Children and Tuberculosis: From Neglect to Action,” “makes some core recommendations for donor governments and high burden countries to tackle the rates of children with TB and the knock-on financial and social difficulties faced by millions,” according to the TB Europe Coalition (11/13). In the GHTC’s blog, Slutsker writes, “It’s time for civil society, health care workers, governments, and the private sector to come together and ensure no child dies from this preventable and treatable disease” (11/13).
Recent successes in increasing the treatment and decreasing the incidence of HIV/AIDS, tuberculosis (TB), and malaria, along with other global health advances, “is thanks to the hard work and cooperation of people from many different walks of life: politicians of all stripes, business leaders, grassroots activists, clergy, health workers, government agencies and many more,” Deborah Derrick, president of Friends of the Global Fight Against AIDS, Tuberculosis and Malaria, writes in the Huffington Post “Impact” blog. She says the Global Fund to Fight AIDS, Tuberculosis and Malaria has been “[c]entral” to these developments, and the “U.S. government has been a crucial leader in supporting international health and the Global Fund.” She adds, “Sustained commitment will ensure more lifesaving success.” Derrick also recognizes the work of doctors and businesses.
The BMJ examines the history of fraud allegations against the Global Fund to Fight AIDS, Tuberculosis and Malaria and the organization’s ongoing reform efforts. “Most observers agree that after a honeymoon first decade, the Global Fund had grown so big, and the economic climate and attitudes to diseases such as AIDS have changed so dramatically, that more rigor and efficiency was needed, fraud or no fraud,” BMJ writes. The Fund is expected to appoint a new director “and a new funding model, to be announced on November 15, [which] are supposed to get things back on track” (Arie, 11/12).
“Look in the global strategies for HIV, [tuberculosis (TB)], malaria, maternal and child health, polio eradication, [neglected tropical diseases (NTDs)], and [non-communicable disease (NCDs)] — among many others — and you’ll see Nigeria at or near the top of the ‘Must Win’ countries,” Todd Summers, a senior adviser at the Center for Strategic & International Studies’ (CSIS) Global Health Policy Center, writes in the CSIS “Smart Global Health” blog. “Home to 170 million people, many of them desperately poor, Nigeria carries a huge and disproportionate share of burden for many of the world’s most deadly diseases,” he writes, noting the country, “one of the most important countries for all three diseases, is losing more in revenues than all of the Global Fund’s annual contributions combined.” He continues, “So, somehow, the Nigerian government needs to do a better job of capturing the revenues it’s due, and channeling a greater percentage of that revenue to the urgent health needs of its citizens, but that doesn’t seem to be happening.” However, Summers concludes “there’s some good news to report” on overall governance in the country, and he provides some examples (11/8).