U.S. Secretary of State Hillary Clinton on Tuesday visited officials in South Africa and discussed the response to HIV/AIDS, the Associated Press/Huffington Post reports. Speaking with Foreign Minister Maite Nkoana-Mashabane “in the second cabinet-level strategic dialogue between the two nations,” Clinton said “that global efforts to stop the virus ‘have saved hundreds of thousands of lives,’” the news service writes. “In South Africa, 5.7 million people — 17.8 percent of the population — have tested positive for HIV,” and PEPFAR “has spent $3.2 billion on antiretroviral drugs and HIV prevention programs in [the country] since 2004,” according to the AP.
US Global Health Policy
With incentives to find new antibiotics signed into U.S. law last month, “multiple players are vying for the lead in the [multi-drug resistant tuberculosis (MDR-TB)] drug development niche,” Nature Medicine reports. “The fifth reauthorization of the U.S. Prescription Drug User Fee Act (PDUFA), signed into law on 9 July, includes a subsection called the Generating Antibiotic Incentives Now (GAIN) Act that aims to spur development of antibiotics for drug-resistant bacteria, including MDR-TB,” the news service writes, noting, “Drug makers that ask for approval of medicines to treat these pathogens will receive priority review, as well as five additional years of market exclusivity and fast-track status.” Currently, MDR-TB treatment “involves a bevy of regular tuberculosis medicines that, in many cases, must be administered for as long as two years or more … [and] don’t always work,” Nature Medicine states, adding, “The hope is that new medicines will shorten treatment times and improve cure rates.” The article discusses several medicines that are in different phases of research (Willyard, 8/6).
“The Obama Administration released eight interim reports last week measuring results achieved in core elements of our U.S. global health programs through the Global Health Initiative (GHI),” the ONE Blog reports. “While the targets on each of the eight core areas were specific … the data in the reports was a bit of a muddled mess,” the blog writes, adding, “To their credit, the administration prefaced the release by saying ‘The data is still preliminary inasmuch as our aim is to consult with key stakeholders, in and out of government, on improvements we can make to the methodology, format, and usability’” (Hohlfelder, 8/20).
In this post in Management Sciences for Health’s (MSH) “Global Health Impact” blog, Belkis Giorgis, senior technical advisor for the Leadership Management and Governance Project at MSH, reports on the International Protecting Girls by Preventing Child Marriage Act (House Resolution 6087), which “establishes a strategy to prevent child marriage and promote the empowerment of girls.” She writes, “If passed into law, the International Protecting Girls by Preventing Child Marriage Act must be implemented in a matter that views the long-term resolution of child marriage as ensuring that young girls are kept in school,” adding, “Most importantly, the legislation must provide effective means to enforce it, to ensure long-term health impact for young women and girls” (8/16).
“During the recent [XIX International AIDS Conference (AIDS 2012)] in Washington, D.C., exciting breakthroughs in HIV prevention, treatment, and care — even a possible cure — took center stage,” but, “despite recent advances, many men and women remain at risk of HIV as a result of structural issues that fuel and have an impact on the epidemic,” Molly Fitzgerald, technical advisor for AIDSTAR-One, writes in this post in USAID’s “Impact Blog.” “Addressing gender inequality, poverty, stigma, and other social, economic, cultural, and legal factors is necessary to create an ‘enabling environment’ for these promising biomedical and behavioral interventions,” she continues, noting, “There is increasing agreement worldwide that structural issues are too often overlooked where HIV prevalence remains high” (8/16).
“With Congress adjourned until after Labor Day and not a single funding bill for the federal fiscal year beginning October signed into law before the recess even began, the virtual standstill of legislative action could have a mixed impact on global health funding,” the Center for Global Health Policy’s “Science Speaks” blog reports. “It appears that House and Senate leaders have reached a tentative agreement to fund most government programs under a so-called ‘continuing resolution’ that would essentially continue funding for most programs at current levels through March 30, 2013,” the blog writes, adding, “PEPFAR is likely to see at least a modest cut from current funding so that resolution could delay or potentially reduce the overall hit to the program” (Lubinski , 8/10).
“Health care, taxes, energy, favorite flavor of ice cream — it seems our elected leaders must disagree at every turn. But one issue that has so far repulsed the partisan pressures of the times was highlighted [at the XIX International AIDS Conference (AIDS 2012)] in our nation’s capital last week: the fight against HIV/AIDS,” former Senate Majority Leader Bill Frist (R-Tenn.) writes in an opinion piece in “The Week.” He says, “The conference was a celebration of the remarkable success made because of this leadership, and a call for continued support” in the response against HIV/AIDS. Noting he moderated a panel discussion with Rep. Barbara Lee (D-Calif.) and Sens. Chris Coons (D-Del.), Marco Rubio (R-Fla.) and Mike Enzi (R-Wyo.) on congressional bipartisanship at the conference, Frist continues, “I witnessed what I felt to be an accurate portrayal of how we got to the point where we could celebrate so many successes. Fundamental to the progress has been bipartisanship.”
U.S. Secretary of State Hillary Clinton “expressed concern” over Uganda’s increasing number of HIV infections on a visit to the country last week, part of an 11-day trip to eight African nations, Uganda’s New Vision reports (Mukasa, 8/4). According to the Observer, Clinton “said while America recognizes the strides Uganda made in the 1990s when HIV prevalence dropped from 20 percent to seven percent, prevalence is now rising.” PEPFAR is the largest donor for HIV programs in the country, the newspaper notes, adding that “[t]he U.S. government recently committed $25 million to help Uganda eliminate mother-to-child HIV transmission and … [m]ore than 300,000 Ugandans are receiving treatment through PEPFAR” (Mwesigye, 8/5). “The reversal is particularly disappointing to health experts given the time and attention that have been focused on AIDS here, and the billions of dollars spent,” the New York Times writes (Kron, 8/2). “I am hoping that we can work together to make prevention the focus again. We are going to review our strategy because we want to emphasize what will work,” Clinton said, according to the Observer (8/5).
As part of its monthly series Stories Behind the Statistics, “guest edited by FHI 360 on behalf of USAID’S IYWG, which provides technical leadership to improve the reproductive and sexual health of young people,” the Bill & Melinda Gates Foundation’s “Impatient Optimists” blog features a story by Gaj Bahadur Gurung, program coordinator for the National Federation of Women Living with HIV and AIDS in Nepal, who discusses the impact of adolescent pregnancy on girls and young women in South Asia. He writes, “Policies and programs must both help prevent early and unintended pregnancy (for married and unmarried women) and mitigate the negative consequences for girls who do become pregnant. Programs should provide young women access to, control over, and informed choice of their sexual and maternal health services” (8/3).
In this post on the Center for Global Development’s (CGD) “Global Health Policy” blog, CGD’s Victoria Fan, Rachel Silverman, and Amanda Glassman examine “the preliminary report [.pdf] on the pilot of PEPFAR’s Expenditure Analysis Initiative, an important and exciting move by PEPFAR towards evidence-based decision making and greater transparency.” Expenditure analysis (EA) “provides an account of where money gets spent and on what,” they continue, adding, “Here’s why it could be a game changer: This seemingly simple tool is essential for realizing huge potential gains in both technical and allocative efficiency, two core components of value for money.” After describing some of the report’s shortcomings, they write that “the report demonstrates the wide range of potential applications for using EA to improve value for money, which is particularly encouraging given PEPFAR’s plans to institutionalize EA into its routine annual reporting” (8/1).