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Recent Releases In Global Health

Lancet Infectious Diseases Piece Highlights Positive Results Of PEPFAR In Mozambique

In a Lancet Infectious Diseases Reflection and Reaction piece, a group of “PEPFAR-implementing partners” in Mozambique counter a previous piece published in the journal that says there is “abuse” of PEPFAR money in the country. The authors contend that “since the introduction of PEPFAR, great strides have been made in increasing access to life-saving drugs and developing both infrastructure and human capacity. Exhaustive efforts have been made by the government of Mozambique and its PEPFAR partners in creating those institutional structures necessary to provide transparency, oversight, and improved monitoring and evaluation of implemented activities” (Moon et al., 1/10).

Lancet Infectious Diseases Examines Methods To Improve Management of ART In Resource-Limited Settings

“Despite the enormous progress made in scaling up antiretroviral therapy (ART) in sub-Saharan Africa, many challenges remain, not least of which are the identification and management of patients who have failed first-line therapy,” write the authors of a Lancet Infectious Diseases Personal View piece that examines the current challenges associated with diagnosing and managing ART failure in resource-limited settings in the region. The development of a point-of-care HIV viral-load test “combined with simple and inexpensive second-line therapy, such as boosted protease-inhibitor monotherapy, could revolutionise the management of ART failure in resource-limited settings,” according to the authors (Harries et al., 1/10).

PLoS One Article Examines Short- And Long-Term Outcomes Of ITN Use

A PLoS One article examines the short- and long-term outcomes of ITN use by studying the interaction between ITN use and age (comparing ages 12-42 months to 42-80 months) in determining febrile malaria risk. “Our data showing that ITN use reduced febrile malaria risk in younger but not older children is consistent with older children having used ITNs when they were younger, and therefore having acquired less immunity,” the authors write. “Policy may move towards community wide ITN distribution programmes rather than continue targeting vulnerable populations, to ensure that reduced transmission offsets reductions in host immunity. However, if the policy of targeted distribution for under 5 year old children continues, then large scale, long term studies should monitor the outcomes in terms of individual susceptibility,” they conclude (Bejon et al., 12/23).

Third Annual USAID Report On Orphans And Vulnerable Children In Developing Countries

The report, which is titled “U.S. Government and Partners: Working Together on a Comprehensive, Coordinated and Effective Response to Highly Vulnerable Children,” features “recent data and research findings on orphans and orphanhood” and “outlines priorities for USG assistance to highly vulnerable children,” including a Global Health and Child Survival account (Policy Tracker, 12/23). More information on recent U.S. global health policy developments is available on Kaiser’s Policy Tracker tool.

PLoS Medicine Examines Sexual Inequity In TB

A PLoS Medicine article examines tuberculosis susceptibility in men and women. “Although there is clear evidence that socioeconomic and cultural factors leading to barriers in accessing health care may cause undernotification in women, particularly in developing countries, biological mechanisms may actually account for a significant part of this difference between male and female susceptibility to TB,” the authors write. The TB community should work to “unravel the many faces of sexual inequality in TB, and to decipher the delicate mechanisms involved in natural and sex-associated resistance to TB. Such work would facilitate the design of future intervention strategies for combating the disease and the development of useful tools for evaluating prognosis and protection in future clinical trials” (Neyrolles/Quintana-Murci, 12/22).

PLoS Medicine Policy Forum Explores Methods To Reduce Surgical Burden Of Disease In Sub-Saharan Africa

A PLoS Medicine Policy Forum examines the overall surgical burden of disease in sub-Saharan Africa. The policy forum features recent recommendations compiled by Bellagio Essential Surgery Group (BESG) – a network of surgeons, anesthesiologists, public health professionals, economists, and policy makers – on how improve access to surgical services in the region. The recommendations include efforts to strengthen surgical services at district hospitals, improve systems for the delivery of trauma care, increase the number of health workers trained in surgical services, among others (Bellagio Essential Surgery Group, 12/22).

Malaria Journal Commentary Examines Global Fund’s Use Of Competitive Bidding Processes

A Malaria Journal commentary examines the implications of the Global Fund to Fight AIDS, Tuberculosis and Malaria’s call for grant recipients to use international competitive bidding processes for some drug purchases. In Kenya, this system has “caused more harm than good” and it could exacerbate “an already dire situation” in Uganda, according to the authors. “A tender process based primarily on price cannot account for a company’s ability to consistently supply sufficient product in time,” they write in the conclusion (12/22).

Uganda’s ‘Unsung Hero of NTDs’ Profiled

PLoS Neglected Tropical Diseases profiles Narcis Kabatereine of Uganda’s Ministry of Health Vector Control Division (VCD). According to the journal, “Kabatereine manages the ministry’s Bilharzia and Worm Control Programme and chairs the Neglected Tropical Disease (NTD) Secretariat in the VCD. Without fanfare, he has steadily built a career as both an academic and a highly trusted technical expert whose advice on tropical disease control is greatly in demand across Africa. … Dr. Simon Brooker of KEMRI/Wellcome Trust in Nairobi, Kenya, calls him ‘the unsung hero of NTDs'” (Yamey, 12/22) The article was funded by a Kaiser Family Foundation Mini Fellowship.

U.S. Should Expand Family Planning Access To Achieve MDGs

A Stimson Center Spotlight article argues for the U.S. to expand access to voluntary family planning services to help achieve Millennium Development Goal targets. “Common ground exists. It’s time for the President to invite political, religious, and other leaders to join a call for universal access to voluntary family planning in a manner that clearly fences off abortion from U.S. funding. He should seek to double U.S. spending, and use that prospect both to challenge other donors and to enlist the developing countries with greatest need,” according to the article (Moore, 12/21).

Uganda‘s Anti-Gay Legislation Prevents Health Officials From Understanding Factors Driving HIV

The anti-gay legislation currently under consideration in Uganda would “undermine [the country’s] efforts to combat its HIV epidemic. That would be a tragedy in any country, but perhaps more so in a place with a record of leadership and success on HIV prevention,” according to a Huffington Post blog post. The post highlights how understanding the “drivers of the spread of HIV” serves to inform prevention programs. The legislation would prevent “public health officials from assessing the factors driving the spread of HIV. Without adequate knowledge of the drivers of the epidemic, it is not possible to effectively plan and implement programs to combat it,” according to the post (Dybul, 12/19).

Blog: Senate Letter Calls On Obama To Fund PEPFAR At Congressionally-Authorized Levels

“There seems to be a significant – and hopefully growing – degree of displeasure on Capitol Hill about the Administration’s commitment to combating the AIDS epidemic,” according to the Infectious Diseases Center for Global Health Policy’s “Science Speaks” blog. The post focuses on a letter to President Barack Obama (available on the blog), which asks for PEPFAR to be funded at the levels authorized by Congress. The Senate letter was “spearheaded by Sens. Barbara Boxer, D-Calif., and Johnny Isakson, R-Georgia” (Shesgreen, 12/18).

Blog: Goosby Says PEPFAR Funds Will Be Used For Syringe Exchange

The “Housing Works” blog looks at the repeal of the “federal ban on syringe exchange funding” for domestic HIV/AIDS efforts. According to the blog, while the ban didn’t apply to global HIV/AIDS programs, “U.S. Global AIDS Coordinator Director Eric Goosby said now that the ban has been lifted he is working to redirect PEPFAR dollars to provide funding for syringe exchange. ‘I’ve been involved in working with injection drug users for a long time, and my view is that the evidence strongly supports the value of needle and syringe programs as part of a comprehensive prevention portfolio,’ Goosby said” (Scholl, 12/17).

Blog: How PEPFAR Fares In Addressing Stigma, Discrimination

The Physicians for Human Rights’ blog, “Health Rights Advocate”, analyzes how several PEPFAR country framework agreements fare in addressing issues related to stigma and discrimination. “PHR found that although PEPFAR’s newly released five-year strategy incorporates the vital goals of stigma-free HIV programs and reaching even the most marginalized populations, the initial partnership framework agreements inadequately address these issues,” the blog writes. The blog summarizes several key findings from the analysis and provides a link to recommendations by the group (Friedman, 12/15).