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Recent Releases In Global Health

Lancet Infectious Diseases Reflects On TB Diagnosis In Children

“[N]ew diagnostic techniques [for tuberculosis] need to be studied in children,” according to a Lancet Infectious Diseases Reflection. “Tuberculosis is an important cause of morbidity and mortality in children worldwide, but estimates of disease burden are inaccurate because most cases are not confirmed,” the author writes. He discusses a study published in the same issue that examines various methods for diagnosing TB in children. “The low overall yield of culture-confirmed cases in this study of a large number of children, many with strong clinical evidence of pulmonary tuberculosis, emphasizes the ongoing diagnostic challenges for research,” he writes, adding that the emergence of culture facilities in response to drug-resistant TB “provides an important opportunity for child tuberculosis research” (Graham, September 2010).

Blog: PEPFAR-Funded Zambian Program Provides Support, Treatment To Women

A post on the Center for Global Health Policy’s “Science Speaks” blog examines the Zambian program Corridors of Hope, run by Family Health International (FHI) and funded by PEPFAR. The author writes that the group “meets weekly outdoors to discuss challenges and problems associated with their lives – from negotiating condom use to remaining adherent to their HIV medications.” The program “provides these women with HIV and TB screening, sexually transmitted infection diagnosis and treatment, and linkages to HIV treatment.” About half the women in the group said that “in addition to their own children, they were raising the children of others who had died from AIDS.” The author concludes, “[t]hese energetic, articulate women reminded us all that structural interventions, which respond to the poverty and vulnerability of these women and their families, are also key to reducing the toll of HIV on these young women and their children” (Lubinski, 8/24).

NEJM Perspective Examines Cancer Treatment In Low-Income Countries

“[V]ery little has been done to develop evidence-based guidelines for cost-effective cancer treatment or recommended therapeutic algorithms for use in poorly funded health care systems,” write the authors of a New England Journal of Medicine Perspective. The article presents guidelines for cancer care in low-income countries, noting that the “first step forward is to establish an interdisciplinary task force that could develop cancer-treatment guidelines for low-income countries” which would be comprised of oncology, health economics and clinical pharmacology experts. Meanwhile, the authors add, “we should not stop attempting to solve specific problems through ‘lateral thinking,'” including a planned clinical trial to dispense tamoxifen and provide breast-exams to Ghanian women.  The authors conclude by asking, “So will we be able to treat cancer for a dollar a day? At one level, the answer might be yes, but we need to develop an evidence base that is appropriate to the capacity of available health funds,” using a multidisciplinary approach (Kerr/Midgley, 8/26).

Blog: Lessons From Haiti Provide Guidance In Pakistan

“[T]he response to the Haiti earthquake might provide some guidance for a way forward” in Pakistan, writes the author of a post on U.N. Dispatch. Noting that both countries have a “democratic and internationally supported but weak civilian government,” the author writes that “donors must ultimately empower and strengthen the civilian government’s capacity to deliver services to its people.” He cites the Interim Haiti Recovery Commission, created to “help thread the needle between wanting to empower a civilian government while satisfying donor’s concerns about transparency,” and he asks whether Pakistan will create a similar “hybrid” commission (Goldberg, 8/25).

Blog: AIDS Still Not A ‘Centerpiece’ For Obama

“President Obama is coming in for a very public flogging over a perceived lack of action on the global AIDS pandemic. Is it deserved?” asks the author of a post on Change.org’s “Human Rights” blog. He writes despite the fact that the U.S. funds most of the developing world’s HIV/AIDS efforts, people are “angry” because “the president led voters to believe we could – and he would – do so much more on AIDS than his predecessors. As Obama said in a 2006 speech, ‘AIDS must be an all-hands-on-deck effort’ that demanded more money and more attention.” A year and a half into Obama’s term, the author continues, “AIDS is still not an administrative centerpiece … when I see the comparison between money spent on Afghanistan in 2010 ($102 billion) and on HIV/AIDS ($6.5 billion), it’s easy to understand the rage” (Green, 8/22).

New Republic Examines Secretary Clinton’s Approach To Development

A New Republic article examines what the author calls “Hillary Clinton’s Naïve, Muddled Approach to Development.” In response to Clinton’s remark that the Global Health Initiative would be a “crucial component of American foreign policy and a signature element of smart power,” the author writes, “[o]n its face, this seems highly unlikely. Anyone doubting this should ponder the fact that one military program, the F-35 Joint Strike Fighter … is on course to cost $325 billion, and may well go higher (the budget request for fiscal year 2011 is $11.4 billion, roughly the same as each of the six years of the Global Health Initiative).” The article also discusses what he calls the “hyper-conceited, hyper-complacent conviction of America’s good intention [that] is so internalized in U.S. policymakers – even in one as intelligent as Secretary Clinton – that they are incapable of thinking clearly about how U.S. foreign aid, whether for emergency relief, health, or long-term development, is received by its beneficiaries” (Rieff, 8/23).

Blog: At MDG Summit, Leaders Should Up Investment In Women And Girls

A Huffington Post blog post discusses “Why We Shouldn’t Look Away From the Mistreatment of Girls Worldwide,” noting TIME magazine’s recent and “much discussed” cover of a young Afghan woman disfigured by the Taliban for running away from abusive in-laws. Ahead of next month’s Millennium Development Goal (MDG) summit, the author writes, “[o]ne of the best ways for governments to close in on the goals they made 10 years ago is to redouble their commitment, and investment, in women and girls. Investments in education and health for women and girls have been linked to increases in productivity and national income – all of which contribute to the achievement of the MDGs.” The author also calls on world leaders to “cut maternal mortality by three-quarters by 2015 and guarantee universal access to reproductive health [which] undergirds the success – or failure – of a number of the other global development goals, including reducing child mortality, combating HIV/AIDS and eradicating extreme poverty and hunger” (Bushkin Calvin, 8/20). 

Health Service Research In Africa Needs Funding, Coordination

A Tropical Medicine & International Health editorial discusses strengthening health services in Africa, especially “an urgent need to invest more in research to maximise the impact of health interventions.” The authors examine health care worker shortages as well as a need to integrate services, including those for tuberculosis and HIV, which “commonly occur together; yet, only 3% of HIV-infected subjects are tested routinely for tuberculosis, and only 45% of patients with tuberculosis are tested for HIV.” The editorial also recommends types of research needed “to inform delivery services,” such as studies carried out by researchers in collaboration with health service staff. The authors also note that “scarce” funding for health service research and staff who have “no time for research” are hurdles to facilitating research in Africa (Jafar et al., 8/19).