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Recent Releases In Global Health

Lancet Study Finds Level Of HIV Services For IDUs ‘Is Poor In Many Countries’

A Lancet study performed a systematic review of HIV prevention and treatment services targeting injecting drug users (IDUs) globally based on the availability of “core interventions for IDUs: needle and syringe programmes (NSPs), opioid substitution therapy (OST) and other drug treatment, HIV testing and counselling, antiretroviral therapy (ART), and condom programmes.” The authors conclude, “although the number of countries with core HIV prevention services is growing … worldwide, there are few countries in which the level of intervention coverage is sufficient to prevent HIV transmission” (Mathers et al., 3/20).

“HIV continues to spread among IDUs in many different countries, and the need for scaling up prevention and treatment is urgent,” according to Lancet comment. The authors recommend “framing the issue in community health-economic terms might be the most useful for immediate policy change. Long-term sustained efforts to protect the health of individuals who use both licit and illicit drugs might require that policy makers acquire a basic scientific understanding of drug use and addiction, and frame policies toward drug users within a public health and human rights perspective” (Jarlais/Arasteh/Gwadz, 3/20).

Lancet Comment Examines How ‘Two Camps’ Of HIV Prevention Can Inform Unified Approach

Sucessfully supporting the prevention of 12 million new HIV infections, as proposed by the PEPFAR five-year strategy, “will require resolving a deep gulf dividing the prevention community,” a Lancet comment writes. “One camp sees that multiple sexual partnerships drive infection in generalised epidemics in eastern and southern Africa, dispersed through the broad population. The other emphasises the large number of already infected individuals, particularly the many existing discordant couples, and stresses widespread HIV testing,” according to the journal. The piece explores lessons drawn from both components and presents a priority system for approaching prevention strategies (Shelton, 3/20).

CSIS Commission On Smart Global Health Policy Releases Final Report

The CSIS Commission on Smart Global Health Policy report, released on Thursday, “marks the culmination of nine months of deliberation by the Commission – a group formed to develop actionable recommendations for a long-term U.S. strategic approach to global health.” The report – “A Healthier, Safer, and More Prosperous World” – lays out a five-point global health policy agenda, which aims to “advance America’s core interests … making better use of the influence and special capabilities of the United States, motivating others to do more, and creating lasting collaborations that could save and lift the lives of millions worldwide.” A webcast of the report’s release is available online (3/18).

Blog Features Series Examining QDDR

In anticipation of the imminent release of the State Department’s Quadrennial Diplomacy & Development Review (QDDR), Modernizing Foreign Assistance Network’s “ModernizeAid” blog has a series featuring analysis of the QDDR by development experts. The first post raises questions that should be asked when the QDDR findings are released (Ingram, 3/16). A second post highlights the importance of a presidential study on global development (Unger, 3/17). A third post discusses the need for an “elevated, streamlined, and empowered 21st century U.S. development agency” (Beckmann, 3/18).

Blog: Foreign Aid Reform A Top Priority, But Legislation Won’t Move Until Next Year, House Foreign Affairs Chair Says

“This morning the Chairman of the House Foreign Affairs Committee, Howard Berman, told an audience at the Center for American Progress that foreign assistance reform will continue to be a top priority of his, but that real movement of legislation will likely not happen until next year,” according to the U.S. Global Leadership Coalition’s blog (Smith, 3/18).

Blog: Millennium Villages Project Needs Better Evaluation

A Center for Global Development “Views from the Center” blog post critiques the Millennium Villages Project. “The big problem with the enterprise is that the effect of the MV intervention is not being as carefully evaluated as it should be. Without sound evaluation, it simply cannot be known – regardless of what is observed today at MV sites – whether the money devoted to the MVs is accomplishing its goals,” according to the blog (Clemens, 3/18).

Blog: Highlights From Recent Malaria Honoree Breakfast

Modernizing Foreign Assistance Network’s “ModernizeAid” includes some quotes from speakers at the Malaria No More Policy Center’s recent Champions Breakfast. Rear Admiral Tim Ziemer (ret.), the coordinator of the President’s Malaria Initiative, and Ezekiel Emanuel, a senior health advisor at the Office of Management and Budget, were honored. The blog notes the major “takeaways” from the breakfast:

“1. With the right resources and political backing, USAID is more than capable of leading major, interagency efforts on global health and development – and they should lead these efforts.

2. The President remains committed to development and global health, and he is pushing his high-level staffers to make sure we are getting the best results possible” (3/17).

Symposium Highlights Need For New Technology To Address Growing Global Food Needs

Several studies released during a symposium held in Washington, D.C., on Wednesday highlight the importance of agricultural innovation and the development of new technologies for “meeting growing global food, feed, fiber and industrial needs,” according to a Global Harvest Initiative press release. The release features several study highlights and comments researchers made during the symposium (3/17).

PLoS Medicine Explores Factors Influencing Country Adoption Of New Vaccines Into National Immunization Programs

A PLoS Medicine looks at how adoption of the Haemophilus influenzae type b (Hib) vaccine in low-income countries is effected by “country-level economic, epidemiological, programmatic and policy-related factors, as well as the role of the Global Alliance for Vaccines and Immunisation (GAVI Alliance).” The authors conclude, “This study substantiates previous findings related to vaccine price and presents new evidence to suggest that GAVI eligibility is associated with accelerated decisions to adopt Hib vaccine. The influence of neighboring country decisions was also highly significant, suggesting that approaches to support the adoption of new vaccines should consider supply- and demand-side factors” (Shearer et al., 3/16).

UNICEF, WHO Provide Expectant Mothers With ARVs, Antibiotic Take-Home Kits

Out of concern that the first prenatal check up will be the only time expectant mothers with HIV are able to make it to the clinic, the Lesotho government began distributing drug kits, complete with antiretrovirals (ARVs) and antibiotics, as well as instructions, to help prevent mother-to-child transmission (PMTCT) of HIV, UNICEF writes. According to the piece, the WHO and UNICEF plan to begin providing color-coded take-home “Mother to Baby Packs” in Lesotho and four other countries in eastern and southern Africa by July (Bloemen, 3/16).

Blog Highlights Role Of Global Health Reporting

“Without investigative reporting, our understanding of the key roles government leaders, global trade policies and agricultural practices, pharmaceutical companies and medical practitioners play in a variety of health issues is diminished,” according to a post on the Nieman Foundation’s “Watchdog” blog which examines global health reporting. The article highlights the contributions of former Nieman fellows to the coverage of global health (Giles, 3/15).

Blog: U.S. Agencies Team Up To Bolster Medical Education In Africa

In an effort to fulfill PEPFAR’s commitment to train 140,000 health worker, as part of its five-year strategy, the NIH, together with PEPFAR, the CDC and the Department of Defense have joined together to launch a program aimed at strengthening medical education in sub-Saharan Africa, according to the Center for Global Health Policy’s “Science Speaks” blog. “The NIH says it will also serve a related objective: strengthening developing country medical education systems and enhancing clinical and research capacity in Africa,” the blog writes (Shesgreen, 3/17). The Kaiser Policy Tracker includes links to an NIH press release announcing the initiative (3/15).

Blog: PEPFAR’s Focus On Health System Strengthening Is ‘Not So Simple’

A post on the George W. Bush Institute’s blog that addresses “the thoeory” of diverting some money from U.S. HIV programs in Africa to strengthen “general health systems” there, includes a quote from former U.S. Global AIDS Coordinator Mark Dybul, now a fellow the institute. According to Dybul: “HIV itself reduces the capacity of an already strained and stretched health workforce in countries hard hit by the epidemic. In Kenya, health workers are twice as likely to be infected as the general population. In Zambia, 38 percent of exits from the work force were due to HIV. In Swaziland, 4 percent of nurses are lost each year from HIV.” He concludes, “Unless prevention, treatment and care of HIV are available and effective, there is little hope of building a strong health work force and, therefore, a strong health system” (3/15).

Study Uses Mathematical Model To Investigate Reach, Cost-Effectiveness Of HIV Test-And-Treat Strategy

An AIDS study describes the impact of test-and-treat HIV interventions under various conditions, using a mathematical model. The researchers report that though the model “shows that such an intervention can substantially reduce HIV transmission … that impact depends crucially on the epidemiological context” and “testing every year and treating immediately is not necessarily the most cost-efficient strategy.” The authors “also show that a test-and-treat intervention that does not reach full implementation or coverage could, perversely, increase long-term ART costs,” according to the study (Dodd/Garnett/Hallett, 3/13).

Clinical Infectious Diseases Explores Problem, Proposes Solution To ‘Antibiotic Pipeline Problem’

A Clinical Infectious Diseases public policy piece examines the lack of new antibiotic drug candidates in the drug pipeline and suggests possible solutions to bolster available drugs in the future. “[T]he antibiotic pipeline problem can be solved by bringing together global political, scientific, industry, economic, intellectual property, policy, medical and philanthropic leaders to develop creative incentives that will stimulate new antibacterial research and development (R&D),” the authors write, before describing their support for the development of an initiative “to develop 10 new, safe, and effective antibiotics by 2020.” The piece also notes President Barack Obama’s commitment to a transatlantic task force focused on coming up with “solutions to the antibacterial drug pipeline problem…” (3/9).