Lancet Infectious Diseases Editorial Reflects On Need To Integrate HIV/AIDS, TB Prevention, Treatment Services

Ahead of the International AIDS Conference, held July 18-23 in Vienna, Austria, a Lancet Infectious Diseases editorial notes, “While there has been welcome progress in making ART available, HIV/AIDS raises other challenges that we are only just beginning to face. Among the most pressing of these challenges is the intersection of the global HIV and tuberculosis pandemics.” The piece reflects on the WHO policy for collaboration between prevention and treatment efforts for HIV/AIDS and TB and the growing recognition that “an early start to ART can reduce the incidence of tuberculosis in people infected with HIV. … However, earlier testing and treatment of patients infected with HIV requires funding, implementation, and convincing evidence of cost-effectiveness” (July 2010).

The July 2010 issue of the journal also features several review and personal view papers on the intersection between HIV and other diseases (July 2010).

Global Health Magazine Blog Reported From Pacific Health Summit

Global Health Magazine’s blog reported from the Pacific Health Summit June 22-24 in London. The posts include descriptions of topics addressed during meeting sessions, including statements made by WHO Director-General Margaret Chan. Additional posts feature Q&As with health experts presenting at the meeting and descriptions of an on-site photo exhibit of women from developing countries who recently gave birth (Donnelly, 6/24).

Shifting G8, G20 Roles Mean Uncertain Future For Global Health, Development Goals

“Many former G7/8 ‘sherpas’ – as the organizers for each country’s delegation are called – say the G8 is on its last legs. The next week will reveal whether they are correct,” according to a Council on Foreign Relations Expert Brief, which outlines how the shifting G8 and G20 power structures could affect various global health-related efforts. “Meanwhile, the global health community faces two tough challenges. First, the world is approaching the five-year countdown on the Millennium Development Goals (MDGs), three of which are direct health targets. None of these targets is likely to be achieved without bold changes in strategic approaches, along with infusions of billions of more dollars on a sustained (if not radically increased) basis. The second challenge is internal. Fear of shrinking financial resources, coupled with arguments over global health priorities, has weakened the global health advocacy community,” the piece states. The author concludes, “In a time of shifting global power, the future of health and development remains uncertain” (Garrett, 6/24).

G20 Involvement In Global Health 

“The G20 does not implement, nor does it convene and raise issues in the same manner as formal U.N. institutions and their regional offices. However, its reach extends beyond the political networks accessible to the G8 and it also avoids some of the limiting bureaucracy of formal structures. … These factors might mean that the G20 responds more favourably to health issues that have an emerging consensus, for example donor coordination,” the authors of a Lancet Viewpoint (.pdf) write in a piece exploring how the G20 might be well suited to get involved in global health issues.

“The G20 already recognises the axis between the global economy, security, health, and development, and could be at the centre of a broad historic debate that will stretch out over the next several years. The trillions invested in recovering from recession show that where there is a collective will, the global response can be rapid and powerful. Just a few drops of the G20’s distinctive potion could ensure the health and wellbeing of millions,” the authors write (Chand et al., 6/23).

Blog: Will Canadian PM Deliver On Maternal Health?

On the eve of the G8 summit, a Huffington Post blog post reflects on how Canadian Prime Minster Stephen Harper will help lead G8 countries in efforts to improve maternal health worldwide. “As some very sensible proposals put forth have suggested, G8 countries may contribute to various aspects of maternal health that they are most equipped to,” the blog writes. “The overall plan should be comprehensive, but issues like family planning can be funded by certain governments and donors while other equally critical aspects such as nutrition, infant mortality, and health worker training, can be funded by others. The underlying key is that the plan is based on scientific evidence and cost-effective solutions we know work,” according to the post.

“After the tremendous momentum that has built around maternal health as a key development issue, the G8 Summit should not be a denouement but an important stepping stone on the way to achieving our goal,” the author of the blog writes (Sheffield, 6/23).

Blog: Fighting Corruption Key To Country Ownership

“It is not only the donors and their domestic constituencies who have an interest in whether aid program money is spent as intended. The local citizens of recipient countries have an even more vital interest,” two panelists at a Center for Global Development event on country ownership pointed out, according to the organization’s “Global Health Policy” blog. “Local public disclosure might be part of the solution,” the author writes. “Due to almost complete obfuscation of the amounts donors spend in country and of the amounts that should go through various channels to various destinations for various purposes, the local citizens have no way of telling whether the money has been stolen before it gets to them.” The author also cites Zambia, where the Global Fund removed millions of dollars in AIDS funding due to corruption charges (Over, 6/22).

G8 Is The ‘Wrong Forum’ To Address Global Health Issues

“If history is any guide, G8 declarations on health will accomplish little. … In fact, the G8 has made dozens of health promises, especially in the last decade. However, consensus statements have led to few new programs or only limited mobilization of resources aimed at improving health outcomes in developing countries,” according to a Canadian Medical Association Journal editorial. After reviewing previous G8 programs to tackle HIV and hunger, the authors write that the G8 “seems to be the wrong forum to seek real progress on global health issues. The right forum must incorporate a group of national leaders, including the G8, and cannot be restricted to a few rich countries. … Perhaps the G20 conference, being more inclusive, might better meet some of these criteria. Or maybe it’s time for the world’s most prominent health leaders to take the initiative and create a parallel meeting.”

According to the authors, “World leaders, particularly the economic powerhouses of the G8, might also begin addressing health and well-being as an economic issue. Doing so would entail investing in broad-based long-term health strategies rather than opting for new piecemeal programs only suited for press releases. Ensuring that any new health priority is supported and aligned through the Global Fund is another important role for the leaders of the G8” (Attaran et al., 6/21).

Reproductive And Sexual Health Vital In Maternal Health

PLoS Medicine presents new data on maternal, neonatal, and child health “to inform an evidence-based approach to policy that can reduce maternal deaths, support women’s ability to determine their reproductive and sexual lives, increase access to family planning resources, and ensure that women are no longer denied the benefits of even the most basic medical care during pregnancy and childbirth,” states an editorial accompanying the journal’s issue on Maternal, Newborn and Child Health (MNCH) in Africa. The series “updates the current status of MNCH in the region, reviews evidence based solutions, and identifies high-impact opportunities for reducing maternal and child mortality.” According to the editorial, the data “reveal the importance of considering the whole of women’s reproductive and sexual health in maternal health policy. … [I]ncreased use of contraceptives could avert a quarter of maternal deaths each year even in the most under-resourced health systems” (6/21).

Evidence-Based Strategy Needed For Maternal And Child Health In Sub-Saharan Africa

“Every year 4.4 million children – including 1.2 million newborns – and 265,000 mothers die in sub-Saharan Africa. This amounts to 13,000 deaths per day or almost nine deaths every minute. Sub-Saharan Africa has half of the world’s maternal, newborn, and child deaths,” according to a PLoS Medicine Policy Forum. The authors write that despite proven medical interventions, “many African governments are currently underutilizing existing scientific knowledge to save women’s and children’s lives.” The journal calls for an approach based on epidemiological data to prioritize “appropriate interventions in a given context.” Though much of sub-Saharan Africa is behind on meeting Millennium Development Goals for maternal and child health, the authors write, “progress in several low-income countries demonstrates that the MDGs could still be attained through immediate strategic investments in selected evidence –based interventions and targeted health systems strengthening” (Kinney et.al., 6/21).

Targeted Health Interventions Could Save 4M African Women And Children

“Nearly 4 million African women, newborns, and children need not die each year if already well known interventions reached 90% of families,” estimates a new report published in PLoS Medicine. Researchers estimated the decrease in mortality in 42 sub-Saharan African countries if targeted health interventions were used. The researchers also analyzed statistics from nine African countries to determine additional cost for increases in interventions and their related mortality reductions and found “[a] 20% coverage increase for selected community-based/outreach interventions would save an estimated 486,000 lives and cost an additional US$1.21 per capita. Increasing the quality of current facility births would save 105,000 lives and cost an additional US$0.54 per capita” (Friberg, et al., 6/21).