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Independent research & practical ideas for global prosperity
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Independent research & practical ideas for global prosperity
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December 1, 2009Should Poor Countries Follow WHO’s New Advice on When to Start AIDS Treatment?Posted by Mead Over in HIV/AIDS & Infectious Diseases, HIV/AIDS and other Infectious DiseasesWHO and UNAIDS have just put poor country AIDS treatment program managers on the spot. Will they choose to follow the new WHO advice to push patients to begin treatment earlier – when many are still healthy? Or will they turn their backs on the new advice and push instead for expanded access to those in need. In conjunction with World AIDS Day on December 1, WHO and UNAIDS have released new treatment guidelines for AIDS patients. Until this week, WHO’s official position has been that AIDS treatment programs should strive to start patients on antiretroviral therapy when the number of CD4 cells in their blood drops from normal levels of between 800 and a 1,000 per cubic millimeter down to 200 per mm3. The fact that poor countries have not been able to achieve this goal accounts for WHO’s current estimate that there are about 5 million people currently needing treatment, twenty percent more than the 4 million receiving it. Read More… 2 Comments »August 4, 2009Will a New NIH-Funded Study Tell Us Whether Immediate AIDS Treatment Slows HIV Transmission?Posted by Mead Over in HIV/AIDS & Infectious Diseases, HIV/AIDS and other Infectious Diseases, Health Product Innovation and AccessEach year in Sub-Saharan Africa there are about 2-million new cases of HIV infection, most of whom would not need antiretroviral therapy (ART) under current guidelines for 8 to 12 more years. Since donors have not managed to place on treatment more than about half of those needing it each year, the 8 to 12 year lag between infection and need for treatment has been seen as a breathing space. But a radical new idea discussed at last week’s Conference on HIV Pathogenesis, Treatment and Prevention in Cape Town, South Africa would start the 2-million newly infected people on ART within days or weeks of their infection. Would immediate treatment work as a prevention strategy? At the IAS meeting, Dr. Anthony Fauci, Director of the National Institute of Allergy and Infectious Disease, told the South African Times that “[w]e will be doing research to determine the feasibility of several assumptions underlying [the immediate treatment strategy].” Now the University of North Carolina’s Institute for Global Health and Infectious Disease has announced that researchers William Miller and Audrey Pettifor have been awarded a $3.5 million, four-year research grant to test some of the assumptions flagged in Dr. Fauci’s conference talk. Read More… 7 Comments »August 4, 2009Dire Straits: Money for Treatment, Prevention for Free?Posted by Nandini Oomman in HIV/AIDS & Infectious Diseases, HIV/AIDS and other Infectious DiseasesLast week, the Kaiser Family Foundation and the National Alliance of State and Territorial AIDS Directors (NASTAD) released a report of a study on the state of HIV Prevention in the U.S. This week, Drew Altman of the KFF shared his thoughts on the sorry state of spending at scale on prevention in the U.S., “despite the fact that the CDC determined in August of 2008 that the number of new HIV infections in the U.S. is 40% higher than we thought it was – at about 56,000 per year.” While Altman seemed to suggest that global health efforts are more successful at preventing HIV than the U.S. response, I would argue that the state of HIV prevention in the U.S. (especially exemplified by drastic cuts in California) provides a preview snapshot of the global situation in the very near future: with flat lined budgets and freezes on program activities, prevention is unlikely to get the funding it should for programs to be implemented at scale and with intensity. As my colleague David Wendt reported in an earlier post, the worsening financial crisis is already beginning to manifest itself in global funding budget cuts for AIDS in countries where HIV incidence is still very high. With these cuts, countries will scramble to pull together resources for treatment, an important human and political priority in the short term, but it’s less apparent how prevention will be supported both by global funders like PEPFAR and the Global Fund, and by domestic budgets for health. In these dire straits, with a continuing focus on treatment, prevention is unlikely to happen (for real success) for free. Comment »July 31, 2009“Will You Still Need Me, Will You Still Feed Me?”Posted by Danielle Kuczynski in HIV/AIDS & Infectious Diseases, HIV/AIDS and other Infectious Diseases Tags: Demographics and DevelopmentThis is a joint post with Rachel Nugent. A new report from the US Census Bureau offers the surprising fact that in the next 30 years, the human population over 65 will double. In ten years, there will be more over-65s than under-fives. Old news, you say? Yes, in Italy, Japan, and Russia this is old news. In developing countries, it is new – and somewhat alarming. In 2008, 62 percent of all those aged 65 and over (313 million people) lived in the developing countries of Africa, Asia, Latin America, the Caribbean, and Oceania. The elderly population in developing countries is growing twice as fast as in developed countries (on a not very small base in India and China, as it turns out. Those two countries account for 1/3 of the world’s aged population and 37% of the total global population.) Read More… 3 Comments »July 29, 2009If You Drive, I’ll Pay for Gas: Critical Developments in Ownership and Financing of the National HIV/AIDS ResponsePosted by David Wendt in HIV/AIDS & Infectious Diseases, HIV/AIDS and other Infectious Diseases, Health Systems, Services and Financing Tags: PEPFARWhile taking a stroll though the newspaper headlines on allAfrica.com, I was struck by a story from Uganda which provides a real world illustration to ground some of the discussions at the International AIDS Society Conference that just happened in South Africa and the AIDS Implementers’ Meeting in Namibia last month. Apparently many bi-lateral and multi-lateral donor-funded ART providers in Uganda have announced they are scaling back ART services (funding scale backs have also been announced in Tanzania). Many examples are given including a PEPFAR supported antiretroviral therapy clinic in Masindi Hospital – which is run by one doctor and a number of volunteers – that had enrolled over 2000 patients (with around 500 currently on ARVs). The article quotes Dr Michael Strong, the PEPFAR coordinator, describing problems with the supplies of ARVs in the national programme. Read More… 2 Comments »July 24, 2009Task-Shifting Can Be Part of the Answer to ART Access—If the Numbers of Lower Level Health Workers Expand Fast EnoughPosted by Mead Over in HIV/AIDS & Infectious Diseases, HIV/AIDS and other Infectious Diseases, Health Product Innovation and Access Tags: ARTThere has been a great deal of discussion at this week’s IAS Conference on HIV Pathogenesis, Treatment and Prevention in Cape Town, South Africa of four expensive directions for proposed expansion of access to antiretroviral treatment for AIDS patients in poor countries (ART):
2 Comments »June 30, 2009Can HIV/AIDS Donors be the lead “Gender Bender” of Global Development?Posted by Nandini Oomman in Global Fund, HIV/AIDS & Infectious Diseases, HIV/AIDS and other Infectious Diseases, PEPFAR, World Bank Tags: GenderThis post originally appeared on the Huffington Post The current economic crisis is forcing HIV/AIDS donors to do more with less. Taking on gender inequality in more than a token way to improve efficiency and effectiveness is a no brainer. The current U.S. administration has made women and girls a high priority so PEPFAR has all the political backing it needs, and multi-lateral donors like the Global Fund and the World Bank also have full support from their boards of directors. The powerful combination of budget squeeze and political commitment creates an opportunity for three of the largest HIV/AIDS donors to become the lead “gender bender” in global development; that is, to support development programs that transform the lives of women and girls, and thus the societies in which they live. Read More… Comment » |
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