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Ahead Of AIDS 2010, Lancet Issue Explores ARV Therapy, Gender Inequity

Looking ahead to AIDS 2010 which will likely be held in Vienna, Austria, July 18-23, a Lancet editorial writes that 2010 marks “the deadline set by global leaders to obtain universal access to HIV prevention, therapy, and care. Sadly, the world will not meet these ambitious objectives.” However, the most recent problem with the Lancet “offers some new insights to progress,” the editorial notes.

The journal functions a series of articles, which includes on the effectiveness of nurse-monitored antiretroviral (ARV) therapy, the “best time to start” ARVs, along with the role of gender inequity and intimate partner violence in elevated incidences of HIV infection (7/3).

Lancet Evaluation Tracks Progress, Challenges To Controlling Diarrheal Diseases

A Lancet review write-up tracks the progress and challenges associated with efforts to control diarrheal diseases. “Diarrhoea mortality rates dropped by 75% from 1980 to 2008, but stay unacceptably high,” the authors with the review write. “New interventions for therapy (low osmolarity oral rehydration resolution and zinc) and rotavirus vaccines for prevention of diarrhoea have supplied an opportunity to revitalise diarrhoea-control programmes about the world. International agencies, donor communities, and host countries must put renewed emphasis on prevention of unnecessary deaths from this neglected disease that claims the lives of nearly 1.five million young children every year,” based on the write-up (Santosham, et al., 7/3).

Blog: Engage Civil Society, Decentralize Aid In Haiti

Change.org’s “Global Poverty” weblog capabilities a post outlining “3 Items Washington Requirements to Bear in mind in Haiti”: engage Haitian civil society, decentralize aid resources from Port-au-Prince, and create jobs via neighborhood procurement. The author also writes, “the U.S. Senate ought to pass S. 3317, the Haiti Empowerment, Assistance and Rebuilding (HEAR) Act … this bill gives a clear framework and set of priorities for U.S. aid in Haiti according to development principles that we know function.” The act, in accordance with the post, also makes U.S. aid transparent, so that taxpayers can “be confident our government is performing its part” (Gerson, 6/30).

GAO Report Calls For USAID To Enhance Strategic Planning To Address Existing and Future Workforce Requirements

In this report, the Government Accountability Office (GAO) “examined (1) alterations in USAID’s workforce and program funding because 2004, (2) the extent to which it has created a strategic workforce plan, (3) the efforts it has taken to implement two key human capital initiatives, and (four) the challenges and constraints that impact its workforce preparing and management” and suggested “that USAID take several actions to develop far more comprehensive workforce plans and enhance its workforce data” (6/30). Much more data on current U.S. global health policy developments is available on Kaiser’s Policy Tracker tool.

Blog: Cutting Off Aid Not A Resolution To Corruption

“If Afghanistan aid is cutoff for corruption, why not Senegal and Haiti too?” asks the author of a post on the Center for Global Development’s “Rethinking U.S. Foreign Assistance Blog.” The post articulates “two huge problems” with retracting aid from Afghanistan: “development in Afghanistan is supposedly part of our national security” and other “development partners,” which includes Senegal and Haiti, “are hardly considerably better” at combating corruption. The post concludes that a “better answer for countries exactly where we most likely will not walk away” would be to “innovate far more on the aid delivery side to make certain we get what we believe we’re paying for” (Moss, 6/30).

PLoS Neglected Tropical Illnesses Policy Platform Looks At Existing State, Future Challenges Of Chagas Illness

One hundred years soon after the discovery of Chagas disease, a PLoS Neglected Tropical Illnesses Policy Platform piece “highlights the current state of research and innovation related to control and care of Chagas illness, also as challenges for the subsequent decade. … A forum is urgently required to address the challenges of keeping Chagas disease on the agendas of scientific and funding agencies” (Lannes-Vieira, et. al., 6/29).

PLoS Neglected Tropical Diseases Examines Challenges Of Clinical Trials In Resource-Limited Settings

“To increase clinical trial conduct in resource-limited settings we require less difficult operational tools and guidance as well as skilled staff. This requirements to be far more than conducting externally sponsored trials that are designed and led elsewhere,” write the authors of a PLoS Neglected Tropical Disease Viewpoints piece that explores the challenges of conducting clinical trials in developing countries. The authors conclude, “We recommend accurate capacity-building may be ideal achieved by establishing a community of developing country based researchers to share locally derived solutions and develop a set of validated methods and operational tools that can enable pragmatic and locally led development” (Lang et al., 6/29).

PLoS Medicine Essay Reflects On Maternal Health Science-To-Policy Gap

As part of a series on maternal, neonatal, and child health (MNCH) in Africa, a PLoS Medicine Essay examines the current gaps among science, policy and practice. The write-up examines “what is already identified about how scientific evidence has influenced MNCH policy and practice, then it considers some of the key challenges in closing the science to policy and practice gap, and concludes by identifying promising paths for future action.” The authors with the piece also propose suggestions for bridging the science to policy gap, such as: developing MNCH policy networks, mainstreaming the use of MNCH science, and “investing in innovate approaches to develop and apply MNCH evidence” (Bennett/Ssengooba, 6/29).

Coordinated R&D Needed In Africa, PLoS Medicine Wellness In Action Argues

“A novel approach to supporting wellness product study and development (R&D) and access in Africa is urgently needed,” write the authors of a PLoS Medicine Well being In Action piece. As part of the development of the African Network for Drugs and Diagnostics Innovation (ANDI), researchers “analyzed biomedical investigation output and collaborative study undertaken across the continent.” They found that “significant well being R&D capacity exists in different parts of Africa, but this capacity is fragmented” and most collaborative study is done with Europe as well as the United States rather than other African institutions. The authors present ANDI “as a new approach to address these challenges, by means of the creation, coordination, and funding of African well being R&D networks” (Nwaka, et. al., 6/29).

Blog: Building On G8 Global Health Commitments

A post on the Center for Global Development’s “Global Wellness Policy” blog outlines the G8 global health initiatives and discusses the “opportunity for the G20 and others to build on them.” About the Muskoka Initiative, the author writes, “While new money is always good news, even if it doesn’t meet global well being advocates’ expectations, the lack of new ideas on how to spend money far more effectively is disappointing.” About the G8′s commitment to HIV/AIDS, the author writes, “It is clear that global funding for well being is being reallocated to address a broader set of global well being priorities, but it is also clear that G8 donors aren’t coming clean with their rationale and strategy for getting ‘as close as possible to universal access to prevention, therapy, care and support for HIV/AIDS’ AND for delivering on their new maternal and child health pledges by 2015″ (Oomman, 6/29).

Blog: A Dissection Of GHI Terminology

Change.org’s “Global Poverty” weblog characteristics a “quick primer” to three important terms frequently used in the Global Well being Initiative (GHI): country ownership, integration and cost-effectiveness. “Unfortunately when it comes to eight of the countries recently selected” for GHI Plus, U.S. officials seem to argue that “such countries would benefit more from ‘management and technical support rather than funds,’ the weblog author writes. The post also notes the GHI’s movement toward “integrated” services for a variety of diseases, and asks, “Can this kind of ‘integration’ generate savings and a higher quality and array of services for patients? These questions remain to be answered.” The piece also examines how comparing costs and benefits of various interventions has “become much more dominant in calculations over out to spend money” and argues that “[p]itting diseases vs. diseases in the battle for funding doesn’t seem like the greatest way forward for global health” (Roy, 6/28).

Weblog: Leadership Required For Feed The Future Program

President Barack Obama’s new Feed the Future initiative “needs a leader: an official with policy and budget authority to execute his or her responsibilities. That leader must be USAID Administrator Raj Shah,” according to the Center for Global Development’s “Rethinking Foreign Assistance” weblog. The author states that a “leader” rather than “coordinator” ought to be appointed to serve as the program’s point person to be “accountable to President Obama, Congress and American taxpayers for the new resources” and writes that Shah ought to be considered because of his “enormous expertise in agriculture.” In addition, a coordinator for Feed the Future would add to the “gross fragmentation and … confusing array of mandates and directives” already present in U.S. development programs, based on the post (Birdsall, 6/25).

This info was reprinted from globalhealth.kff.org with kind permission from the Henry J. Kaiser Family Foundation. You can view the entire Kaiser Daily Global Health Policy Report, search the archives and sign up for email delivery at globalhealth.kff.org.

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IRIN examines the findings of a study (.pdf) about the costs and effects with the U.S. Agricultural Cargo Preference (ACP) policy, noting that “U.S. taxpayers spend about $140 million every year on non-emergency food aid in Africa, and roughly the same amount to ship food aid to global destinations on U.S. vessels; money that could have been used to feed much more folks.”

The study by researchers at Cornell University provides numbers to “back a long-standing call for reforms, and goes a step further in showing that the policy designed to ‘nurture’ or subsidise the U.S. shipping industry ‘under the guise of humanitarian assistance’ is not doing either effectively,” IRIN writes. According to study authors Christopher Barrett, Elizabeth Bageant and Erin Lentz, USAID has provided much more than half with the world’s food aid for decades, but has been the “last and slowest donor to reform its food aid policies.”

“The Cornell researchers used data available for every USAID food aid shipment in 2006 … The un-reimbursed cost of ACP to food aid agencies was almost the same as what USAID spent on non-emergency food aid to Africa, which benefited 1.2 million people and was ‘widely deemed important to preventing food emergencies.’ USAID declined to comment on the findings of the study, saying the research ‘spoke for itself,’” according to the news service.

IRIN notes: “The ACP was put in place to achieve four objectives: ensure that U.S. vessels remained seaworthy and prepared should a war break out; maintain skilled jobs for American seafarers; maintain the financial viability of U.S. ships; protect U.S. ocean commerce from foreign domination.” But the authors found that “‘contrary to its national security and ‘buy American’ objectives,’ ACP used vessels which were not useful to the military, and most with the vessels used were ultimately owned by foreign corporations.”

The researchers suggest that officials re-examine the policy and possibly separate security and aid goals (7/13).

EU Decides To Leave GM Decisions Up To Member States

The European Commission on Tuesday “dropped its bid to impose a one-size-fits-all approach” to the cultivation of genetically modified (GM) food in Europe, the Financial Times reports. “Brussels said it would now be up to each member state to decide whether to allow the cultivation of GM crops on its territory.”

“The move could aid developing countries that want to grow and export GM crops but have been wary of doing so for fear their exports would be excluded from Europe under cross-contamination rules,” the newspaper notes. Currently the EU allows food to include “up to 0.9 percent unintended GM material, but this ruling has led some creating country governments and farmers to reject all GM crops.”

The decision to allow EU states to make their very own rulings “will make it easier for member states to impose a ban on growing GM crops – as six in effect do already – [but it also] leaves the door open for their cultivation in pro-GM countries such as Spain as well as the Netherlands,” the Financial Times writes (Pignal/Harvey, 7/13).

This data was reprinted from globalhealth.kff.org with type permission from the Henry J. Kaiser Household Foundation. It is possible to view the whole Kaiser Daily Global Health Policy Report, search the archives and sign up for e-mail delivery at globalhealth.kff.org.

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A team of microbiologists at the U.S. Department of Energy’s Savannah River National Laboratory (SRNL) is working with Tuskegee University and Mississippi State University to decrease mold growth in flooded homes via improved prevention and cleanup.

Funded by the Department of Homeland Security (DHS) by means of the Southeast Regional Research Institute (SERRI), Mississippi State University asked SRNL and Tuskegee University to join the “Effective Mold and Contaminant Remediation for Flood and Water Damaged Homes” project.

“SRNL’s Environmental Biotechnology Section has a long history of successfully working with all the assessment and cleanup of mold and fungi in the Savannah River Site. In current years major disasters including hurricanes Katrina, Rita, Ike, and flooding events have unfortunately highlighted this critical need to have in the national level and really underscores what we are doing with this project. This is a strong partnership, and I really think we can make a difference,” stated SRNL team leader Robin Brigmon, Ph.D.

The research focuses on analyzing common types of mold found after water damage to homes. The research will discover the best ways to clean structures, identify which mold types are most toxic to individuals, determine how deep into walls and porous surfaces sanitization is needed, assess how long folks should wait before safely returning to their homes and investigate how to prepare improved housing materials to prevent mold growth.

“Just as humans can be identified by their unique fingerprint patterns, microbes can also be identified by their unique DNA fingerprint composed of specific DNA sequences. In this project, we will use a quantitative polymerase chain reaction (qPCR) to amplify and analyze the unique DNA of any mold contamination present on the flooded housing materials,” said SRNL researcher Scott Miller.

“The results generated from the qPCR will provide a DNA fingerprint for any mold present that could cause a wellness hazard to humans. Using the DNA fingerprint, we can determine whether the mold is a health concern and how much mold is present,” stated Miller.

SRNL will provide expertise and bioanalytical equipment to measure and characterize mold in samples from recent large-scale studies conducted at Tuskegee University. In the experiments, researchers flooded a building with lake water for three weeks, drained it and then let the mold grow for another three weeks while the building was vacant, simulating hurricane conditions.

Various structural materials in the experiment building will be evaluated for their ability to resist mold growth. The development of molds collected inside and on the surface of the walls represents a variety of fungi that would typically grow in a home after severe flooding, hurricanes or other water damage. Techniques to remediate the building will also be evaluated and tested.

SRNL is also collaborating with the National Oceanic and Atmospheric Administration (NOAA) at the Hollings Marine Laboratory in Charleston, SC, to test mold toxin production on the building materials from the experiment at Tuskegee.

The project stemmed from past function with the universities that focused on determining harmful effects from various types of fungi and how to best clean mold growing in homes after floods and hurricanes. The Federal Emergency Management Agency (FEMA) funded the earlier collaboration in 2008, largely spurred by the obvious impact of mold on homes in the New Orleans area after hurricane Katrina in 2005. Dr. Robin Brigmon said that hurricane Katrina is still a strong reason for their work.

Brigmon expects to produce results from the team’s research by the fall of 2010 and complete the project by the fall of 2011.

Source:
Angeline French
DOE/Savannah River National Laboratory

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The U.N. Office for the Coordination of Humanitarian Affairs (OCHA) launched its mid-year appeal Wednesday, requesting “nearly $5 billion to meet its commitment to help 53 million individuals in 34 countries who want humanitarian aid this year as a result of conflict and disasters,” the Associated Press reports.

“The U.N.’s original appeal for 2010, launched last November, sought $7.1 billion but that increased to $9.5 billion together with the earthquake in Haiti and the deepening of crises in Africa’s Sahel region, the Central African Republic and elsewhere,” the news service writes (Lederer, 7/14).

Aid donations are “only lagging slightly” compared with recent years, according to the U.N. News Centre. John Holmes, the under-secretary-general for humanitarian affairs, stated, “Maintaining humanitarian aid budgets this year in the face of recession and budgets has been a real achievement by many donors.” Holmes called for donors to “persist” and “ensure that people struck by disaster or conflict receive the aid they need for the rest of the year to stay alive, avoid recoverable harm, and restore dignity and basic self-sufficiency” (7/14).

Reuters notes that the aid appeal for Niger went up from $191 million to $253 million “after new figures last month showed that over one in five children were already facing acute malnutrition in worst-hit regions.” OCHA’s mid-year review shows that “donors had by June 25 provided 58 percent with the revised requirement, leaving a shortfall of $107 million” (7/15).

“The U.N. appeal for Haiti remains at around 1.5 billion dollars for the year, with 64 percent of the amount met so far, according to OCHA,” Agence France-Presse writes (7/14).

Report Highlights U.N. Shortcomings In Haiti Earthquake Response

Also on Wednesday, the Inter-Agency Standing Committee (IASC) released a report on the aid response to the Haitian earthquake, which calls for “restricting the delivery of some humanitarian goods along with the establishment a certification process to regulate further aid,” Foreign Policy’s “Turtle Bay” blog reports.

“‘Is there a point at which the system can be too inclusive in coordination and planning?’ asks the 32-page report … ‘The Haiti response operation has received literally tons of inappropriate relief items. Many governments appear to feel the require to send a plane full of relief goods, for internal political reasons, whether or not the goods are appropriate,’” the blog reports. The “controversial” report highlights the “U.N.’s shortcomings in coordinating activities with neighborhood charities, the U.S. military, and private businesses eager to play a role in the relief effort,” but it also acknowledges that “huge strides” have been made in refining the U.N.’s role over the last few months (Lynch, 7/14).

In related news, PBS’ NewsHour examines the situation in Haiti for individuals who had a limb amputated as a result of the earthquake (Suarez, 7/14). The NewsHour also featured an interview with Haitian President Rene Preval. Preval discusses switching from an emergency response to reconstruction, foreign aid and reflects on the six months since the quake (Suarez, 7/13).

This details was reprinted from globalhealth.kff.org with type permission from the Henry J. Kaiser Household Foundation. You’ll be able to view the entire Kaiser Daily Global Wellness Policy Report, search the archives and sign up for email delivery at globalhealth.kff.org.

? Henry J. Kaiser Loved ones Foundation. All rights reserved.

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Amnesty International Report Describes North Korea’s ‘Desperate Picture of Health’

A new report by Amnesty International paints a “desperate picture of the health of North Korea’s population,” the Guardian reports. Amnesty International describes “a country of stunted children, where the hungry eat poisonous plants and pigfeed … amputations are conducted without anaesthetic and doctors are paid in cigarettes,” according to the newspaper. In the report, which is based on interviews with aid workers and North Korean defectors, the human rights organization “accuses the North Korean regime of systematic neglect and calls on the international community to intervene to prevent a humanitarian disaster,” the Guardian writes. The post also notes that “malnutrition has paved the way for a tuberculosis epidemic,” from which at least 5 percent of the population suffers (McCurry, 7/15). “There was no immediate reaction from North Korea, which is sensitive to outside criticism and usually responds by means of its state-controlled media, though sometimes days or even weeks later,” the AP reports (Kim, 7/15).

India’s AIDS Activists Unsure Of Epidemic’s Future

“[T]here is disquiet among AIDS activists and well being professionals about what lies ahead” for India’s epidemic, Financial Times reports. “The Geneva-based Global Fund [to Fight AIDS, Tuberculosis and Malaria] will support India’s treatment programme until 2016, but beyond that lies uncertainty as donors enter an era of austerity, and New Delhi has shown little willingness to fill the void,” according to the article. India increased treatment after 2004 after “sustained international pressure and an inflow of foreign financing,” which “marked a sharp turn for a government that long resisted pleas to provide free drugs to AIDS patients,” according to the newspaper. The article includes comments from Siddharth Dube, an HIV/AIDS expert together with the New York-based World Policy Institute, who fears the government will “back away” from its commitment after foreign financing ends, and Domodar Bachani, deputy director of India’s National AIDS Control Organisation, who “insists the government will not abandon those living with AIDS” (Kazmin, 7/14).

Study Suggests Antibiotics Could Prevent Malaria

“People at high risk of malaria may benefit from taking a cocktail of antibiotics as a preventative step, according to the results of a study in mice,” Reuters reports. Researchers said that the antibiotics could “prompt healthy men and women to develop a natural immunity to malaria parasites” and could be useful preventatives in settings where malaria seasons are “high risk but relatively short.” The findings, published in Science Translational Medicine, showed that healthy mice given the antibiotics then infected with malaria parasites “generated a vaccine-like immunity” as well as the team now wants to test their findings in clinical trials in humans, according to the news service (Kelland, 7/14).

WHO Flu Pandemic Status Ruling Delayed

The committee that will advise the WHO on whether to end the H1N1 (swine flu) pandemic status has pushed back its mid-July meeting, according to Agence-France Presse. WHO Director-General Margaret Chan told the news service that “the team had decided to wait a few a lot more weeks in order to obtain a lot more information about the development with the flu in the southern hemisphere’s winter,” particularly in Australia and New Zealand. She stated the committee is now expected to meet at the end of July or in August (7/14).

Dengue Reemerges In U.S. For First Time In 75 Years

The New York Times reports that “about 5 percent with the population of Key West has recently been exposed to the virus that causes dengue fever,” the first reemergence with the virus in the U.S. in 75 years, according to a CDC report. There were 27 cases in Key West last year and 12 so far in 2010, according to the newspaper (Grady, 7/13). Reuters writes that Harold Margolis, chief of the CDC’s dengue branch, is “concerned that if dengue gains a foothold in Key West it will travel to other southern cities where the mosquito that transmits dengue is present, like Miami” (7/13).

Organizations Step In To Fight HIV Among IDUs In Ukraine

“Despite entrenched corruption and police interference, community organisations lead the fight against HIV among drug injectors and sex workers in Ukraine,” the British Medical Journal reports. The feature examines the state’s response to the HIV epidemic, including clinics that provide counseling, testing and substitution therapy but “cannot effectively champion HIV prevention in drug injectors and sex workers” because, as Pavlo Smyrnov, a deputy director in the International HIV/AIDS Alliance in Ukraine said, “both these groups are outside the law, so it’s difficult for government organizations to work with them. The only official outreach they can provide is by means of the police, who either lock them up or take money.” The article also discusses non-governmental action, including function funded by the Global Fund, which is “largely channeled” via the International HIV/AIDS Alliance and is estimated to reach 52 percent of injecting drug users. The post notes that in 2004 the Global Fund “stopped payments” from going directly to the Ukranian government because of “budgetary irregularities and a lack of transparency” (Hurley, 7/13).

This information was reprinted from globalhealth.kff.org with type permission from the Henry J. Kaiser Household Foundation. You’ll be able to view the entire Kaiser Every day Global Well being Policy Report, search the archives and sign up for e-mail delivery at globalhealth.kff.org.

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Imagine a healthcare system in which amputations and major surgeries are performed with no anesthesia, hospitals that do not sterilize needles, hospital bed sheets that are so rarely washed they stink, and a population most of whom do not have the money to pay for their most basic medical needs – according to Amnesty International, North Korea has such a healthcare system.

Amnesty International says the North Korean healthcare system is in “a dire state”.

Their report, called The Crumbling state of health care in North Korea, includes interviews with North Koreans and wellness workers reveals barely-functioning hospitals, without medicines, and serious epidemics caused by serious malnutrition.

Catherine Baber, Amnesty International’s Deputy Director for the Asia-Pacific, said:

North Korea has failed to provide for the most basic wellness and survival needs of its men and women. This is especially true of those who are too poor to pay for medical care.

North Korea spends less than $1 (US) per person per year on healthcare, less than any other country in the world, according to the World Well being Organization (WHO).

If you listen to the North Korean government, the story is very different. They claim they have excellent universal healthcare, free for everybody. However, Amnesty International learnt from many witnesses that this is not true – individuals in North Korea have had to pay for all the services since the 1990s. For a basic consultation, a North Korean doctor is usually paid by barter with alcohol, food or tobacco; for tests and surgery, though, they appear to prefer cash.

According to the report, a significant number of North Koreans go straight to the markets to get their medications and do not bother going to the doctor. They self-medicate according to what they and their friends know, plus feedback from market vendors. A highly addictive narcotic painkiller that many thought of as a cure-all had to be banned by authorities.

Catharine Baber said:

The government’s failure to provide basic education about using medication is especially worrying as North Korea fights a tuberculosis (TB) epidemic. A growing number of patients have developed a resistance to first-line anti-TB drugs. The North Korean men and women are in critical want of medical and food aid. It is crucial that aid to North Korea is not used as a political football by donor countries.

Donor countries are urged by Amnesty International to continue providing humanitarian aid to North Korea by means of the United Nations. The organizations also urges donors to base their donations on want, rather than political considerations.

Food shortages are a permanent way of life in North Korea. The price of rice has a lot more than doubled since December 2009 after the North Korean government’s disastrous currency revaluation. Thousands of men and women starved to death between January and February this year in just one province, Amnesty International reports. Things are so bad that many men and women have to resort to eating tree bark, grass and roots. Severe malnutrition has brought back tuberculosis in a big way.

Catharine Baber said:

International law, which includes covenants ratified by North Korea, demands that the government provide adequate levels of food and wellness care to its population, and to seek international cooperation and assistance when it cannot.

“North Korea: The crumbling state of well being care in North Korea” (PDF)

Source: Amnesty International

Written by Christian Nordqvist
Copyright: Medical News Today
Not to be reproduced without permission of Medical News Today

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Science Communication Can Promote Development

“Helping developing countries communicate and use science is essential to international aid and diplomacy. The biggest single factor limiting developing countries’ potential for achieving sustainable economic growth – or even attaining the Millennium Development Goals – is their ability to access and apply the fruits of modern science and technology,” David Dickson, the director of SciDev.Net, writes in an editorial on the website.

In the piece he discusses the relationship between science communication and diplomacy and notes current efforts by aid organizations and countries, such as the U.S., to use science communication to further development goals. “Good science communication is not a public relations exercise. … Rather, it should put scientific knowledge into the hands of those who can use it … Seen from this angle, science, communication and diplomacy can form an important alliance, particularly in the context of development aid. Putting this alliance into effect is not easy. But it is essential if the goals of sustainable economic growth and social development are to be achieved across the developing world,” he concludes (7/16).

To Improve Global Disaster Response, International Community Should Prepare In Advance

U.N. Undersecretary-General for Humanitarian Affairs and Emergency Relief John Holmes looks in the international response six months after Haiti’s earthquake, writing “We want to make sure that, when the next major disaster happens, we improve our response,” in a Globe and Mail opinion piece. “Many countries wanted to send assist, and filled planes with goods and sent them off. But the goods were not always was what was needed, and there was not always an identified organization in the other end to distribute these goods. … Clearer advance guidance is needed about what really helps in these disasters -” mostly money for the organizations that know what they’re doing. And global stockpiles of necessary goods, such as tents and tarpaulins, need to have to be looked at again,” he writes.

According to Holmes, international donors were not “sufficiently sensitive to the concerns and capacities of local civil society, and did not listen enough to what the individuals whose lives had been destroyed by the quake were saying.” The humanitarian operation in Haiti “will still be needed for months. … So there’s no question of relaxing and just reflecting on the lessons. But the lessons still have to be learned and applied for the future,” he writes. “And the biggest lesson of all is the require to reduce the risks of disasters before they happen, through measures such as enforced building codes, and to prepare for them more systematically, not just to respond effectively to them afterward” (undated).

This data was reprinted from globalhealth.kff.org with kind permission from the Henry J. Kaiser Family Foundation. You can view the entire Kaiser Day-to-day Global Health Policy Report, search the archives and sign up for email delivery at globalhealth.kff.org.

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Blog: Global AIDS Coordinator Goosby Speaks About Uganda HIV Treatment

As part of a series in advance of AIDS 2010, the “Science Speaks” blog features an interview with U.S. Global AIDS Coordinator Eric Goosby “about his expectations for the conference, what was behind the Uganda problem with shortages of AIDS medicine, and whether The New York Times was right when it reported in May that the Ugandan drug shortfall was ‘the first example … of how the war on AIDS is falling apart.’” The series, “Looing Toward Vienna,” also features interviews with Gottfried Hirnschall, director of the HIV department in the World Well being Organization, Mark Harrington, executive director of the Treatment Action Group, and Daniel Kuritzkes, professor of medicine at Harvard Medical School (Donnelly, July 2010). Goosby writes of his recent trip to Uganda on the State Department’s “Dipnote” blog (7/13).

Brookings Paper Discusses Housing Haiti

A paper from the Brookings Institution discusses “the question of temporary shelter and permanent housing” in Haiti which the authors say has “received little attention in the media and which bridges the immediate relief and long-term reconstruction efforts.” The piece examines “economic pressures that might impinge on long-term recovery as well as the particular challenges of reconstruction in an urban context.” The authors also discuss Haiti’s need to have for urban transitional shelters, the cost of “building back better” and also the challenges of delivering and administering aid money (Ferris/Petz, 7/15).

Lancet Infectious Diseases Review Changes In Incidence, Prevalence Of Malaria In Sub-Saharan Africa

A Lancet Infectious Diseases review examines “studies that have reported recent changes in the incidence or prevalence of malaria in sub-Saharan Africa.” The write-up looks at changes in African regions such as southern Africa, where researchers found that malaria control to show “substantial lasting declines linked to scale-up of specific interventions.” In some countries, a change in drug treatment or “scale-up of insecticide-treated bed nets” were associated with malaria reduction,” the authors report (O’Meara, 7/15).

Nature Supplement Examines Global HIV/AIDS Epidemic

Nature features a supplement “Outlook: HIV/AIDS,” which examines how “miraculous drugs” have “blunted the urgency with which individuals talk about the AIDS epidemic,” and looks at the “renaissance afoot in HIV/AIDS research, with renewed focus on a cure, much more powerful drugs and innovative approaches to prevention.” The series of articles consists of “Developing Solutions,” in which the author argues that “there is far more to combating HIV in the creating world than providing affordable drugs” (Padma, 7/15) and “Grassroots Initiatives,” which looks at a Cambodian group that has “developed a pioneering community-based method to HIV and TB care” that is being “expanded to other war-torn countries” (Maxman 7/14).

Blog: Little Praise For Obama On Africa

“Eighteen months into the Obama administration, there is precious little to praise. Africa is fighting the same enemies we fear in the United States. But they are also fighting extreme poverty, famine, preventable diseases, AIDS/HIV, war, and for their lives on every front imaginable. Funding has been cut,” according to a post on the Day-to-day Caller. After searching in the records of former Presidents George W. Bush and Bill Clinton in Africa, the piece concludes by asking the “human rights community [to] recognize that pursuit of President Obama and also the Democratic majority’s domestic agenda has placed real action in Africa on the altar for sacrifice. All the advocacy in the world does not matter if we look away when our own political team fails” (Blackney, 7/13).

Blog: Former USAID Adminstrators Reflect On The Future Of USAID

A Huffington Post blog post reflects on the future of USAID, writing that while “a national investment that pays dividends in the forms of greater national security, economic growth, and revitalized American values could be a wise investment in the future of our country … the International Affairs budget – which funds America’s vital development and diplomacy programs – is burdened with a disproportionate share of the budget cuts now being made by Congress.” The authors continue, “We recognize that Congress is faced with agonizing choices – and many competing priorities – on the budget front. However, cuts to the International Affairs budget will only weaken USAID and other agencies that make vital contributions to global development and our national security,” the authors argue.

“America needs a vibrant USAID with improved capacity to be a force for good around the globe. But USAID’s leader needs a full team to implement new initiatives,” the authors continue. “We call upon the administration to work tirelessly and fill the vacant senior leadership positions. And we call upon Congress to ensure that USAID is adequately funded and has the resources to do its important perform,” the authors conclude (Atwood/Holsman/McPherson/Natsios, 7/14).

NEJM Examines HIV Vaccine ‘Renaissance’

“If we are to control [the HIV] pandemic, we should recognize the urgent need to develop and deploy better prevention tools and, most important, a safe and effective HIV vaccine,” write the authors of a New England Journal of Medicine Perspective piece. Searching ahead to AIDS 2010, the authors write, “among the most exciting developments the delegates will hear about this year are a series of current advances that collectively represent a renaissance in HIV infection vaccine development. These include the first demonstration of protection – albeit modest protection – against HIV infection in humans through immunization … in Thailand, new vaccine approaches that have significantly improved control of simian immunodeficiency virus (SIV) infection in rhesus monkeys,” along with the identification of ” antibodies against HIV that have revealed vulnerable targets on the virus ” (Koff/Berkley, 7/14).

Priority Setting To Benefit MNCH Policy

A PLoS Medicine Essay examines “evidence-based priority setting” to “support policy in maternal, neonatal, and child well being in Africa.” The authors conclude that “the key challenges that need to have to be overcome in sub-Saharan Africa to improve the processes of prioritization in wellness care and health research include the following: increased acceptability and popularity with nearby policy makers, appreciation with the nearby context, clarity about the criteria used, transparency in the input from the stakeholders, and far more specific guidance on translation into policy” (Rudan et al., 7/13).

Blog: ‘Bolder’ Solutions For Haiti

“What if the idea of Haiti as a country simply won’t work? They have been trying for two centuries. Even before the horrific tragedy of the earthquake six months ago, Haiti festered,” according to a Foreign Policy blog post. “[A]fter decades of watching Haiti (and many other countries) struggle with resource limitations, cultural obstacles, competitive disadvantages and chronic crises … it is worth asking whether we need to be bolder in our approach to finding solutions and to truly ask ourselves what we would and could do if we sought to truly serve the folks of these countries rather than the ideas of long dead founders, the consequences of long-forgotten geopolitical twists and turns or the objectives of elites who benefit from old ideas that no longer benefit anyone other than the few,” the author writes (Rothkopf, 7/13).

Blog: President Should Lead On Foreign Aid Reform

A Huffington Post blog post calls for the President Barack Obama’s leadership on foreign aid reform writing, “At a policy level, the administration should be commended for its approach to development” but “[p]rogress on actual nuts and bolts of turning policy into action has been less forthcoming.” The author continues, “it is time to act on the broad recognition that multiple agencies carrying out similar or inconsistent programs is not good practice; that assistance programs require greater transparency and accountability; and that the legislative foundation for our foreign assistance system, a 500-page Cold War-era statute, lacks clear goals and objectives and is bursting in the seams with outdated, overlapping, and duplicative and conflicting provisions.” The author outlines “three immediate steps” that the President can take to reform foreign aid, including: the creation of “America’s first-ever Global Development Strategy,” by expressing his commitment to function with Congress on foreign aid reform, and empowering USAID with clear authority” (Ingram, 7/14). Modernizing Foreign Assistance Network has posted “core principles” and examples it “believes should provide the underpinnings of foreign assistance reform” (7/12).

Blog: Haiti Needs Sustainable Solutions

In a Huffington Post blog post, the executive director with the American Society of Mechanical Engineers, writes about Haiti’s “need for sustainable answers.” The differences between life and death in an earthquake, he writes, are “rooted locally. They include geography and topography, but especially the robustness and integrity of infrastructure – which, in Haiti’s case, has been tragically neglected as a result of that nation’s abject poverty.” In order to improve infrastructure in the creating world, the author argues, “standards should reflect the deep understanding of neighborhood economic realities, locally available resources, and recognition that only those standards that can be locally executed will be sustained to the benefit of those most directly affected” (Loughlin, 7/12).

USDA Report Analyzes Current, Future Food Security Situation In Creating World

The U.S. Department of Agriculture released a report summarizing the current state of food security in 70 developing countries. The report forecasts that the “number of food-insecure individuals at the aggregate level will not improve much over the next decade, declining by only 1 percent. While there will be notable improvements in Asia and Latin America, the situation in Sub-Saharan Africa is projected to deteriorate after 2010″ (Shapouri et al., July 2010). Much more information on the report is available on Kaiser’s Policy Tracker tool (7/8).

This data was reprinted from globalhealth.kff.org with type permission from the Henry J. Kaiser Loved ones Foundation. You’ll be able to view the entire Kaiser Everyday Global Well being Policy Report, search the archives and sign up for e-mail delivery at globalhealth.kff.org.

? Henry J. Kaiser Family members Foundation. All rights reserved.

Current Write-up Ratings:
Patient / Public:

3.33 (3 votes)

Healthcare Prof:

The National Alliance on Mental Illness (NAMI) blasted BP oil company for ignoring Louisiana’s appeals for support in funding mental well being care in communities affected by the BP oil spill.

“It is imperative that BP recognize the urgent mental health crisis that has been created by the oil spill, such as the heightened risk of long-term, chronic mental illness triggered by immediate conditions,” wrote NAMI Executive Director Michael Fitzpatrick in a letter to BP Chief Operating Officer Doug Suttles.

The NAMI letter comes after Louisiana’s Department of Health and Hospitals advised the U.S. Department of Well being and Human Services in a July 9 letter that the state has written twice to BP asking for $10 million for mental health services without receiving any reply — “not even a courtesy call” — to acknowledge the request. Those letters were dated May 28 and June 28.

“BP has put considerable resources into media advertisements pledging to assist men and women affected by the oil spill,” Fitzpatrick said. Failure to reply swiftly to the request is “inconsistent with that pledge.”

“Ours is a public health concern,” he warned. Depression, suicide attempts, loved ones violence and other mental wellness problems are on the rise. “The consequences of neglect and inaction are deadly.”

NAMI’s letter follows:

Mr. Doug Suttles Chief Operating Officer BP Exploration and Production Houston, TX 77079

Dear Mr. Suttles:

On behalf with the National Alliance on Mental Illness (NAMI), I want to strongly support the request from Allen Levine, Secretary of the Louisiana Department of Health and Hospitals for $10 million to assist fund mental wellness services in communities affected by the Deepwater Horizon oil spill. With much more than 1,100 state and local affiliates, NAMI is the nation’s largest grassroots mental well being organization dedicated to improving the lives of individuals and families affected by mental illness.

It is imperative that BP recognize the urgent mental well being crisis that has been created by the oil spill, including the heightened risk of long-term, chronic mental illness triggered by immediate conditions.

In current weeks, BP has put considerable resources into media advertisements pledging to help men and women affected by the oil spill. The company’s apparent failure to respond swiftly to two appeals from Secretary Levine requesting financial assistance for mental well being crisis counseling is inconsistent with that pledge.

Louisiana has struggled to provide services to its residents living with mental illnesses since Hurricanes Katrina and Rita in 2005. These storms catastrophically reduced the capacity of the state’s mental wellness care system, particularly by way of adverse impact on the availability of inpatient psychiatric beds, qualified mental well being workforce and community-based services and supports. The state has worked hard to address these problems in recent years, but significant gaps in services remained — even before this latest disaster.

Louisiana’s mental well being system has already been severely strained. The state does not have the resources to respond to the now rapidly growing numbers of people experiencing significant mental health crises due to the trauma with the oil spill and its impact on their livelihoods and ways of life. Nor should the state be forced to divert scarce mental health dollars away from existing services for folks with schizophrenia, bipolar disorder, and other serious mental illnesses. Such a diversion of state funds could be a grave mistake, representing a short-term fix in the expense with the state’s overall long-term needs.

Ours is a public wellness concern. The psychological impact with the oil spill on the lives of men and women is widely documented. Rates of depression, suicides and suicide attempts, loved ones violence, alcoholism and substance abuse and other serious mental well being problems are sharply on the rise in affected communities. These problems are so severe that mental wellness issues were identified as the priority wellness concern from the disaster at a current meeting of the Institute of Medicine in New Orleans.

BP has a legal and moral obligation to help finance mental health services and supports to individuals and families whose lives are now at risk as a result of the oil spill. The consequences of neglect and inaction will be deadly.

Sincerely,

Michael J. Fitzpatrick
Executive Director

Source:
NICE

Current Write-up Ratings:
Patient / Public:

5 (1 votes)

Healthcare Prof:

The World Health Organization suggests that treating people with HIV earlier could save lives and help them stay healthy for longer, while at the same saving money; the organization also estimates that a record 5.2 million folks worldwide were receiving life-saving HIV treatment in the end of 2009, compared with 4 million a year earlier.

At the XVIII International AIDS Conference being held in Vienna from 18 to 23 July, WHO Assistant Director-General for HIV, Tuberculosis, Malaria and Neglected Tropical Diseases, Dr Hiroki Nakatani, told the press that:

“This is the largest increase in individuals accessing treatment in a single year. It is an extremely encouraging development.”

The rate of increase is remarkable: since 2003, when the “3 by 5″ campaign was launched (to have 3 million folks in poorer nations on HIV treatment by the end of 2005), the increase in the number of men and women receiving HIV treatment has increased 12-fold.

WHO’s latest estimates show that 1.2 million men and women started HIV treatment in 2009, bringing the total number receiving treatment to 5.2 million.

WHO is now recommending treating people with HIV earlier: currently HIV-infected folks normally receive treatment when their CD4 cell count falls below 200 cells/mm3, the WHO wants treatment to start at 300 cells/mm3. (CD4 cell count is a measure of immune system strength, a healthy person’s count is between 1,000 and 1,500 cells/mm3).

Estimates from epidemiological models suggest that as many as 20 per cent of HIV-related deaths can be avoided between 2010 and 2015 by treating infected individuals earlier; and deaths from tuberculosis (TB), the number one killer of men and women with HIV, could be reduced by as much as 90 per cent, if people with both HIV and TB were to start treatment earlier.

If people infected with HIV can start antiretroviral therapy before their immune system gets weak and they fall ill, they are likely to live longer, healthier lives, stated Dr Gottfried Hirnschall, WHO Director of HIV/AIDS.

Earlier treatment also boosts prevention, because men and women then have lower levels of HIV and are less likely to pass it onto their partners, he added.

The effect of recommending earlier treatment will increase the number of HIV-infected folks that should be in treatment from an estimated 10 million to an estimated 15 million.

The cost of HIV treatment for 2010 will be about 9 billion US dollars, according to estimates from the Joint United Nations Programme on HIV/AIDS (UNAIDS).

But as Dr Bernhard Schwartlander, Director, Evidence, Strategy and Results, UNAIDS, explained, earlier treatment saves money because people with weaker immune systems who get treated later need to have a lot more complex and a lot more expensive drugs and care.

“The investments we make today can not only save millions of lives but millions of dollars tomorrow,” said Schwartlander.

WHO has also updated their guideline for antiretroviral therapy for HIV infection in adults and adolescents. The guide is aimed at national treatment advisory boards and organizations providing technical, clinical and financial resources in limited healthcare settings.

The guidelines review the case for starting earlier treatment in settings with limited health systems, citing “GRADE evidence profiles, systematic and targeted reviews, risk-benefit analyses, consultations with PLHIV, technical reports, and assessments of impact, feasibility and cost”.

Four separate working groups, the Internal WHO ART Guideline Working Group, the ART Guideline Drafting Group, the external ART Peer Review Panel as well as the full ART Guideline Review Committee, were involved in the update.

The consensus was that earlier HIV diagnosis and earlier ART “promote the use of less toxic regimens and a lot more strategic laboratory monitoring”.

The updated guideline also details the best first line, second line and subsequent drugs to use with most populations, the best time to start ART, and when to switch to third-line drugs.

The WHO urges that the guidelines be followed in the context of the receiving nation’s HIV epidemic, the strength and weaknesses of their particular healthcare system, and how much support they have in terms of individuals, money and other essential resources.

They stress the importance of implementing the new guidelines in such a way as not to undermine what is already happening, so that at risk populations continue to have access, and the biggest possible, sustainable impact is created for the greatest number of men and women.

“Antiretroviral therapy for HIV infection in adults and adolescents: recommendations for a public wellness method (2010 revision).”
World Well being Organization, Geneva (pdf)
ISBN: 9789241599764

Source: WHO (Vienna).

Written by: Catharine Paddock, PhD
Copyright: Medical News Today
Not to be reproduced without permission of Medical News Today