“An increasing number of developing countries are introducing universal health care coverage — and creating new models to do it — according to research … by the Results for Development Institute and others, published in the Lancet as part of its universal health care coverage series,” IRIN reports. “Lessons learned from countries like Ghana, India, and Rwanda are already shaping the way countries like South Africa are beginning to pilot their own bids for universal coverage,” the news service writes. “The research, which surveyed nine developing countries in Africa and Asia (which are now part of a joint learning network on the issue) found that the new models vary considerably but have several common characteristics, including increased revenue and health budgets, larger risk pools and use of the private sector,” IRIN adds, and details some of the findings (9/11).
Access to Health Services
The Center for Strategic and International Studies (CSIS) on Thursday hosted a panel discussion focusing on the policy implications of findings published by the Lancet in a special series on HIV/AIDS and men who have sex with men (MSM), the Center for Global Health Policy’s “Science Speaks” blog reports (Barton, 9/7). Chris Beyrer, a professor of international health at the Johns Hopkins Bloomberg School of Public Health and a contributor to the Lancet series, explained two factors are affecting the expansion of the HIV epidemic among MSM worldwide, according to Inter Press Service. First, HIV “is far more efficiently transmitted through the gut, hence leading to a far higher transmission probability in anal sex, for either a man or a woman — around 18 times more likely than through vaginal transmission,” the news service writes. Second, “because gay men can switch sexual roles in a way that is impossible among heterosexual couples — acting as both the acquisition and transmission partner — the efficiency of transmission among MSM networks appears to be far higher than previously understood,” IPS adds, noting, “These two factors, the new research suggests, account for a full 98 percent of the difference between HIV epidemics among MSM and heterosexual populations.”
Reuters Examines Challenges To Implementing 'Treatment As Prevention,' Other HIV Prevention Strategies In Current Economic Climate
In an “Insight” feature article, Reuters examines how new information on the prevention benefits of HIV treatment and other strategies, such as male circumcision, “could finally break the back of the AIDS epidemic.” But, “[w]ith some recession-strapped donor countries already struggling to meet their current commitments for treatment and prevention programs, AIDS activists worry that money, and not science, could hold up progress,” the news agency states. “‘The benefits of early detection and treatment have never been more clear, but countries have never been more challenged to provide needed resources,’ Kaiser Family Foundation [President and CEO] Drew Altman said in a statement,” the news service writes. Reuters highlights the results of several studies, discusses the challenges of “treatment as prevention,” and looks at the costs associated with implementing that and other strategies. “One hesitation is that the drugs work so well that people who take them can live basically a normal life, which means countries are on the hook for a lifetime of treatment,” the news service writes, adding, “The challenge is trying to sell the prevention aspect of treatment as cost-effective.” Reuters notes, “HIV/AIDS experts will test these efforts — along with less costly approaches, such as counseling, condom use and circumcision — in as many as 50 studies globally to see how well they work in real-world settings” (Steenhuysen, 9/6).
Civil Registration Of African Children Necessary For Human Rights, Access To Health, Education, Other Services, Conference Hears
“Birth certificates and other forms of civil registration of children in Africa are critical for their enjoyment of human rights and access to health, education and other services, an official of the United Nations Children’s Fund (UNICEF) told a conference on the issue, in Durban, South Africa,” the U.N. News Centre reports. UNICEF Deputy Regional Director for Eastern and Southern Africa Elke Wisch said at the two-day Second Conference of African Ministers Responsible for Civil Registration, “Birth registration protects children from child labor, recruitment into armed forces and militias, human trafficking, early marriage as well as other forms of exploitation. … Birth registration is essential for children to access health care and education, as well as for orphans to inherit from their parents,” according to the news service (9/6). In a statement, UNICEF said only 38 percent of children under age five in sub-Saharan Africa have a birth certificate, SAPA/Independent Online notes. South African President Jacob Zuma said at the conference opening, “By not registering and planning for your people you are putting your country into difficulty,” the news service reports (9/6).
NPR’s “Shots” blog examines the “test and treat” approach to HIV care and prevention, which “relies on the fact that taking HIV drugs dramatically reduces a person’s risk of transmitting the virus to others,” and, “[a]s more and more people are put on medication, the epidemic theoretically should fizzle out.” The blog continues, “Test and treat sounds good on paper, but some doctors and policymakers have doubts about its feasibility on a large scale.”
In Foreign Policy’s “Passport” blog, Associate Editor Uri Friedman reflects on former President George W. Bush’s efforts against AIDS, highlighting PEPFAR, which he “established in 2003 and which now supports antiretroviral treatment for 4.5 million people around the world.” Friedman quotes former President Bill Clinton, who, speaking at the Democratic National Convention on Wednesday, said, “I have to be grateful, and you should be too, that President George W. Bush supported PEPFAR. It saved the lives of millions of people in poor countries.” Friedman continues, “[W]hat’s particularly notable about the reference is that, during a convention season designed to draw sharp distinctions between Republicans and Democrats, the two parties have found common ground on at least one point: the success of Bush’s efforts to fight AIDS.”
Ugandan Parliamentarians Threaten To Hold Up National Budget Unless More Funding Committed To Health Care
In Uganda, where “there are fewer than two health workers for every 1,000 people — a level the World Health Organization defines as a severe shortage” — the nation’s parliamentary “social services committee, which has initial oversight of the country’s health budget, pushed a resolution through parliament last week threatening to hold up approval of the entire budget unless funding to recruit and retain new health workers is increased,” VOA News reports. “Committee members, with support from the Women’s Parliamentary Association, called for a specific increase of at least $103 million to the sector,” the news service notes. “In addition to the funding increase, the parliamentarians are calling for an end to a wage freeze for current employees and a ban on recruiting new health workers,” as well as “demanding a supplementary pool of money to improve health care in communities that are particularly short staffed,” according to the news service.
In a 200th anniversary article for the New England Journal of Medicine, Salmaan Keshavjee of the Department of Global Health and Social Medicine at Harvard Medical School and Paul Farmer of Partners in Health “seek to elucidate the reasons for the anemic response to drug-resistant tuberculosis [TB] by examining the recent history of tuberculosis policy,” they write. The authors outline the history of TB drug development and how the disease became resistant to myriad drugs, and write that by the 1970s, “[t]uberculosis, whether caused by drug-susceptible or drug-resistant strains, rarely made even medical headlines, in part because its importance as a cause of death continued to decline in areas in which headlines are written. They continue, “In the United States, federal funding for tuberculosis research was cut; consequently, drug discovery, development of diagnostics, and vaccine research ground almost to a halt.”
“Kenya has launched an investigation after researchers claimed HIV-positive women were being routinely sterilized without their consent in government hospitals,” the Guardian reports. The African Gender and Media Initiative issued a report “based on interviews with 40 women, suggest[ing] the practice was widespread and ongoing,” according to the newspaper. “The report also includes examples of coercive tactics used by medical staff to obtain consent — for instance, threatening to withhold antiretroviral medication or baby milk if the woman did not agree to the procedure,” the newspaper writes. “‘These allegations are very serious and the Kenya Medical Practitioners and Dentists Board is going to investigate them before appropriate action is taken,’ Shariff Shahnaz, the director of public health, told the Daily Nation newspaper,” the Guardian reports (Mojtehedzadeh, 9/4).
“Despite pledges from governments across Eastern Europe and Central Asia to fight HIV/AIDS — one of the eight Millennium Development Goals — the region has the world’s fastest-growing HIV epidemic,” Inter Press Service reports in an article examining challenges to stemming the spread of the disease, particularly among injection drug users. “Punitive drug policies, discrimination and problems with access to medicines and important therapy are all driving an epidemic which is unlikely to be contained, world experts say, until governments in countries with the worst problems change key policies and approaches to the disease,” the news service writes. According to experts and activists, a lack of opiate-substitution therapy (OST) and needle-exchange programs, as well as discrimination against and “active persecution” of drug users who try to access therapy programs, contributes to the spread of HIV, IPS notes (Stracansky, 9/3).