IRIN examines the controversy surrounding the Affordable Medicines Facility-malaria (AMFm), writing, “The argument over the way it operates has reignited ahead of a board meeting of the [Global Fund to Fight AIDS, Tuberculosis and Malaria] on 14-15 November, which is due to assess the success of the project and its reliance on private sector providers.” The news service reports on an evaluation of AMFm published recently in the Lancet and another paper by Oxfam criticizing the facility. The Global Fund Board, which administers AMFm, “is meeting in nine days to decide whether AMF has worked as was intended, and whether it should be continued, scaled up, or abandoned altogether,” IRIN writes (11/5).
The Associated Press examines the debate over the future of the Affordable Medicines Facility-malaria (AMFm), after the recent release of two papers evaluating the program’s effectiveness. AMFm was established in 2010 as “a pilot project to subsidize artemesinin combination drugs, the most effective malaria treatment,” the AP writes, noting the $460 million program is managed by the Global Fund to Fight AIDS, Tuberculosis and Malaria. “Last week, a report by Oxfam, an international charity, labeled the program a failure and said there was no proof it had saved lives because officials didn’t track who received the drugs,” the news service writes, adding, “But in another paper published Wednesday in the journal Lancet, experts insisted the program was ‘an effective mechanism’ to lower the price of preferred malaria drugs and make them widely available.” The Global Fund is scheduled to discuss the future of the program at a meeting next month, according to the AP (Cheng, 10/31).
Researchers from Imperial College London, the Harvard Global Equity Initiative, and Harvard School of Public Health “have identified three global organizations that new funding initiatives should emulate in order to meet health priorities in poorer countries, in research published [Thursday] in the journal the Lancet,” Imperial College London reports in an article on its webpage. The study, “a comprehensive review of new funding methods that raised money for health in developing countries between 1990 and 2010 … found that the GAVI Alliance, … the Global Fund [to Fight AIDS, Tuberculosis and Malaria], and UNITAID, … were the sole organizations whose innovative financing methods had raised and distributed funds on a global scale,” the article notes, adding, “The authors concluded that innovative financing is essential to reduce dependence on contributions from donor governments. These innovative instruments provide a different way of raising money from new sources and making it available to address global health problems” (10/25).
Negative Effects Of Global Health Initiatives On Developing Countries' Health Systems Exaggerated, Review Shows
“An evaluation of the scientific evidence on the effects of global health initiatives on the health systems of developing countries concludes that the harmful effects have been exaggerated,” according to a press release from the Royal Society of Medicine. The systematic review, published on Wednesday in JRSM Short Reports, “found that much of the research literature did not fulfill the requirements of rigorous scientific evidence,” according to the press release. “The systematic review identified 24 studies published in peer-reviewed scientific journals between 2002 and 2009 that have commented on adverse effects on health systems arising from investments by the Global Fund,” the press release states, adding, “All the studies evaluated contained only seemingly anecdotal evidence or authors’ perceptions or interpretations of circumstances” (10/24).
Differing Opinions About AMFm 'Unlikely To Be Resolved' After Global Fund Decision On Program's Future
In her “Global Health Blog,” Guardian health editor Sarah Boseley examines the Affordable Medicines Facility-malaria (AMFm), “which aims to enable countries to increase the provision of affordable artemisinin combination therapies (ACTs) through not only the public sector but also the private sector and [non-governmental organizations (NGOs)].” Following pilot projects in seven African countries and an independent evaluation by the London School of Hygiene and Tropical Medicine, the Global Fund to Fight AIDS, Tuberculosis and Malaria, which hosts AMFm, is set to decide the future of the scheme at a board meeting in November. She notes Oxfam recently released a report criticizing the mechanism, saying the evaluation was flawed because it looked at the number of ACTs sold and not lives saved.
The Associated Press examines access to antiretroviral treatment in Myanmar, which “ranks among the world’s hardest places to get HIV care, and health experts warn it will take years to prop up a broken health system hobbled by decades of neglect.” The country, also known as Burma, has been hindered by decades of rule by a military junta and economic sanctions imposed by developed countries, including the U.S., the AP notes, and writes, “Of the estimated 240,000 people living with HIV [in the country], half are going without treatment.” However, “as Myanmar wows the world with its reforms, the U.S. and other nations are easing sanctions,” the news agency writes, adding, “The Global Fund [to Fight AIDS, Tuberculosis and Malaria] recently urged Myanmar to apply for more assistance that would make up the shortfall and open the door for HIV drugs to reach more than 75 percent of those in need by the end of 2015,” as well as medications to fight tuberculosis (TB). The AP details one man’s efforts to obtain antiretrovirals, which are reserved for patients with CD4 cell counts below 150 cells, versus the WHO recommended 350 (Mason, 10/22).
In the last of a series of posts on the U.K. Department for International Development’s (DfID) blog examining the department’s work in Malawi, Neil Squires, DfID head of profession for health, looks at the sustainability of the country’s HIV/AIDS program. “Malawi’s success in increasing access to antiretroviral drugs for HIV is highly dependent on donor funding for medicines,” he writes, adding, “Malawi has to actively consider its resource allocation in order to maximize the benefits and the health gained from the limited resources available.” He notes a report commissioned by UNAIDS on Malawi concluded that “unless Malawi can reduce the incidence of new infections, the scale up in access to antiretroviral drugs will not be sustainable in the medium to long term.” He concludes, “This is an important issue for the Government of Malawi, but also for the key donors who have supported the massive scale up in access to drugs, particularly the Global Fund. Malawi will need to maintain high levels of funding from the Global Fund if it is to maintain its supply of antiretroviral drugs” (10/23).
Aidspan, an independent watchdog of the Global Fund to Fight AIDS, Tuberculosis and Malaria, on Thursday published Issue 199 of its “Global Fund Observer.” The issue features an article on a diagnostic review of Global Fund grants in Peru; a commentary by Aidspan’s David Garmaise on language used in the Global Fund’s Office of the Inspector General reports; an article looking at Global Fund grants to Nigeria, which include $50 million in “new” money to purchase bed nets; as well as several other articles (10/18).
PlusNews examines challenges and concerns over an announcement by the Zimbabwean government that it plans to train nurses to prescribe and administer antiretroviral drugs (ARVs) to people living with HIV in the country. “Previously, nurses were allowed only to administer the drugs after a doctor had prescribed them,” the news service writes, adding, “Now, changes made in the job descriptions of nurses by the Nurses’ Council of Zimbabwe will see them prescribing the medication.” Owen Mugurungi, director of the HIV/AIDS and TB unit in the Ministry of Health and Child Welfare, said, “I need to point out that it’s not enough that a professional council allow nurses to administer drugs; this should be followed up with measures to capacitate nurses to do this work correctly,” according to PlusNews. The news agency looks at how the possibility of work overload for nurses, a government hiring freeze on nurses, and ARV availability could affect the country’s plan to reach 85 percent of the population in need of HIV treatment by the end of this year (10/16).
“Health workers in Myanmar are confident that efforts to narrow the country’s huge gap between access to, and need for, life-saving medicines to treat HIV/AIDS are back on track after the Global Fund to Fight AIDS, Tuberculosis and Malaria invited the country to apply for additional funding,” IRIN reports. “The agency’s coordinator for Myanmar, Eamonn Murphy, said new funds will allow the country to close a ‘treatment gap’ where only one-third of the 120,000 people nationwide who need [antiretrovirals (ARVs)] receive them,” the news service notes. “A spokesman for the Global Fund said it ‘had encouraged an application by the country for more money’ following an August visit to Myanmar by its general director,” IRIN writes. “Health officials drafted a ‘concept note’ outlining how additional funding might be used, which will be reviewed by the Global Fund’s board, Murphy said,” according to the news service, which notes, “It offers two scenarios: the first ensures 85 percent of those who need ARVs receive them by 2015; while with the second, 76 percent of people would be covered, he said.” The news service adds, “Based on feedback from the board, the government will choose a strategy for the proposal to be submitted early next year” (10/12).