Kaiser Daily Global Health Policy Report
In The News
- Donors Pledge $12 Billion To Global Fund For 2014-2016
“The world’s donor countries on Tuesday pledged $12 billion over three years to the Global Fund to Fight AIDS, Tuberculosis and Malaria,” the New York Times reports. “The amount was more than the fund took in at its last pledge conference in 2010, but less than the $15 billion it had hoped for. And it is far short of the ambitious goal of $10 billion a year set when the fund was created in 2002,” according to the newspaper (McNeil, 12/3). “The pledges represent a 30 percent increase over the $9.2 billion in firm pledges secured in 2010 for the 2011-2013 period,” a Global Fund press release states, adding, “The contributions announced [Tuesday] include funding from 25 countries, as well as the European Commission, private foundations, corporations and faith-based organizations.” On Monday, President Barack Obama “said the United States — the Global Fund’s biggest donor — would uphold its challenge to pledge $1 for every $2 committed by others through September 2014,” the press release notes.
Ambassador Samantha Power, the permanent representative to the U.N. for the United States government, gave an opening address at the replenishment meeting, which took place in Washington, D.C., according to the press release (12/3). “These pledges are a demonstration of global solidarity and trust to move towards ending the three diseases,” UNAIDS Executive Director Michel Sidibé said at the meeting, the U.N. News Centre reports. Global Fund Executive Director Mark Dybul said in his closing remarks, “The 21st century ideals that led to the founding of the Global Fund are now stronger than ever: partnership, shared responsibility, and mutual accountability. In many ways, this is a replenishment of hope. It is a lifting up of the human spirit,” the news service notes (12/3). U.S. National Security Adviser Susan Rice, who also spoke at the meeting, said, “[O]ur mission is clear. We cannot stop until we have seen the last AIDS-related death, and no child is again born infected with HIV,” according to United Press International (12/3).
Additional information regarding the U.S. Global Fund pledge, as well as other announcements made in recognition of World AIDS Day, is available from the Kaiser Family Foundation’s “Policy Tracker” (12/3).
- ScienceInsider Examines Source Of $100M For U.S. HIV Cure Research
Noting President Barack Obama on Monday at a World AIDS Day event at the White House announced $100 million would be redirected to “a new initiative at the National Institutes of Health [NIH] to advance research into an HIV cure,” ScienceInsider examines the funding’s source. “Obama did not specify where the money would be redirected from, and a subsequent NIH press release offered only a hint of more detail, noting that money ‘will come from existing resources and a redirection of funds from expiring AIDS research grants over the next three years,'” the news service notes, adding, “In an e-mail to ScienceInsider, Jack Whitescarver, director of NIH’s Office of AIDS Research, explained that ‘existing resources’ means NIH’s existing $3.1 billion HIV/AIDS budget: No new money will come from other parts of NIH.” The news service notes, “Obama’s announcement took many HIV cure researchers and advocates by surprise, but it was welcome news — with a decided note of cautious optimism” (Cohen, 12/3).
- U.S. Senator Urges Obama Administration To Remain Firm On TPP Intellectual Property Provisions
“The U.S. should consider dropping countries from Trans Pacific Partnership [TPP] trade talks if they fail to accept its demands on data protections for drugs and unrestricted cross-border data flows,” Sen. Orrin Hatch (R-Utah), “the top Republican on the Senate finance committee” has said in “a letter to Michael Froman, the U.S. trade representative, urging the Obama administration to hold firm on tough intellectual property provisions in the negotiations, which are entering their final stage,” the Financial Times reports. “Hatch has long insisted that the U.S. pushes for 12 years of data exclusivity for biologic drugs, a position supported by pharmaceutical manufacturers but opposed by groups such as Médecins Sans Frontières who say it would restrict access to affordable medicine around the world,” the newspaper notes.
In the letter, “Hatch said he was ‘increasingly concerned’ that some of the 12 countries in the negotiations — spanning Asia, Latin America and North America — may not be willing to ‘undertake the high level of ambition to conclude a high-standard agreement’ and urged Mr. Froman to only ‘move forward’ with the countries that were on board,” the Financial Times writes (Politi, 12/3). “Hatch suggested wrapping up negotiations on a staggered timetable as countries become willing to meet the high TPP standards,” The Hill’s “On the Money” blog adds, noting, “Negotiators of the TPP — Vietnam, Mexico, Canada, Japan, Malaysia, Singapore, New Zealand, Australia, Brunei Darussalam, Chile and Peru — have said they are aiming to complete a deal by year’s end” (Needham, 12/3). The New American highlights a recently published Salt Lake City Tribune opinion piece, in which Hatch “calls for approval of the [TPP] and for ‘breaking down trade barriers'” (Wolverton, 12/2).
- WTO Ministerial Meeting Begins Amid Questions On Food Security, Other Issues
“Amid looming uncertainty, trade ministers and officials from 159 countries Tuesday began formal negotiations at the [World Trade Organization (WTO)] ministerial meeting [in Bali] in a bid to reach consensus on issues such as food security and trade facilitation,” Zee News reports. “India, which is an important member of the G33 grouping, is demanding amendments in the [WTO] draft on agriculture to ensure its food security program doesn’t attract penalties if subsidy limits are breached,” the news service notes (12/3). Ministers are aiming “to give a shot at revival of the 12-year old Doha Round of global trade talks,” the Financial Express adds (12/3). “Failure to agree on a pact, which supporters estimate could boost the world economy by as much as $1 trillion, will call into question the effectiveness of the WTO and may mean the end of the Doha process, [WTO Director-General Roberto Azevedo] said,” Bloomberg reports (Chatterjee, 12/3).
- World Needs To Significantly Increase Food Production To Feed 2050 Population, Report Says
“The world will need 70 percent more food, as measured by calories, to feed a global population of 9.6 billion in 2050, and must achieve this through improvements in the way people produce and consume, according to a report released today by the United Nations and its partners,” the U.N. News Centre reports. “The report, titled ‘World Resources Report: Creating a Sustainable Food Future,’ finds that boosting crop and livestock productivity on existing agricultural land is critical to saving forests and reducing greenhouse gas emissions,” the news service states, adding, “The report also recommends achieving replacement-level fertility, a rate it says most of the world is nearing by educating girls, reducing child mortality and providing access to reproductive health services” (12/3). The report was produced by the World Resources Institute (WRI), the United Nations Development Programme (UNDP), the United Nations Environment Programme (UNEP), and the World Bank, according to a WRI press release (.pdf), which notes the report was released at the 3rd Global Conference on Agriculture, Food and Nutrition Security and Climate Change, in Johannesburg, South Africa (12/3).
- CNN Interviews U.S. Ambassador To South Africa About Future Of Country's AIDS Response
CNN’s Christiane Amanpour on her show recently interviewed U.S. Ambassador to South Africa Patrick Gaspard “about HIV/AIDS and the future of the Rainbow Nation,” where “more than six million people — or 10 percent of the entire population — are infected with HIV.” They examine U.S. funding for AIDS programs in the country through PEPFAR and discuss progress against the disease, noting that while there are more people living with HIV in the country than there were 10 years ago due to an increase in access to antiretroviral drugs, the rate of new infections is down 32 percent and only three percent of HIV-positive pregnant women are transmitting the virus to their children. “Still, there’s more work to be done,” Amanpour states. They examine challenges in the response moving forward, CNN notes and provides video footage of the interview (12/3).
- CNN Interviews Bill Gates About Global AIDS Response
“While much progress has been made” in the effort to eradicate AIDS, an AIDS-free generation “is still a far way off,” Bill Gates, co-chair of the Bill & Melinda Gates Foundation, said in an interview with CNN on Monday, after “attending President Barack Obama’s remarks on World AIDS Day at the White House.” “‘We are going to be living with some level of AIDS for decades to come,’ [Gates] told CNN’s ‘The Lead with Jake Tapper,'” the news service notes. “‘We don’t have a cure and so we have to keep them on drugs to keep them alive, and that requires not only generosity, but getting very innovative about how we reach that kind of a number. We need a vaccine, or a tool to prevent people from getting infection,’ said Gates,” CNN adds. The news service provides video footage of the interview (12/2).
- WHO Releases Report On Global Spinal Cord Injuries
“The [WHO] says as many as 500,000 people suffer spinal cord injuries every year,” VOA News reports (DeCapua, 12/2). “People with spinal cord injuries are two to five times more likely to die prematurely, with worse survival rates in low- and middle-income countries, says a new report,” released Monday, RTT News writes, adding, “The report, titled ‘International perspectives on spinal cord injury,’ summarizes the best available evidence on the causes, prevention, care and lived experience of people with spinal cord injury” (12/3). According to the report, “males are most at risk of spinal cord injury between the ages of 20-29 years and 70 years and older, while females are most at risk between the ages of 15-19 years and 60 years and older”; “up to 90 percent of spinal cord injury cases are due to traumatic causes such as road traffic crashes, falls and violence”; and “variations exist across regions,” PANA/AfriqueJet notes (12/3).
According to a WHO press release, the report highlights several essential health, social and economic measures “for improving the survival, health and participation of people with spinal cord injury” — including “timely, appropriate pre-hospital management”; “acute care appropriate to the level and severity of injury”; “access to ongoing health care, health education and products”; and “elimination of discrimination in employment and educational settings,” among others (12/2).
- UNAIDS' 'Zero Discrimination' Campaign Discourages Criminalization Of HIV Transmission
UNAIDS’ “Zero Discrimination” campaign, launched this week, “among other goals, seeks to discourage countries from criminalizing the transmission of HIV,” Slate reports. “Over 63 countries have laws on the books, mandating criminal penalties for HIV-positive people who engage in sex without disclosing their status, according to the organization,” the news service notes. “In addition to human rights concerns, such laws can be counterproductive, creating a climate of fear which discourages patients from seeking treatment,” Slate writes (Keating, 12/3). “Meanwhile, 76 countries criminalize same-sex relations — a factor that is linked to increased HIV prevalence. And in countries with punitive laws of this kind, one in seven HIV-positive people report being denied health care, with one in 10 denied jobs,” New Scientist writes. “‘Getting to zero new HIV infections will be impossible without striving towards zero discrimination,’ says Michel Sidibé, executive director of UNAIDS,” according to the news service (Coghlan, 12/3).
- China Sees Rise In HIV Among Youth, MSM
“Two decades after tens of thousands — some say hundreds of thousands — of Chinese contracted HIV from contaminated blood products in an epidemic that raged in the 1990s, the major transmission route today is sex, according to Chinese media reports, citing figures from the National Health and Family Planning Commission,” the New York Times’ “Sinosphere” blog reports. “And a new at-risk group is growing fast: young people aged between 15-24, according to Wang Ning, an AIDS specialist at the Chinese Center for Disease Control and Prevention,” the blog notes. “Linked to the rise is gay sex, experts said,” the blog continues, adding, “On its website, the China office of the [WHO] said counseling for men who have sex with men, or MSM, was ‘critical.'” The blog notes Chinese President Xi Jinping marked World AIDS Day by “issuing a ‘written instruction’ on AIDS work for ‘Party and government organs at all levels to step up the fight against HIV/AIDS,’ Xinhua reported” (Tatlow, 12/3). “Xi stressed legal and scientific prevention and control work as well as the smooth implementation of support policies, calling on the public to jointly eliminate discrimination and help provide timely and effective treatment and support for HIV carriers and AIDS patients,” Xinhua writes (11/30).
- Devex Examines Need For Focus On Women, Girls In AIDS Efforts
“Although the international development community has scored significant wins in the battle against HIV and AIDS, interventions to protect most at-risk populations — including women and girls — have fallen short,” Devex reports. The news service examines “what makes women and girls more susceptible to contracting HIV” and includes comments from Elisha Dunn-Georgiou, Population Action International’s vice president of programs, and Elise Young, Women Thrive Worldwide’s vice president of policy and government affairs (Parmanand, 12/3).
Editorials and Opinions
- Global Community Can End AIDS With Continued Commitment, Shared Responsibility
“As recently as 10 years ago, AIDS was a death sentence for many, and experts warned that in parts of the world, we had reached a point literally of no return,” U.S. Secretary of State John Kerry writes in the Huffington Post’s “The Big Push” blog. “But what I remember most [from that time] — and what I’ve been privileged to be part of every step of the way — is how everybody came together to push back against that pessimism,” he states, reflecting on the global response to the AIDS epidemic over the past decade. “Now, with World AIDS Day and the meeting at the White House and the follow-on conference [for the replenishment of the Global Fund to Fight AIDS, Tuberculosis and Malaria], we are renewing that commitment,” he writes, adding, “But the battle is not won. There are major challenges ahead and they will require major commitments to live up to the memory of all those for whom it was too late and to make sure we are not too late to save another generation.”
“Now to meet the challenge of PEPFAR’s second decade we have to transform America’s role,” and South Africa, Rwanda, and Namibia “provide a model for how PEPFAR is transitioning from providing direct aid to delivering support for locally run and self-sustaining efforts,” he states, adding, “And greater commitments from our partners in the Global Fund should give greater confidence to this initiative.” Kerry writes, “We know that working to achieve an AIDS-free generation will continue to pose an incredible test,” concluding, “But with our continued commitment, I am certain that we can all look forward not only to passing that test, but to working with each other and providing a new definition of the character of our nation and the character of our global spirit” (12/3).
- Ending AIDS Is 'Both Possible And Our Moral Responsibility'
“The global response to AIDS over the past decade has been a great success — but there is still more work to do,” Ira Magaziner, vice chair and CEO of the Clinton Health Access Initiative, writes in the Huffington Post’s “The Big Push” blog. “Since 2002, the global community has learned how to treat people effectively and efficiently,” he states, noting, “Over 10 million people are now receiving treatment. 10 million people who would have died are now alive.” However, new WHO treatment recommendations, “if implemented, will mean treating over twice as many people as we treat today, saving millions more lives and dramatically reducing the transmission of the disease,” he adds.
“At the Clinton Health Access Initiative, we know from over 11 years of experience in helping to build AIDS care and treatment programs around the world and negotiating agreements that lower the prices of drugs and tests, that it will be possible to meet these new goals over the next few years and to do so within existing annual spending levels,” Magaziner continues. “To be successful, global donors must fully replenish organizations like the Global Fund and PEPFAR. And those responsible for spending these funds must commit themselves to be as efficient as possible,” he writes. “It is within our power as a global community to prevent children from being born with HIV, it is within our reach to dramatically reduce the transmission of the virus among adults and it is both possible and our moral responsibility to try to save the lives of people suffering from AIDS,” he notes, concluding, “This can be done and it is the right thing to do” (12/3).
- Coordinated Effort On Vaccine Development Will Accelerate Progress
“I, along with eight fellow scientists, have proposed the establishment of a new human-immunology-based clinical-research initiative, the Human Vaccines Project,” Wayne Koff, senior vice president and chief scientific officer of the International AIDS Vaccine Initiative, writes in a Project Syndicate opinion piece. “In February 2014, leading scientists and public health specialists will gather in La Jolla, California, to craft a scientific plan to identify, prioritize, and, most important, solve the major problems currently hindering development of vaccines against diseases such as AIDS, tuberculosis, and malaria,” he states. “In just the past few years, many candidate vaccines against HIV, dengue, herpes, tuberculosis, and staphylococcus aureus have failed, at a cost of more than $1 billion,” Koff says, adding, “Investing that amount over the next decade in a coordinated effort to address the major questions facing vaccine development would rapidly accelerate our search for effective solutions, implying a transformative impact on individual and public health” (12/3).
- Opinion Pieces, Editorial Address Global Fund Pledges
Donor countries, non-governmental organizations, and the private sector on Tuesday pledged $12 billion to the Global Fund to Fight AIDS, Malaria and Tuberculosis at its replenishment meeting. The following summary of opinion pieces and editorial discuss the Global Fund and its work.
- Lucy Chesire, Huffington Post’s “The Big Push” blog: “Come 2014, it’s exciting to know that the funds raised today will be disbursed to priority countries where the burden of tuberculosis, HIV and malaria is highest,” Chesire, a TB-HIV advocate from Kenya and board member of the Global Fund Board Communities Delegation, writes. “The Global Fund’s strategic investment provides the greatest opportunity to end the three diseases,” she says, concluding, “Let’s not lose momentum now, let’s leave Washington, D.C., this week and recommit to finding the collective political will to fully fund the Global Fund and see just how much further we can be in three years if we invest now” (12/3).
- Tom Hart, Huffington Post’s “The Big Push” blog: “As we move forward, it is crucial that donors provide additional resources to the Global Fund to turn the tide against these three killer diseases,” Hart, U.S. executive director of ONE, writes. “It is entirely possible — but not inevitable — that this generation will be the last to suffer from the disease. The only variable is whether there is the will to make it happen,” he concludes (12/3).
- Julio Montaner, Huffington Post British Columbia Blog: Noting “the government of Canada announced $650 million in new funding over three years for the Global Fund,” Montaner, director of the B.C. Centre For Excellence In HIV/AIDS, writes, “Canada’s newly announced contributions are not nearly enough, especially when compared to our international peers.” He continues, “I urge the Harper government to … match our peers’ contributions to the Global Fund” (12/3).
- Anchorage Daily News: “Congress should make good on the [U.S.] pledge, and our delegation of Sens. Lisa Murkowski [R] and Mark Begich [D] and Rep. Don Young [R] should be leaders in the appropriation,” the Alaskan newspaper writes, concluding, “Support for the Global Fund is one of those constant threads of good in the work of the United States in the world. Let’s keep it strong” (12/3).
- Developing Countries Need Access To Cheap Fossil Fuels As World Transitions To Greener Energy
“There’s no question that burning fossil fuels is leading to a warmer climate and that addressing this problem is important. But doing so is a question of timing and priority,” Bjorn Lomborg, the director of the Copenhagen Consensus Center, writes in a New York Times opinion piece. “[B]illions of people face a more immediate problem: They are desperately poor, and many cook and heat their homes using open fires or leaky stoves that burn dirty fuels like wood, dung, crop waste and coal,” he states, adding, “About 3.5 million of them die prematurely each year as a result of breathing the polluted air inside their homes — about 200,000 more than the number who die prematurely each year from breathing polluted air outside, according to a study by the [WHO].”
“What those living in energy poverty need are reliable, low-cost fossil fuels, at least until we can make a global transition to a greener energy future,” Lomborg continues, adding, “This is not just about powering stoves and refrigerators to improve billions of lives but about powering agriculture and industry that will improve lives.” He states, “The developed world needs a smarter approach toward cleaner fuels,” adding, “We need to export this technology and help other nations exploit it.” He writes, “At the same time, wealthy Western nations must step up investments into research and development in green energy technologies to ensure that cleaner energy eventually becomes so cheap that everyone will want it,” and he concludes, “But until then they should not stand in the way of poorer nations as they turn to coal and other fossil fuels. This approach will get our priorities right. And perhaps then, people will be able to cook in their own homes without slowly killing themselves” (12/3).
From the Global Health Policy Community
- Reps. Himes, Lee Introduce 'Cure For AIDS Act'
“On the observance of World AIDS Day, Representatives Jim Himes [D-Conn.] and Barbara Lee [D-Calif.] announced they have re-introduced the ‘Cure for AIDS Act,’ a bill they first introduced last Congress that would fund research and development of a cure for HIV/AIDS,” a press release from Himes states. The bill would establish a five-year “$100 million research program within the Congressionally Directed Medical Research Program managed by the Department of Defense [to] fund research targeted directly toward discovering a cure for HIV/AIDS,” the press release notes (12/2). The bill (HR 3630) was referred to the House Armed Services, House Energy and Commerce, according to the Government Printing Office (12/2). Additional information on the bill is available from the Kaiser Family Foundation’s “Policy Tracker” (12/4).
- U.S. Launches 'Lives Without Limits' Campaign On International Day Of Persons With Disabilities
On the International Day of Persons with Disabilities, observed December 3, the U.S. Bureau of Educational and Cultural Affairs (ECA) “launched Lives Without Limits, a campaign to promote the importance of including persons with disabilities in international exchange programs,” Assistant Secretary of State for Educational and Cultural Affairs Evan Ryan writes in USAID’s “IMPACTblog.” The “campaign provides a platform for ECA partners, disability advocates, alumni and participants with disabilities to share their vision for a life without boundaries,” she writes (12/3). On this day, “we reaffirm our determination to ensure that our disabled brothers and sisters can travel abroad with the same dignity and respect that they enjoy here at home, and that disabled people around the world can at last share in the promises that Americans believe are a right, not a privilege,” U.S. Secretary of State John Kerry said in a press statement marking the day (12/3).
- Ending TB Deaths Is Vital To Defeating AIDS
“[L]et’s not forget that if the dream of making this the generation that defeats AIDS is to become reality, we must also tackle the leading killer of people with HIV — tuberculosis (TB),” Cheri Vincent, chief of the Infectious Diseases Division at the USAID Global Health Bureau, writes in USAID’s “IMPACTblog.” She continues, “Bold steps of commitment by the global community will indeed strengthen our fight against TB and will give countries the tools, particularly life-saving commodities, to reduce the spread of TB, cure people suffering with TB, and prevent the further development of [multi-drug resistant TB (MDR-TB)]. We need new drugs and tools that are safe and effective for people with TB, MDR-TB, and those co-infected with TB and HIV.” Vincent concludes, “By the global community banding together with resources and endorsements to meet the challenge, the goal of ending TB deaths in our lifetime is within our reach” (12/3).
- AIDS Vaccine Needed To End Pandemic
In a post in the ONE blog, Rajat Goyal, India country director at the International AIDS Vaccine Initiative, reflects on progress in the global AIDS response, which he attributes largely to the development of and improved access to antiretroviral medicines, and he examines the need for a vaccine in order to bring an end to the epidemic. “More than 6,000 people worldwide are newly infected with HIV every day, and the pandemic is still spreading faster than the drugs to treat and prevent it: more people are newly infected each year than gain access to treatment,” he notes, adding, “In this context, it is clear that to ‘end AIDS’ we must not only provide more of what works, but also develop a vaccine” (12/3).
- Capitol Hill Briefing Addresses Youth, HIV/AIDS
The Center for Global Health Policy’s “Science Speaks” blog highlights a Capitol Hill briefing on youth and HIV/AIDS that took place on Monday. Moderated by Smita Baruah, director of global health policy and advocacy for Save the Children United States, the panel included Nandita Sugandhi of the Clinton Health Access Initiative, Scott Kellerman of Management Sciences for Health, Erin Hohlfelder of ONE, and Victoria Fan of the Center for Global Development (Aziz, 12/3).
- New Initiative Aims To Identify Innovations To Use Water More Efficiency
“As the global water resources become increasingly scarce, we must learn how to adapt to a new reality,” Christian Holmes, global water coordinator for USAID, writes in the agency’s “IMPACTblog.” He states, “In part, this means learning how to do more with less. Learning to use available water better, learning how to store water more efficiently, and learning how to grow more food using less water.” He notes “on September 2, 2013, at the opening session of World Water Week, we announced Securing Water for Food: A Grand Challenge for Development,” a $25 million initiative that aims to “identify, source and bring to scale promising new low-cost innovations that use existing water resources more efficiently, improve water capture and storage technology, and reduce salinity of existing resources to ensure new sources of water for agricultural production” (12/3).
- PMA2020 Initiative Using Mobile Technology To Improve Family Planning Access In 10 Countries
In a post in the Bill & Melinda Gates Foundation’s “Impatient Optimists” blog, Christopher Elias, president of global development at the foundation, examines a program “known as PMA2020, [which] is using mobile technology to help 10 countries — eight in Africa and two in Asia — improve their family planning services.” He writes, “PMA2020 will generate valid estimates of contraceptive prevalence, quality of care, and other key indicators on an annual basis, which will allow countries to make evidence-based decisions about policies and programs on a schedule that more closely corresponds with annual planning cycles,” noting, “Until now, the availability of nationally representative, population-based data to inform progress of family planning programs has been limited, generally coming from surveys done once every five years” (12/2).