‘Ethical Issues Raised By PrEP Are Difficult, But Not Insurmountable’: “The AIDS movement is at a pivotal point in history, where it will face scrutiny not only to demonstrate that interventions are cost-effective and equitably distributed, but also to balance resource demands with other global health imperatives, such as maternal/child health, noncommunicable diseases, and the human resources and infrastructure required to ensure the health of individuals and communities,” write the authors of a JAMA Commentary that examines the ethical issues surrounding preexposure prophylaxis (PrEP). “The ethical issues raised by PrEP are difficult, but not insurmountable,” the authors write before offering guidance on ways to “help ensure ethical allocation under circumstances of scarcity” (Gostin et al., 1/12).

Steps For Helping Haiti: “Haiti’s next government will be called upon to make difficult decisions that will have a lasting impact on Haitian society, such as the allocation of resources for cholera treatment efforts and earthquake reconstruction projects. If these decisions are made by a government that is not perceived as legitimate, the recovery process could be impeded for years to come,” Rep. Maxine Waters (D-Calif.) writes on The Hill’s “Congress Blog.” Waters also calls on U.S. and “other donor governments to keep their promises to the Haitian people” (1/12).

PEPFAR Helping To Rebuild Haiti’s Health System: Reporter John Donnelly writes about a recent senior U.S. officials’ news briefing on health concerns in Haiti on the Center for Global Health Policy’s “Science Speaks” blog. Officials said that just four months after the earthquake, “the number of those treated for AIDS was at 95 percent of pre-earthquake levels. … [T]he number of pregnant women receiving AIDS treatment increased to 1,900 in 2010 from 1,100 a year before,” Donnelly writes. Donald Steinberg, a USAID deputy, “said the emergency response used ‘in large part the PEPFAR facilities on the ground,’ including everything from triage centers to food and supply distribution sites” (1/11).

Obama’s Global Development Strategy In Haiti And Around The World: “The bottom line is that in order to move beyond inequality and poverty, Haitians must be given a voice in decisions about their country’s rebuilding process. Leaving them out of the process only creates greater dependency on foreign aid,” Raymond Offenheiser, president of Oxfam America, writes in a post on The Hill’s “Congress Blog” looking at how President Obama’s global development policy might affect the Haitian reconstruction effort. “As we enter into the critical second year of Haiti’s recovery from the devastating earthquake, the new U.S. Global Development Policy gives us the initial framework to make this a reality in Haiti and around the world” (1/11).

Global Medicine Quality: “For the global health community, pharmaceutical product quality and patient safety cannot be ignored. The huge levels of donor funding for the procurement of life-saving medicines for priority health problems require us to assume responsibility for ensuring that decades of investments in public health are not undone through lack of vigilance on these issues,” writes Maria Miralles, USAID’s senior pharmaceutical management advisor in a post on USAID’s “Impact” blog. Miralles also notes that USAID has supported the development of “drug quality surveillance programs in more than 20 nations” (1/11).

Strengthening Women And Girls In 2010: Melanne Verveer, the State Department’s ambassador-at-large for global women’s issues, highlights the U.S. government’s work to empower women and girls around the world in a post on State’s “DipNote” blog. “We have made key links between women’s empowerment and tackling global challenges such as climate change, health, and food security. It is well known that women face severe personal security risks while carrying out the task of foraging for fuel, especially in refugee camps and conflict zones, but there are also major health risks associated with exposure to traditional cookstoves and open fires, with women and young children the most affected,” Verveer writes (1/11).

Reflections On PEPFAR’s Recent Scientific Advisory Board Meeting: “If the U.S. (in PEPFAR) or the global community (in the Global Fund for AIDS, TB and Malaria) helps some of the world’s most resource-limited nations put millions of their citizens on ART, neither can step back and simply say, ‘Sorry, no more money or technical assistance!’ We have an ethical obligation to continue ART support as we help countries capacitate to manage such programs themselves,” Sten Vermund, a professor of medicine and director of the Institute for Global Health at Vanderbilt University School of Medicine, said in an interview on the Center for Global Health Policy’s “Science Speaks” blog (Mazzotta, 1/10).

CGD’s Rethinking U.S. Foreign Assistance Initiative Launches USAID Resource: The USAID Monitor will be “devoted to all things USAID. … this new monitor will track happenings inside USAID that affect aid reform and aid effectiveness,” Connie Veillette, director of the initiative, writes on CGD’s Rethinking U.S. Foreign Assistance Blog. “Through the USAID Monitor, we will also track what is happening elsewhere in the U.S. government that affects how the agency accomplishes its mission” (1/10).

The Role Of Water Issues In China’s Rural Health Car Reform: “Eliminating the burden of water-related illness would have a lasting preventative health effect on the rural poor who are already shouldering skyrocketing healthcare costs. The eradication of water-borne diseases requires acknowledging the interplay between equitable access to health services and the distribution of water and sanitation infrastructure,” Angela Ni, a Fulbright fellow in China, writes in a post on PLoS Medicine’s “Speaking of Medicine” blog discussing China’s health reform effort in rural areas (1/7).

Nature Medicine Community Corner Asks Health Experts To Weigh In On Future Of PrEP: A Nature Medicine Community Corner asks health experts to weigh in on “the implications for the implementation of HIV prevention programs with antiretroviral drugs, the impact on public health and the next step in HIV therapeutics.” In response, Diane Havlir of the University of California San Francisco writes, “With many people infected with HIV already struggling to access antiretroviral therapy (ART) globally – even in the U.S. – one anticipates a constructive debate on resource allocation for PrEP. The good news is that the era of combination prevention that harnesses the power of ART has arrived. Indeed, 2011 promises to be an interesting year as this field takes off.” The piece also features comments by: Myron Cohen, director of the University of North Carolina’s Institute of Global Health and Infectious Diseases; Steven Deeks of the University of California; and John Mellors of the University of Pittsburgh School of Medicine (1/7).

‘Now Is The Time’ For International Community, Public And Private Sectors To Come Together To Meet Health Care Challenges Facing Developing Countries: “In order for developing countries to grow, innovative ideas are needed to address their specific health care challenges. These will vary by disease, product, and market,” Andrew Witty, CEO of GlaxoSmithKline writes in a Health Affairs article where he examines what he refers to as “promising strategies” to develop drugs for diseases that disproportionately affect developing countries as well as the some “challenges that the public and private sectors still need to address” moving forward. “[N]o matter what tools are used, now is the time for the international community and the public and private sectors to come together and show that all stakeholders can work in concert toward ambitious new goals. For these efforts to be successful, it will be necessary to find tailor-made solutions to specific public health problems and to evolve our business practices and models in an effort to improve and do more,” he concludes (January 2011).

USAID and the State Department’s blogs included several updates about the Haitian earthquake anniversary:

DipNote: One Year Commemoration of Haiti’s Earthquake (1/12).

Impact: Haiti: The First Year of the USG’s Long-Term Commitment (Weisenfeld, 1/12).

DipNote: Building on What Works: U.S. HIV/AIDS Programs Forge Haiti Earthquake Response (Goosby, 1/11).

DipNote: Haiti: One Year Later (Adams, 1/11).

DipNote: Conversations With America: Haiti in 2011—The Way Forward (1/10).

DipNote: Press Briefing on Haiti (1/7).