Recent releases in Global Health

Aug 7 2010

Lancet Comment Calls For More Research Into Alcohol Use, HIV

According to a Lancet Comment, "alcohol remains conspicuously absent from the larger field of research and programming in HIV and substance use. ... Patterns of hazardous alcohol consumption prevail in countries with the most severe HIV epidemics, notably eastern and southern Africa."  In addition, "hazardous drinking patterns also dominate in the concentrated epidemics of eastern Europe and Asia, where alcohol use by injecting drug users and other marginalised groups might be an additional barrier to effective efforts to prevent HIV infection." The comment notes that both men and women are harmed by excessive alcohol use and calls for more research "focused on reducing alcohol-related sexual-risk behaviour, [which] might offer valuable lessons for the wider field of HIV and substance-use research" (Fritz et. al, 8/7).

Lancet Comment Says HIV Treatment Needs Continued Scale-Up

Keying off a Lancet study on how prognostic modeling might help guide antiretroviral therapy in sub-Saharan Africa, the authors of a Lancet Comment write about the "enormous" challenge of treating all HIV-positive patients in need of drugs and the importance of gaining efficiencies in overall health care in developing countries. "There is a growing pessimism among donors about how to deal with the difficulty of HIV treatment in resource-poor settings. There is a move towards control of other diseases with less expensive therapies that are time-restricted and strengthening of health systems instead of provision of antiretrovirals. Funding for HIV treatment should again be put on the international agenda otherwise the efforts of the past will have been in vain," the authors write (Koole/Colebunders, 8/7).

Gates Foundation To Transition Living Proof Project To ONE

The Bill & Melinda Gates Foundation "will transition 'The Living Proof Project: U.S. Investments in Global Health Are Working' to the global anti-poverty advocacy organization ONE," according to a foundation press release. The project is "a multimedia storytelling initiative to reach American audiences with positive stories about global health, emphasizing the progress, optimism, and opportunity that have been created with the help of U.S. investments," according to the release. Through its 2 million member network, ONE will "expand The Living Proof Project to reach new audiences in more countries around an expanded set of development issues, including agriculture and access to clean water" and feature the benefits of European investments abroad, the release notes (8/5).

Council On Foreign Relations Examines Politics of HIV Donor Support

An expert brief posted on the Council for Foreign Relation's website examines the "messy politics" of HIV donor support. Despite criticism, the author writes, the U.S. government is "by far the biggest supporter of both bilateral and multilateral HIV efforts," noting that when combined with private donations including the Gates Foundation, the U.S. accounts for 85 percent of global HIV/AIDS support. The author also observes the "essentially zeroed out" commitment from AIDS 2010's host Austria and notes that none of the Eastern European countries, including Russia, "even sent high-level delegations to the conference, though the region has the fastest-growing HIV epidemic." The author also describes the world's growing economies - China, Brazil and India - as "negligible donors." Additionally, the post examines President Obama's FY2011 foreign assistance budget request and how Congress has responded (Garrett, 8/4).

Blog: Innovation Needed To Address 'Grand Challenges' Of Development

A Huffington Post article stresses the importance of "the search for elusive solutions to development 'grand challenges'" as discussed at a recent USAID meeting with "leading scientists, inventors, engineers and technologists." For example, the authors write, one longstanding development challenge that could be addressed is "how to provide high-quality, affordable, primary health care in rural communities." The post cites examples of how USAID and the Obama Administration "understand the importance of science, technology and innovation for global development," including calls for better relationships between U.S. and foreign scientists and USAID's creation of a "center of excellence for science and technology" (Shah/Holdren, 8/4).

U.N. Examines MDG Priorities Ahead of 2015

"Even as we strive to achieve the [Millennium Development Goals] MDGs by 2015, the heightened attention and greater public and private investment in global health in recent years is paying dividends," UN Chronicle writes, citing reductions in child and maternal mortality, increased vaccination and the distribution of antiretroviral drugs. The author also writes that "many of the low-income countries are unlikely to achieve" the MDGs partly because of health worker shortages and "weak health care systems." The article also examines the need for collaboration among governments, academia and non-governmental agencies and concludes that a "balanced funding strategy for vaccine and drug development on one hand, and capacity building on the other, will determine how well and how fast we achieve the MDGs and address the other global health priorities for the twenty-first century" (Debas, 8/3).   

Blog: Global Community Should Invest In Vaccines

"New vaccines can prevent a large proportion of deaths but the global community has not committed the resources necessary to bring the full range of vaccines to all children," write the authors of a blog on the "Huffington Post." The authors argue that reducing under-five child mortality by two-thirds by 2015, which is Millennium Development Goal (MDG) 4, "will not be possible without additional support for immunization. It would be a crime if this goal were missed simply for lack of adequate financial support." The authors outline possible reasons for the lack of investment in vaccines including: fewer passionate advocates for prevention, stress on the global economy, and donor and recipient fatigue. They call for a "balanced immunization investment strategy that reinforces routine immunization, achieves existing initiatives to eradicate polio and reduce measles deaths by 95 percent, and enables introduction of new vaccines" (Carter/Annan, 8/3).

Several Blogs, Publications Examine Obama Administration's MDG Plan Released Last Week

• Details Needed On Obama's Plan To Meet MDGs: A post on the "One" blog reflects on President Barack Obama's plan to meet the Millennium Development Goals (MDGs), writing that it is a "first step toward providing leadership," but "a successful outcome … will require some more details on how this plan will become a reality." The author writes that the U.S. should clarify how its strategies will "complement other countries' efforts to meet the MDGs and feed into the global plan," and provide further details on its effort to "expand development-related activities … including a clear timeline, process, and metrics for success." The Administration also "needs to provide clarity" on how the plan will fit in to "ongoing efforts to reform U.S. development policy," the author writes (Thornton, 8/3).

• USAID Administrator Discusses U.S. MDG Strategy With UN Dispatch: USAID Administrator Rajiv Shah discussed the Obama Administration's MDG strategy in an interview with UN Dispatch. "This document fully embraces the MDGs, our desire to build on past progress, and our analysis of where we are about 10 years in," Shah said. In order to find solutions "that scale," he continued, "we are going to have to do things differently … we have huge opportunities to transition from more costly and ineffective strategies to things that are more highly scalable and lower cost." In the article, Shah also spoke about focusing on the "cross-cutting nature" of the MDGs, rather than treating them as separate goals, and the importance of empowering women and girls in development (Goldberg, 7/30).

• USAID Deputy Chief Comments On U.S. MDG Plan: The Center for Global Policy's "Science Speaks" blog features an interview with Ben Hubbard, deputy chief of staff at USAID, commenting on the Obama Administration's MDGs strategy. Hubbard told the blog, that while the plan is "a U.S. strategy, we want this to help shape global strategy. It is important we don't want to take a siloed systems approach. An effective strategy needs to address multiple goals at the same time." He also discusses investing in research, a commitment to science and technology, and focusing investment where the U.S. "can really move the dial forward in some of these key sectors" (Donnelly, 7/30).

• Blog: Obama Needs A Bigger Global Poverty Strategy: Analyzing the new MDGs plan, a post on the "One" blog asks "where's the bigger plan?" Acknowledging that the plan is a "great stepping stone," the author writes, "If the U.S. is committed to fighting global poverty, President Obama needs to deliver a global development strategy at the upcoming MDG Summit." The author also writes that she is "happy to report" the plan mentions a "development policy," which would unify "all of these piecemeal reform efforts." The post also cites a leaked White House document that describes the U.S.'s role as being one that helps "to create a world with more prosperous and democratic states, able to meet the needs of their people and to be our partners in addressing common threats, challenge and opportunities" (McConnell, 7/30).

• Education Key To Achieving MDGs: The Obama administration's MDGs plan "represents a missed opportunity to deliver on Obama's commitment to invest $2 billion in a Global Fund for Education to achieve universal primary education," according to a post by the Brookings Institution. Success for most of the MDGs, the author writes, will be "nearly impossible without the achievement of universal primary education, MDG 2." The post examines the role education plays in each of the MDGs, including the reduction of child mortality by educating mothers, improving maternal health and combating HIV/AIDS, citing "research on the last decade of the AIDS epidemic" that indicates "increased schooling is lowering the rate of AIDS infections" (Gartner, 7/30)

Blog: 100 Reps. Sign Letter Asking President Obama To Make 3 Year, $6B Global Fund Commitment

Last week, 100 members of the House of Representatives, led by Rep. Barbara Lee (D-Calif.), sent "a letter to President Obama encouraging him to make a three-year commitment of at least $6 billion to the Global Fund to fight AIDS, Tuberculosis and Malaria," according to the Center for Global Policy's "Science Speaks" blog. After attending AIDS 2010, Rep. Lee stated, "there's a lot of concern in the international community that we are not providing the necessary funding to meet our promises to combat this disease." The letter precedes a Global Fund "replenishment meeting" expected to take place in New York in October (Bryden, 8/2).

This week, Sen. Richard Lugar (R-Ind.) also sent a letter to President Obama, "expressing concern about funding being diverted [from HIV/AIDS programs] to other parts of the President's global health initiative," according to a post on his website (8/4).

Blog: Nine Empty Management Positions Hamper USAID

USAID Administrator Rajiv Shah "cannot captain his own ship without a crew," writes the author of a post on the Center for Global Development's "Rethinking U.S. Foreign Assistance Blog," noting that nine management positions must be filled before Shah will "have a full management team in place." Despite skilled leaders throughout the agency, the author writes, "having all remaining management seats empty eighteen months into the administration is unconscionable." Other "important decisions," like "whether USAID will lead the Feed the Future initiative may very well depend on whether Shah has staff in place," the author notes. The post also examines possible explanations for the unfilled positions, including Shah's attention to Haiti, good candidates who may be "worried about USAID's future and turning jobs down," and the difficulty of the White House vetting process (Staats, 8/2).

Health Affairs Examines Motivation of Ethiopian Doctors, Nurses To Work In Rural Areas

An article published in Health Affairs examines what would "best motivate doctors and nurses to work in rural areas of poor countries." After asking 861 Ethiopian health professionals hypothetical questions, researchers found that doctors value "higher wages and quality housing incentives," while nurses were more likely to move to a rural village after "improvements in the availability of medical equipment and supplies." The least attractive element for both doctors and nurses was time commitment, measured by "having to pay back an extra year of work in a remote location after receiving training," the study found (Hanson/Jack, August 2010).

Blog: Despite Warning, Aid Is 'Too Little and Too Slow' To Sahel Region

A post on The Hill's "Congress Blog" looks at the 10 million people across the Sahel region of Africa facing "devastating hunger." The author writes that "despite plenty of warnings of a looming crisis, aid has been too little and too slow to arrive," noting that the U.S. is leading the way in providing emergency food to the region with a $100 million contribution. However, "donors have so far only provided only 25 percent of what aid agencies estimate is needed." The post also states that the U.S.'s generosity is "undermined" by requirements that aid has to be given as food rather than cash and sent from the U.S. on American ships, citing a report to Congress which "estimated that for each dollar spent on food aid, less than 50 cents is actually spent on food." The author also writes that USAID is taking the "extraordinary step" of providing cash to enable local organizations to purchase food in the region" (Offenheiser, 7/30).

American Bar Association Journal Highlights HIV/AIDS And Human Rights

The latest issue of the American Bar Association's "Human Rights" magazine is dedicated to HIV/AIDS and the rule of law. In the issue, the editors "hope to shine a light on the human rights issues at home and around the globe that continue to fuel this epidemic," according to the magazine. The issue includes articles on the need for more "focused attention to human rights" to achieve universal access, sex trafficking and HIV/AIDS, a "deadly junction for women and girls," the role of faith-based organizations and how "culture, history and laws can combine to deny women and girls equal access to HIV prevention and care" (Spring 2010).