The largest agency in global health, spreading word of home-grown research, a look at the Global Health Initiative’s life — and afterlife, and more . . .

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The U.S. Department of Defense and Global Health: It is the oldest agency in the United States, has a reach that extends effectively to all countries, is involved in health service delivery and health research, but is not budgeted as a global health agency, nor is global health considered its mission. All the same, the role of the Department of Defense is changing, with emphasis on preserving peace by supporting and strengthening infrastructures and addressing issues that threaten stability. With that in mind, this Henry J. Kaiser Family Foundation report analyzes the history, activities, budget and priorities of the department to clarify the current role, objectives and  potential of its global health activities. Consolidated oversight of these activities could help decision makers to better understand the impact of the department’s role, and of changes, the report suggests.

What has the US Global Health Initiative achieved: Maybe because global health advocates wanted to give the initiative time before judging its efforts, maybe because the muted delivery of the news that its office was closing, as when a child is told the family dog has gone to live on a farm, didn’t offer much opportunity to reflect on what had really happened, and maybe because its goals were so important, comprehensive critical looks at what it did achieve have been hard to come by. The insights collected here put the pieces together — what happened, and what can happen next to realize the aim of consolidating critical global health responses.

South African Declaration targets TB in mining sector: Why did representatives of 15 southern African countries recently commit to improving their response to tuberculosis among miners and their families? This Lancet article gives some of the reasons — with South Africa’s miners showing the world’s highest tuberculosis infection rate (the article estimates  a rate of 3,000 to 7,000 of every 100,000 miners infected), and the impact of the disease and of conditions fostering it reaching into all of the countries miners come from and return to, while just $6 of every $100 of Global Fund money that goes to Africa goes to fighting tuberculosis.

Africa: Need for better research dissemination: Like the question about the tree that falls in the forest that no one hears, this IRIN article raises the question of what happens to home-grown evidence-based medical breakthroughs if word about them doesn’t get out. Do they get replicated, at the cost of wasted resources? Do they get used? Do they provide the basis for further research? Focusing on a five-day workshop in Addis Ababa, this article highlights a need for research to be made accessible to the health workers and researchers in Africa, by training, and by the creation of regional information centers.

Preexposure Prophylaxis for HIV Prevention — Polling Results: The New England Journal of Medicine’s Clinical Decisions interactive feature presented readers in August with the situations of two HIV-negative patients. One was a New York man who had had sex with multiple men including his long-term partner, and had been treated in the past for syphilis, the other was a young South African woman, who had recently started having sex and didn’t know the HIV status of her partners. The question, presented to readers with arguments to support both sides — which if either patient was a candidate for antiretroviral medicine to help prevent them from getting HIV? The answers, fairly split down the middle gave a glimpse of the number of factors that will have to be weighed and balanced in guidelines.

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