Health Systems & the Growing Threat of Drug Resistant HIV & TB

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Dr. Luis Sambo, the WHO’s regional director for Africa, sought to draw attention this week to the growing threat of drug-resistant strains of HIV, tuberculosis and malaria on the continent, calling for aggressive action “before the situation gets out of hand.”

Sambo made his comments during the 59th session of the WHO regional committee meeting in Kigali, with Rwanda getting some praise for progress in improving its health services. But more broadly, Sambo said African countries needed to respond forcefully to the emergence of virulent new strains of TB and other deadly diseases. He called for a nine-point plan that includes developing human resources, strengthening lab capacity, and bolstering drug supply chains, among other steps.

All those concepts go to the very core of health-system strengthening, a fresh point of focus in the US, where the Obama Administration is reshaping US global health priorities. On that front, there was this very interesting blog post on the Center for Strategic and International Studies’ website today about broader benefits of the US global AIDS program in Kenya to that country’s health system.

Through PEPFAR, the US has provided lifesaving antiretroviral therapy to nearly 200,000 HIV-positive patients in Kenya. But, writes Peter Lamptey, “US funding supports much more than antiretroviral therapy. It also contributes wrap-around services, purchases commodities, strengthens technical cooperation, and rehabilitates health infrastructure.”

He cites a Kenya program run by Family Health International that “provides integrated services for HIV/AIDS, sexually transmitted infections, maternal and child health, family planning, TB, and malaria. The program also coordinates provision of food supplements to disadvantaged people in HIV-affected communities. An additional striking element of this program is its extensive and highly engaged network of community-based peer educators who are reaching out to populations most at risk of HIV infection.”

With the issue of PEPFAR’s impact on developing country health systems percolating in policy and scientific circles right now, we’re gathering information and data to help illuminate a debate that’s often been driven more by ideology than science. Please share your insights, research, or first-hand experience about this much-debated but often misconstrued topic.

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