Revival of Uganda’s anti-gay bill, righting the Global Fund, and more…

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The following is a compilation of recent articles and releases making headlines in HIV, TB and global health news.

Resentment toward the West Bolsters Uganda’s New Anti-Gay Bill: The New York Times delved into the story of the highly controversial “anti-gay bill” once again being considered by Ugandan lawmakers. Originally proposed to the Ugandan Parliament in September 2009, the bill would impose the death sentence or life imprisonment for same-gender consensual sex. Those found guilty of not reporting homosexual acts to authorities also could face prison time.  New pressure on U.S. and British foreign aid recipients to extend human rights to their gay citizens is not sitting well with some countries, according to the article. “… This time around … it is a bitter and broad-based contempt for Western diplomacy that is also fueling [the bill’s] resurrection. ‘If there was any condition to force the Western world to stop giving us money,’ said David Bahati, the bill’s author, ‘I would like that.’” 

Righting the Global Fund: This new report from the Center for Strategic & International Studies (CSIS) outlines the troubled recent history of the Global Fund to Fight AIDS, Tuberculosis and Malaria, and highlights five areas where the Fund should concentrate its repair efforts this year:

  • Improved Grant Oversight (to quell fears of corruption and fraud at the country level)
  • Management (to alleviate concerns over tension among staff, appropriate allocation of staff and resources, skill and competency of senior staff, etc.)
  • Reevaluate Board Governance (“… to strengthen the quality and authority of the board’s participation and to preserve its delicate cohesion,” according to the report)
  • Address Program Inefficiencies (e.g. take advantage of purchasing commodities and services at more competitive rates, ensuring a focus on investing for impact, etc.)
  • Financial Forecasting and Donor Reliability (develop a strategy to engage new donors, address the likelihood of limited resources going forward in the face of expanding needs, and effectively managing with less).

The report also comments on the crucial role the U.S. government plays in the Fund’s survival, and suggests ways the U.S. can help improve the tough path ahead for the Fund.

Starke: Combat TB before it strengthens: Tuberculosis expert Dr. Jeffrey Starke penned this op-ed in the Austin Statesman discussing the threat posed by multidrug-resistant tuberculosis (MDR-TB), noting a recent case at a high school in Fort Wayne, Indiana – one of 100 cases in the U.S. every year that cost up to $250,000 each to treat. “If we fail to control the disease, particularly in developing countries, deadlier forms of tuberculosis will continue to emerge and find their way to us,” according to the article. Starke goes on to describe how drug resistance develops, the “ghastly experience” of treating MDR-TB,  the need for new drugs, and the critical work the TB Alliance is doing in that arena.

Least among Equals: This commentary in the journal Clinical Infectious Diseases (CID) by lead author Dan Kuritzkes, MD, discusses the financial pressure in a bleak global economy to treat HIV-infected patients with less-expensive antiretroviral regimens, despite the fact that data might be lacking to support their efficacy. Kuritzkes describes an accompanying article in CID that raises concerns about the efficacy of an intial combination antiretroviral regimen of tenofovir, lamivudine, and nevirapine and its possible inferiority to other regimens. “The concerns raised by Tang et al [3]emphasize the need for adequately powered, prospective, randomized trials to establish the efficacy of tenofovir-lamivudine-nevirapine before that regimen can be recommended with confidence as an alternative to other established, albeit more costly, regimens,” according to the article.

PrEP Could Be “Game Changer” in Fight against HIV: The Fenway Institute released a report recently making the case for implementing taking antiretroviral medications to prevent HIV transmission – or pre-exposure chemoprophylaxis (PrEP) – which could prove to be an invaluable tool in preventing the spread of HIV. The report reviews implementation issues surrounding PrEP, summarizes the state of PrEP and microbicides research, “looks at willingness to use PrEP among various populations, addresses concerns about PrEP that could present obstacles to implementation, offers strategies for effective implementation, and examines policy issues related to cost and how to make PrEP accessible to those most vulnerable to HIV.” Guidance on the use of PrEP by the World Health Organization is expected to be released this year.

Global Fund needs cash to stem deaths: This op-ed by former Global Fund Executive Director Richard Feachem, which appeared in the South Florida Sun Sentinel February 27, pushes the U.S. to lead efforts to convene an emergency donor meeting needed to sustain the Fund and the lifesaving programs it supports. As an example of the Fund’s broad reach, “…Nearly half of all people currently on AIDS treatment in low- and middle-income countries depend in some way on the Global Fund to stay alive,” according to the piece.

The Global Health President: This article in Foreign Policy by Jack Chow – U.S. Global AIDS Ambassador from 2001 to 2003 – chronicles Republican presidential candidate Rick Santorum’s historically consistent support for the U.S.’s role in global health diplomacy.  “If Santorum [were] ebullient about spending $50 billion on global AIDS in 2008, as president he might be emboldened to seek even higher amounts of money for health and anti-poverty initiatives, beyond what Bush and Obama have done, to implement his principles on a worldwide scale…” the piece reads.

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