Alarming but not surprising drug-resistant TB rates, survival sex, “a kind of truce,” and more . . .

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Resistance to second-line drugs in people with multidrug-resistant tuberculosis in eight countries: This Lancet article looking at rates of  resistance to second line anti-tuberculosis drugs in Estonia, Latvia, Peru, Phillipines, Russia, South Africa, South Korea and Thailand, put numbers on a situation already known: tuberculosis is growing harder to cure. Following a June New England Journal of Medicine article on drug-resistant tuberculosis in China, the articles cite diverse factors leading to the rise in acquired and transmitted drug resistance but add up to basic conclusions, including that with treatment options perilously limited, attention to improved and accessible diagnostics is critical.

Sex for survival in Madagascar: In a port city where an estimated one in seven residents is involved in commercial sex, this article looks at efforts to keep sexually transmitted diseases, including HIV from gaining ground. With a newly opened mine driving up living costs amidst widespread poverty, the establishment of sex worker identification cards providing links to health care and legal support, discussion groups to educate police and combat abuses, and condom distribution in neighborhoods and bars where sex workers gather,  are among efforts to protect women selling sex to survive.

Church part of uneasy alliance:  When much of rural health care depends on institutions with church ties, and where HIV prevalence is estimated at more than 13 percent , the role of religion in the fight against the HIV epidemic is critical and conflicted, this article in the National Catholic Reporter says. Citing the role of CHAZ — the Churches Health Association of Zambia — in disbursing life-saving Global Fund dollars, and gay rights activists’ concerns about pastors who continue to “preach hate from the pulpit,” the writer, who accompanied a Global Fund sponsored delegation to Zambia in July, examines efforts and adaptations in faith-based efforts there.

Model for designing more effective drug cocktails: Scientists explain how they came up with a mathematical model that can predict resistance to medicines for HIV, based on the combinations of drugs used and patients’ adherence to treatment in this Harvard Gazette article that tells the story behind a recent Nature Medicine article. Math can be more efficient than trial and error, point out the researchers, who collected “huge amounts of data” that can help design more cost effective and durable combination therapies for HIV.

HPV infection doubles HIV acquisition risk: This aidsmap article summarizes a review of studies finding that the human papillomavirus doubled  a woman’s risk of getting HIV, and also increases risks for gay and heterosexual men. The article notes that the virus linked to higher rates of HIV acquisition are effectively targeted with vaccines, including Gardasil.

FDA priority review for tuberculosis drug: Bedaquiline, a new drug candidate submitted to the European Medicines Agency last week by drug maker Janssen-Cilag International for approval as treatment for drug-resistant tuberculosis has been given priority review status by the U.S. Food and Drug Administration, making it likely an FDA decision on the drug could come early next year, this article says.

A look at the nonprofit approach to drug development: It can take a worldwide network of villages to raise a drug from concept to use, says this story in Chemical and Engineering News, looking at TB Alliance’s cooperative international efforts “to refill a once-empty pipeline” of tuberculosis treatments.


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