A modest proposal and mixed messages, treatment for mothers, and counting TB

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WWRlogocolor_NewAfter filling our heads with numbers this week in the wake of the Obama administration’s release of its FY 14 budget request, we’ll keep it simple, with a picture that’s worth a thousand words, some recent pieces that remind us of what the fraction of a percent of the budget spent on global health can do, and facts about HIV/TB coinfection.

FY2014 Budget Plans and Global HIV/AIDS: The Human Impact
: The mixed message of the President’s continued commitment to the Global Fund, with continued cuts to the President’s Emergency Plan For AIDS Relief could be confusing. This amfAR infographic gives the human impact at a glance, in rise and fall of the numbers of people receiving HIV/AIDS treatment through the Global Fund, the number receiving HIV/AIDS treatment through PEPFAR, and the numbers of women receiving services to prevent transmission of HIV from parent to child, under the Senate plan, the White House plan and the House plan. The group has followed the potential impact of sequestration cuts under their evolving scenarios over the past year, and reiterates the consistent conclusion now: “Cutting US government global health programming will have a negligible impact on deficit reduction, but will be devastating to the lives of many thousands of people globally.”

About 25 percent of pregnancy-related deaths in sub-Saharan Africa attributable to HIV: Okay, so this systematic review and meta-analysis of studies that compared pregnancy and post-partum death rates of HIV-infected and uninfected women has a lot of numbers in it too. It looks at 23 studies, and found that HIV-infected women had eight times the risk of pregnancy-related death compared to HIV-uninfected women. Authors estimate that about 5 percent of pregnancy-related deaths worldwide, and 25 percent of pregnancy-related deaths in sub-Saharan Africa are attributable to HIV. “If all HIV-infected women were on ART [antiretroviral treatment],” the authors conclude, “we would expect to see a lower ration in the pregnancy-related moratlity risk comparing HIV-infected and uninfected women.”

What women — and men — want: Focus groups look at treatment for life for pregnant women with HIV: Women living with HIV in a variety of setting in Malawi, the first country to initiate “Option B+” — treatment for life for HIV-infected pregnant women — as well as women and men living with HIV in Uganda, which has promised to initiate the strategy, talked about benefits and concerns surrounding the option for the content of this report. The report, put together by GNP+ (the Global Network of People Living With HIV), ICW Global and ICW Eastern Africa (International Community of Women Living with HIV/AID), and COWLHA (Coalition of Women Living with HIV and AIDS) is intended to inform the upcoming World Health Organization ART Consolidated Guildelines. Among the benefits: feeling healthier and being able to improve the health of their children by being able to breastfeed for longer. Among the concerns: doubts about whether health systems are ready, and fear of conflict with partners who would not be eligible for treatment. The need for strong communication efforts in explaining the plan is foremost among the resulting recommendations.

The facts about HIV-TB Coinfection: In the wake of the revelation that TB spending is slated for deep and debilitating cuts in the President’s budget request, this fact sheet, put out by the Center for Global Health Policy, which produces this blog, can help clarify how profound the need, how great the opportunity is now, to confront the No. 1 killer of people living with HIV.

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