The cost of cutting PEPFAR, What VOICE did tell us, and answers to other pressing questions . . .

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WWRlogocolor_NewIf we want an AIDS-free generation, why are we cutting PEPFAR? The Obama administration’s budget request for fiscal year 2014, which includes a fourth consecutive cut to funding for the President’s Emergency Plan For AIDS Relief that would bring the program to its lowest funding level since 2007, raises questions, this piece by amfAR public policy director Chris Collins says. Among them: Why the mismatch between results, rhetoric and policy? Collins points out that the cut comes on the heels of the administration’s proud announcement of its PEPFAR Blueprint for “creating an AIDS-free generation” and wonders what happened to the plan to “rapidly scale-up” treatment access and other responses that have been proven effective. The likely reason for the cut, Collins says, is a decision to emphasize long-term commitments to multilateral efforts over continued direct aid. But while the Global Fund to Fight AIDS Tuberculosis and Malaria is seeing continued support, the cut to PEPFAR still will have consequences including disruption of services, failure to fortify health systems in partner countries, and threats to the progress that has been made, including in providing services for those in the most vulnerable circumstances.

pxwirecenterfoldAVAC’s take on VOICE: Here’s what the recently concluded trial on Vaginal and Oral Interventions to Control the Epidemic — the VOICE trial — told researchers that they already knew: that ARV-based HIV prevention measures don’t work if they are not used. But the results of the trial offer more than that, this edition of Px Wire from AVAC says. The results of the trial, in which a majority of participants were discovered not to have consistently used the products that were being studied, illustrated a need to better understand both the motives and the barriers to using products to prevent acquiring HIV, and to address those issues, both in trials and real life. The trial outcome also demonstrates that more options, that people want and can  use, are needed. The April – June Px Wire also includes a centerfold showing all of the ARV-based prevention products currently in the pipeline.

Advances in Tuberculosis Diagnostics: This Lancet article looks at what the GeneXpert tuberculosis diagnostic tool can do, why it is valuable enough that struggling country programs are investing in it, and why cheaper alternatives that can be used in clinics and other places patients receive care are needed.

HIV testing in people with presumptive tuberculosis: This article offers straightforward and proven steps to prevent deaths from tuberculosis, which in drug-sensitive forms is curable, in people who have HIV, which is treatable.

Technology revolutionizes TB management: A computer and mobile-phone-based program called TIBU allows facilities to request TB drugs when they are needed, monitor patients, and by providing “phone-based” care, can reduce patients’ need to visit clinics by as much as 10 percent, according to this story. TIBU is Swahili for “treat.”


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