“Country ownership” needs tweaking, circumcision data needs sharing, TB-stricken South African miners need justice . . . What else is new? We’re reading about unmet needs

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NewWWRThe good, the bad, and the uncomfortable in country ownership – This commentary in aidspan’s Global Fund Observer comes in the wake of Nigeria President Goodluck Jonathan’s signature on the newest anti-gay law threatens the country’s HIV response, but that is only one in a series of problems, it shows, that defining “country ownership” as “government ownership” can bring. Even in the United States where free speech and assembly enjoy significantly more protection, an effective HIV response came only after “a seriously angry movement of gay men (ACT UP), with a sustained and brilliant campaign,” the author notes. But in countries receiving Global Fund grants to “own” their epidemic response, significant obstacles to civil society involvement continue, requiring closer attention to who is supposed to own the country — the government, or the people who depend on a fair and functional society for access to health care. This analysis comes at a time when responses to laws standing between citizens and health are unpredictable, with UNAIDS planning a rare challenge to Malawi’s antigay law, while Nigerian newspapers are reporting U.S. Ambassador to Nigeria James Entwistle has assured the country that although its new antigay law is “worrisome” it will not lead the U.S. to cut funding for the government’s HIV response.

AVAC’s Px Wire looks at OGAC nominee Deborah Birx, circumcision data, and cure letdown – AVAC is familiar with the work of Dr. Deborah Birx, a board member, director of the CDC’s Global AIDS Program, former head of the Military HIV Research Program, and now nominee for U.S. Global AIDS Coordinator, and leads its latest Px Wire with a ringing endorsement of the physician scientist. The newsletter also examines why a “very likely” milestone in medical circumcision — more than five million procedures — is going unnoted, and summarizes bad news — as well as a little good news — in cure research.

Fulfilling Broken Promises to South African miners – Working in South Africa’s mines has sickened hundreds of thousands of men with tuberculosis and other lung-weakening diseases, leaving them dead, damaged, broke, while compensation for occupational illnesses promised by law remained out of reach. This report looks at how, with some of the highest lung disease rates in the world, South Africa has failed to keep its promise, and how other countries have come through for workers. The release of the report has been followed with more news of needed attention to tuberculosis in South Africa’s mines with trial results published in the New England Journal of Medicine. The trial showed that while the isoniazide preventive therapy among miners with TB infection reduced incidence of disease, that effect rapidly diminished once treatment was complete. The study suggests a stepped comprehensive, multi-faceted response, against TB that includes stepped up infection control and antiretroviral treatment for those with HIV among South Africa’s miners is critical.

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