Malaria is clearly the disease du jour -- and it waited a long time to get basked in the spotlight.
Two weeks ago in New York, at the UN Millennium Development Goals Malaria Summit (the third malaria summit in so many years), funders announced roughly $3 billion in new (and gently used) funds for malaria control, treatment, and research. View a webcast of the event.
XDR-TB, the widely untreatable, mutated manifestation of TB, is spreading; that much is known. Unknown is how much is out there, and how fast it is growing. Between 1996 and 2006, TB cases rose nearly 30%. One-fifth of new cases are resistant to at least one of the drugs available, as my colleague, Rachel Nugent, points out in the most recent issue of Foreign Policy.
This is a joint posting with Luke Easley
In August, CDC released updated estimates of HIV Infection in the U.S. showing that incidence for 2006 and over the previous decade was 40% higher than previously estimated. This was big news on the eve of the Mexico City AIDS Conference, but made more news on September 17th, when CDC officials "at a House Government Reform and Oversight Committee hearing said they would need an additional $4.8 billion dollars over the next five years to reduce the annual number of new HIV infections in the U.S." The LA Times reports that:
The new numbers, published last month in the Journal of the American Medical Assn., were found through improved testing and were not an increase in new infections, which have remained relatively constant since the late 1990s. The higher estimates, however, served as a reminder that preventing transmission of the human immunodeficiency virus is still an issue in the United States, where the prevalence of HIV is greater than in Canada, Australia, Japan or any Western European country except Switzerland.
Sound familiar? Prevention of HIV transmission was NOT the strongest component of the United States' fantastically generous PEPFAR program overseas (see my colleague David Wendt's blog) AND it doesn't seem to be doing the trick at home either. As the LA Times reports: "Young black gay men have been especially hard hit, representing 48% of new infections among gay and bisexual males ages 13 to 29. Yet only four of the CDC's 49 recommended intervention programs specifically target gay men, and only one of them is designed to address gay men of color."
The Affordable Medicines Facility-malaria (AMFm) may be the best idea you've never heard of. It's a piggybank that would accept money from donors of all stripes and then shell the money back out to eligible buyers to help pay for new malaria drugs, specifically artemisinin-combination therapies (ACTs). The goal is to make these new, expensive drugs as cheap as old drugs for the vast majority of developing country consumers, including the more than half who buy their drugs from private-sector pharmacies, shops and drug sellers.
From Aug 2-9, the Center for Global Development's HIV/AIDS Monitor team and its research partners from Mozambique and Uganda attended the international AIDS Conference in Mexico City.
The Times of South Africa recently reported the recall of two TB drugs, manufactured by Pharmascript, after the national health department found them to be substandard. Initial tests at the local WHO laboratory found they did not contain the needed amount of active ingredients, as claimed on the label, and concluded that they "would most likely not have effectively treated 'thousands' of TB patients."
What do you get when you cross cartoonists with public health experts? You get a bunch of baccili-busters! The WHO-hosted Stop TB Partnership released a comic book on July 24 aimed at teaching children and teens about tuberculosis and how to prevent it. The Stop Tuberculosis Team is captained by the Portuguese soccer star, Luis Figo, who in the comic book leads his team to victory against a team of tuberculosis germs.
Somewhere in the cross-oceanic battle over where doctors and nurses are allowed to work, I saw a rather pathetic cartoon: a bunch of little paper dolls with stethoscopes and nurses caps being suspended along a rope traversing half the globe – they were each hanging from their own little noose. Behind this story, real people are indeed victims, and the world is treating them like two-dimensional dolls.
While AIDS activists in the 1980's were surely right that Silence = Death, it was not voices and attention alone that brought the life-sustaining advances of AZT treatment and its successors. For all the flaws in process along the way, it was breakthroughs in biomedical science that yielded the therapies that literally raise people from their deathbeds to be productive and active members of their families and communities.
Mexico City, August 4, 2008: The biannual international AIDS conference opened last night with great fanfare here in the capital of one of the countries that has the greatest success in combating AIDS. To me, the biggest surprise is the noticeable increase in attention to the need to assure prevention coverage among those at highest risk, including sex workers, men who have sex with men, and other groups at high risk.