Ideas to Action:

Independent research for global prosperity

Tag: HIV/AIDS

 

Our Condolences to All Affected by Flight MH17

CGD and its health team express our condolences to the families of all lost on MH17. We know that many of those attending the International AIDS Conference, which starts this week-end in Melbourne, have been touched personally by the AIDS researchers and activists lost on the plane and will deeply feel their loss.

What to Expect at This Year's International AIDS Conference

There’s no doubt that Treatment as Prevention (TasP) will receive continued emphasis at this year’s International Aids Conference (IAC), as advocates argue for aggressively expanding treatment from the 9 million worldwide currently on antiretrovirals (ARVs) to the 35 million people who are HIV infected.  But at the TasP workshop in Vancouver last month the more challenging and novel topic was pre-exposure prophylaxis, or PrEP.  A whole array of sessions on PrEP is already on the agenda for next week’s conference in Melbourne, and our bet is that PrEP will generate a lot of buzz – an approach with intriguing potential, but edgy downside possibilities.

AIDS Donors and Patients Need the World Bank – but Only If It Is Hard to Provoke

Earlier this year, Uganda’s President signed into law an Anti-Homosexuality Act  that strengthens penalties against gay people and defines some homosexual acts as crimes punishable by life in prison.  If enforced to its full extent, the law is expected to endanger public health by handicapping HIV prevention and treatment efforts; already, the national police have raided and forced a US-supported HIV/AIDS treatment center to shut down. 

Wanted: Better HIV Infection Data

UNAIDS recently convened a diverse group of experts to discuss how UNAIDS should go about estimating the post-2015 cost of the HIV/AIDS response.  Participants opinions varied on most topics: whether estimates should assess the cost of treating all HIV infected people as soon as they are infected (the “Universal Test and Treat” option) or that of a less ambitious treatment policy; whether spending on poverty reduction and gender empowerment should be included in the cost estimates and, if so, on how to cost these “critical enablers.” But on one question, there appeared to be virtually unanimous agreement:  donors and countries should increase the frequency, the granularity and the precision of HIV infection surveys.

PEPFAR Teams Are Designing Impact Evaluations: Retrospective, Prospective, and Randomized

Last year, PEPFAR submitted guidelines which encouraged country staff to submit a proposal to conduct an “impact evaluation” (IE) as part of their annual Country Operation Plan (COP).  Subsequently, they received four submissions, of which three were funded.  But they also learned that many PEPFAR staff – who are mostly program implementers, or the managers of program implementers – didn’t fully understand what they were being asked to do; what does PEPFAR mean by “impact evaluations”?

Sneak Preview: CDC’s Effort to Measure the Determinants of AIDS Treatment Quality

It’s one thing to measure the quality of AIDS care; it’s another to understand how to improve it.  Our last blog showed how the metaphor of the “treatment cascade” can be a useful way to conceptualize and measure the quality of AIDS care and that PEPFAR supported care has room for improvement on this measure (see more on the treatment cascade here). In order to achieve the health benefits that would result from reducing patient attrition over the course of the treatment cascade, PEPFAR and its partners need to learn why some facilities do better than others and what factors contributors to treatment success. 

A Question of Quality: Why Retention Matters for AIDS Treatment

Counting the number of patients on treatment is no longer enough.  For years even the friendliest critics of the global struggle against AIDS have pointed out that this metric unfairly neglects the people who are not put on treatment and then die, largely because their deaths are uncounted except in so far as they increase the treatment “coverage rate.”  This diverts attention from the challenge of assuring that patients are retained on treatment and remain alive and healthy, rather than failing treatment and dying, sometimes after only a few months.  

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