Tag: HIV/AIDS & Infectious Diseases

 

New Data, Same Story: Disease Still Concentrated in Middle-Income Countries

This is a joint post with Yuna Sakuma.

The majority of the world’s sick live in middle-income countries (MIC) – mainly Pakistan, India, Nigeria, China and Indonesia (or PINCI), according to new data from the Institute for Health Metrics and Evaluation (IHME) at the University of Washington.  Sound familiar? Andy Sumner, Denizhan Duran, and I came to the same conclusion in a 2011 paper, but we used 2004 disease burden data, which didn’t provide an up-to-date view of reality.  So I was pleased to see that our findings still hold based on IHME’s 2010 Global Burden of Disease (GBD) estimates.  

When and How Much TasP Is Value for Money?

This is a joint post with Mead Over and Denizhan Duran.

In mid-2011, one of the biggest developments in HIV/AIDS research took place. The HPTN 052 study found that early antiretroviral therapy treatment could reduce HIV transmission by 96% in couples where one partner is HIV positive and the other is HIV negative. The study was heralded as the breakthrough of 2011 by Science, and was hailed as a game changer by many others, including UNAIDS, The Economist and The Lancet. The World Health Organization wrote a comprehensive guideline for TasP, or treatment as prevention, in June 2012, asserting that “TasP needs to be considered as a key element of combination HIV prevention and as a major part of the solution to ending the HIV epidemic.”

Addressing Entitlements: How the US Can Better Support Lifelong Global AIDS Treatment

Many currently believe that US domestic entitlements are too large, but disregard the fact that the PEPFAR program has created a new class of moral entitlements overseas – in the form of 4 million and counting people receiving US-supported life-sustaining AIDS treatment in low and middle income countries around the world.  Of course, the approximately $2.7 billion that the US spent in 2011 (53% of the $5.3B 2011 budget) on supporting the treatment of these people is only about two-tenths of a per cent of the US’s annual expenditure on Socia

World AIDS Day 2012: Getting to the Beginning of the End

Around this time last year, world leaders called for “the beginning of the end of AIDS” and an “AIDS-free generation”, and committed to reaching the ambitious disease-specific targets for HIV/AIDS: the virtual elimination of mother-to-child transmission; 15 million people on treatment and a reduction in new adult and adolescent HIV infections — all by a rapidly approaching 2015. And this year, US Secretary of State Hillary Clinton recommitted to these ambitious goals in the release of the PEPFAR Blueprint, saying “An AIDS-free generation is not just a rallying cry — it is a goal that is within our reach”. While the overarching World AIDS Day message remains clear – we have made tremendous progress thus far, and there is still a long way to go in the fight against AIDS – one question remains: is this really the beginning of the end of AIDS?

Should UNITAID Rethink Its Raison d’Être?

UNITAID: maybe you’ve heard of it, or maybe not. Launched in 2006, UNITAID has lived in the shadow of its older and bigger global-health siblings (the Global Fund, GAVI, and PEPFAR, to name a few). Perhaps due to its relative obscurity and late entry to a crowded global-health field, UNITAID has proactively worked to differentiate itself through a focus on commodities, market shaping, novel funding sources, and innovation. To wit, UNITAID’s stated mission is “to contribute to scale up access to treatment for HIV/AIDS, malaria and tuberculosis for the people in developing countries by leveraging price reductions of quality drugs and diagnostics, which currently are unaffordable for most developing countries, and to accelerate the pace at which they are made available.”

Ethiopia’s AIDS Spending Cliff

There’s an AIDS spending cliff in Ethiopia and the government is already in free fall. Next year, Ethiopia will experience a 79% reduction in US HIV financing from PEPFAR. The announcement of these cuts came with an explanation that PEPFAR was “free(ing) up resources by reducing programs in lower HIV prevalence countries” (see blog). Further, Global Fund monies have gone almost completely undisbursed in 2012. These cuts in spending might be warranted due to epidemiological trends and improved efficiency, or might cripple progress as health programs dependent on external donors are cut back. The truth is, with the current poor status of basic information on beneficiaries and costs, it’s difficult to judge whether these cuts are good or bad.

Financing Universal Access to ART: Reflections From IAC 2012

Two messages reigned supreme at last month’s International AIDS Conference (IAC) in Washington DC: 1) that there should be universal coverage of HIV/AIDS treatment and 2) that international funding for HIV/AIDS has been flat-lining recently and may even shrink. The most optimistic scenario to reach universal coverage will cost $22 billion dollars annually, which means raising an additional $6 billion per year. Clearly, the goal to provide treatment to the 34 million people currently living with AIDS, and the approximately 2.5 million newly infected each year, conflicts with the reality of shrinking aid budgets.

Cash Transfers: Good for HIV/AIDS Too

In 2009, Michelle Adato and a co-author pointed out that cash transfers could add value to the HIV response, by reaching the poorest households relatively quickly. Now, a new generation of cash transfer programs in sub-Saharan Africa is reducing new infections and HIV-related risky behavior—and documenting the gains—while also providing consumption, nutrition, education, and mental health benefits to the orphans and vulnerable children who are the primary targets of some programs.

Pages