Ideas to Action:

Independent research for global prosperity

Tag: Tuberculosis

 

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.  

TB Trade-Offs

 

This is a joint post with Kate McQueston.

The Wall Street Journal recently reported on a case of extensively drug-resistant tuberculosis (XDR-TB) found in a man who had traveled through 13 countries, and was stopped when attempting to enter the United States. This story – and others like it – make the headlines because both XDR-TB and multiple drug-resistant (MDR) TB are highly contagious and resistant to most treatment, leaving very limited (and often very toxic) options to patients who develop the disease. 

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.”

A Promising Senate Initiative on Neglected Diseases

Early this month the U.S. Senate passed an amendment to pending legislation that has the potential to strengthen and streamline regulations governing the clinical testing of drugs for neglected diseases in the developing world. The targeted diseases include malaria and TB, which annually kill an estimated 2.5 million people in the developing world, plus scores of diseases you may have never heard of (such as Chagas disease and leishmaniasis), but that nonetheless exact a large and lethal toll, especially on children and poor people in developing countries.

When Domestic Meets Global: The U.S. Response to HIV at Home and Abroad

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."

PEPFAR Reauthorization V: Science = Life

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.

Tearing Down the Barriers: Increasing Access in Emerging Pharmaceutical Markets

Yesterday, the Financial Times reported GlaxoSmithKline's exciting new strategy to expand markets and increase access to medicines in low- and middle-income countries. Through an internal policy known as "tearing down the barriers," the company has established differential pricing schemes within and between India, South Africa and other developing countries, in hopes of shifting to a new low price, high volume business model.

Global Fund Grant Programs: An Analysis of Evaluation

The Global Fund to Fight AIDS, Tuberculosis and Malaria has quickly become one of the world's largest funders of health programs. Just five years after its founding, it has approved proposals worth $6.8 billion for 448 programs in 136 countries, and disbursed over $3 billion.

PEPFAR(THER)*: Double the Money, Double the Impact?

In anticipation of the G8 summit and its focus on commitments to international development in Germany next week, President Bush called on Congress a short while ago to double the funding for PEPFAR from 15 to 30 billion dollars when the current plan expires in 2008. The plan for PEPFAR 2, as described in a White House press release is a "continuation and expansion" of the initial PEPFAR program:

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