Global Pulse Blog

In response to a 2010 World Health Organization report Working to overcome the global impact of neglected tropical diseases, this week, the Bill and Melinda Gates Foundation, the World Bank, 13 pharmaceutical companies, the governments of the U.S., U.K. and U.A.E. and other global organizations committed to a new, coordinated effort to advance progress towards controlling 10 neglected tropical diseases by the end of the decade and improve the lives of the 1.4 billion affected by such diseases globally. Guiding this effort, the World Health Organization released targets and a strategy, Accelerating work to overcome the global impact of neglected tropical diseases—A roadmap for implementation.

These neglected tropical diseases include:

• lymphatic filariasis
• blinding trachoma
• sleeping sickness
• leprosy
• soil-transmitted helminthes
• schistosomiasis
• river blindness
• Chagas disease
• visceral leishmaniasis
• guinea worm

Check out the related webcast and infographic

This year marks the 10th anniversary of the Global Fund to Finght AIDS, Tuberculosis and Malaria. This short film by Adrian Steirn presents the story of the Global Fund’s work to collaborate with key international figures in the first ten years of its fight against these global pandemics.

According to the Executive Director of the Global Fund Michel Kazatchkine:

“The story about the Global Fund is a story about how the world could actually come together and turn a hopeless situation into one of promise. This amazing film tells that story through the words of some of the people who were crucial in making this dramatic turnaround. It is fantastic to be reminded of how terrible the future looked for global health ten years ago, and how far we have come.”

The Bill & Melinda Gates Foundation recently renewed its commitment to the Global Fund to Fight AIDS, Tuberculosis and Malaria, giving $750 million through a promissory note. This innovative funding method gives the Global Fund the flexibility and authority to distribute funds efficiently based on immediate needs, leading to greater impact.

The following infographic from USAID graphically illustrates the ways in which investments in females have wide-reaching and significant impacts.

In what ways do you think that investments in females can have an impact?

Kaiser Family Foundation and the U.S. Department of Health and Human Services is holding a briefing on Thursday, January 5, 2012 at 9:30am at the Barbara Jordan Conference Center in Washington, D.C. to explore HHS’ role in global health and the emerging global health strategy. The event will explore the goals of the new strategy and the ways in which it fits with other U.S. global health objectives. If you are in the Washington, D.C. area, register online to attend.

As mentioned recently on the Global Pulse Blog, Research!America held a webcast briefing November 21st on USAID.  If you missed it, you can check out the panel discussion on the agency’s impact on global health research and development and partnerships in the global arena by clicking on the image below.

The panel was moderated by Susan Dentzer, Editor-in-Chief of Health Affairs, and included representatives from USAID and several global health R&D partners from the public and private sectors (representing Product Development Partnerships – or PDPs).

• Hugh Chang, Director of Special Initiatives, PATH
• Rick King, PhD, Vice President, Vaccine Design, IAVI
• Emily Moore, Vice President for Business Development, Temptime Corp.
• Wendy Taylor, Senior Advisor for Innovative Finance and Public Private Partnerships, Bureau of Global Health, USA

With World AIDS Day coming up on December 1st, I had the opportunity to join in a call with Stefano Bertozzi Director of HIV and TB at the Bill & Melinda Gates Foundation.

World AIDS Day is a time to renew our commitment to the 34 million people living with HIV/AIDS worldwide and the recent developments revolving around HIV, including several scientific breakthroughs in HIV prevention research and Secretary Clinton’s recent remarks declaring that it is possible to reach an AIDS-free generation, make this an especially exciting time to reflect on the epidemic.

According to Dr. Bertozzi, the strategy of the Bill & Melinda Gates Foundation includes both decreasing new infections and improving quality of life of those currently infected. A large focus of this strategy is on the delivery of current strategies in large part through the Global Fund as well as smaller national programs.

Despite the proven effectiveness of existing prevention approaches, there are limitations. For example, many women are not in a position to insist that their partners wear condoms and daily adherence to prophylactic treatments is difficult. The development of a vaccine and other new prevention options is critical for successfully fighting the epidemic, especially in developing countries. The largest investment in newer technologies is currently in trying to develop a HIV vaccine. As such, a focus is on the success of the RV144 HIV vaccine trial, which recently showed encouraging results in Thailand and advancing that to the next generation of the vaccine with hopes of increased efficacy.

They are also investing heavily on products that can be used by individuals to protect themselves either topically in the vagina or systemically. While daily use of vaginal microbicides has shown mixed results, many reasons may contribute to this, especially lack of adherence which is a common problem with daily use products. To address these challenges, they are working on products which are less dependent on adherence such as a vaginal ring which slowly releases the antiretroviral compound dapivirine and can be left in for up to a month.

Another strategy is systemic daily antiretroviral prophylaxis which has also had mixed results and faces problems with adherence, but looks promising. They are focusing on injectables which can be injected every 1 to 3 months, decreasing the need for adherance. The Gates Foundation is currently supporting clinical trials to evaluate the effectiveness of Pre-exposure prophylaxis (PrEP) such as this for HIV prevention.

Images from the Bill & Melinda Gates Foundation

Additional efforts are on enhancing the delivery of male circumcision and scaling up these programs with fewer resources. Despite three clinical trials demonstrating the protective benefit of the procedure, donors and countries have been slow to invest in voluntary male circumcision for HIV prevention. The foundation is investing in advocacy efforts to encourage more rapid scale-up of male circumcision for HIV prevention and funding research on new technologies and methods for performing male circumcision safely and less expensively. This strategy is so cost effective that it costs more money to NOT implement such programs due to the future treatment savings.

The Gates Foundation is also working towards improving the delivery and effectiveness of current programs. With decreasing funding in a faltering global economy, scale up of treatment has continued at the same pace by improving efficiency of programs. Fortunately this has been happening in HIV treatment. Continuing efforts to reduce the cost of drugs, design and implement more efficient delivery systems and further task shifting and sharing among health providers is needed without compromising care and can even lead to improved quality of care.

On Monday, Nov. 21^st 9:30am EST, Research!America will be webcasting a briefing on USAID and the agency’s impact on global health research and development.  The panel will be moderated by Susan Dentzer, Editor-in-Chief of Health Affairs, and will include representatives from USAID and several global health R&D partners from the public and private sectors (representing Product Development Partnerships – or PDPs).  Panelists include:

• Hugh Chang, Director of Special Initiatives, PATH
• Rick King, PhD, Vice President, Vaccine Design, IAVI
• Emily Moore, Vice President for Business Development, Temptime Corp.
• Wendy Taylor, Senior Advisor for Innovative Finance and Public Private Partnerships, Bureau of Global Health, USAI

The U.S. Agency for International Development (USAID) is marking its 50th anniversary as the main U.S. humanitarian relief and international development agency. This conversation regarding USAID and its global partenrs will shed insight into instrumental partnerships in global health work.

This important event will be webcast live at http://bit.ly/vWwx9o where you can also submit questions. You can also join the conversation on Twitter under the hashtag #GHPDP.

With Secretary Clinton’s recent speech calling for an AIDS-free generation, one important question revolves around funding for this bold and enthusiastic plan. Pertinently, Funders Concerned About AIDS (FCAA), with support from Joint United Nations Programme on HIV/AIDS (UNAIDS), has released a report which shows that both the number of private U.S. funders and amount of funding has decreased this past year. The U.S. Philanthropic Support to Address HIV/AIDS in 2010 report shows which philanthropic organizations have been, and continue to be, leaders in the HIV/AIDS field.

Today’s guest blog post by Anand Reddi was originally published yesterday in The Huffington Post. Anand Reddi was a Fulbright Scholar in 2005, assisting the Sinikithemba HIV/AIDS clinic at McCord Hospital in Durban, South Africa. Currently, Mr. Reddi is a medical student at the University of Colorado, School of Medicine. Here, he reflects on Secretary Clinton’s speech earlier this week and the importance and potential of a Global Health Service Corp.

Stay tuned to Global Pulse Blog for more views on this monumental speech and its implications.

Yesterday, Secretary of State Hillary Rodham Clinton declared the U.S. government’s intent to create an “AIDS-free generation.” Secretary Clinton outlined a bold plan to reduce new HIV-infections, globally, including the eradication of pediatric HIV by 2015. This new strategy builds upon the success of the President’s Emergency Plan for AIDS Relief (PEPFAR), the U.S. program that addresses HIV/AIDS in resource-limited settings.

A notable feature of Secretary Clinton’s “AIDS-free generation” initiative is to strengthen healthcare systems in sub-Saharan Africa. Clinton stated:

“We know we can’t create an AIDS-free generation by dictating solutions from Washington. Our in-country partners — including governments, NGOs, and faith-based organizations — need to own and lead their nation’s response. So we are working with ministries of health and local organizations to strengthen their health systems so they can take on an even broader range of health problems.”

Strengthening African healthcare systems is a view echoed by many eminent voices in the global health community. Last year, the Institute of Medicine (IOM) of the National Academy of Sciences authored a report entitled: “Preparing for the Future of HIV/AIDS in Africa: A Shared Responsibility.” The IOM report recommended the urgent need to increase African healthcare workforce capacity to address the HIV epidemic.

I offer Secretary Clinton a solution to assist African healthcare workforces and ensure the success of the “AIDS-free generation” initiative. Last year, in an editorial in The New England Journal of Medicine, Vanessa Kerry, Sara Auld, and Paul Farmer reintroduced the idea of enacting a Global Health Service Corp (GHSC). The GHSC, compromised of U.S. healthcare professionals, would provide medical education and technical assistance to enhance the healthcare workforces in low-income countries. The GHSC’s goal would “go beyond that of filling a human resource void to focus on infrastructure development, knowledge transfer, and capacity building.” The GHSC could also offer partial student loan forgiveness for U.S. corps members who engage in service abroad for a specified time period similar to the loan forgiveness offered by the National Health Service Corp.

To address the African healthcare workforce shortage, I encourage Secretary Clinton to adopt the principles of the GHSC. The success of the “AIDS-free generation” initiative depends on the availability of skilled healthcare workers in African resource limited settings. Additionally, the eventual transition from a U.S. to African led HIV/AIDS response requires the U.S. to teach and train healthcare personnel in recipient countries through collaborative partnerships that eventually lead to African ownership of their domestic healthcare needs.

Some may argue that enacting the GHSC, especially in the era of U.S. government austerity measures, is not prudent. However, the funding for the GHSC already exists. In addition to HIV/AIDS prevention and treatment, PEPFAR’s congressional mandate requires the program to “strengthen partner government [healthcare] capacity to lead the response to this epidemic and other health demands.” Last year alone, PEPFAR committed over $734 million in healthcare capacity building initiatives.

Global health is the moral litmus test of our time. As Secretary Clinton asserted: “An AIDS-free generation would be one of the greatest gifts the United States could give to our collective future.” The U.S. should enact the GHSC to ensure the success and sustainability of the “AIDS-free generation” initiative.

-Anand Reddi, The Huffington Post

If you are interested in supporting the Global Health Service Corp please sign the petition to show your support. http://www.globalhealthservicecorps.org/index.php/petition/

Additionally, the Medical Student Section of the American Medical Association is considering a resolution endorsing the GHSC at its 2011 Interim Meeting in New Orleans, Louisiana.

People in the Democratic Republic of Congo rarely use condoms despite the country’s high prevalence of HIV. Amy Lockwood explains why and offers a solution from a marketing point-of-view. Watch here:

http://www.ted.com/talks/amy_lockwood_selling_condoms_in_the_congo.html