Healthy Dose: World will Miss AIDS MDG Targets, Says ONE

A report released yesterday afternoon by the ONE Campaign says that the momentum against AIDS has been lost as progress is off track to meet the MDG. From Reuters:

The conclusion contrasts with a UN report last week, which found that an end to AIDS was in sight due to better access to drugs.

But ONE says “the beginning of the end of the AIDS” remains out of reach, as the number of people newly infected each year still exceeds those who get treated for the first time.

Global leaders last year committed to the “beginning of the end of AIDS” by 2015.

Progress over the past decade has cut the death toll for the disease, mainly due to better access to drugs that can both treat and prevent the human immunodeficiency virus (HIV) which causes AIDS, the United Nations said in its annual report last week.

But while access to treatment has improved, in 2011 there were 2.5 million new cases of HIV. That is more than double the target of having only 1.1 million people newly infected each year, said ONE, a charity co-founded by Irish rock star Bono, that is dedicated to fighting poverty and preventable disease.

There were 34 million people living with AIDS at the end of last year.

At current rates, the world will not reach targets to reverse the spread of AIDS until 2022, seven years behind schedule, according to ONE.

“We recognize the world has done wonders in (fighting AIDS) in the last 10 years. But 2015 is around the corner,” said Michael Elliott, ONE’s chief executive.

“Here’s a moment to put your pedal to the metal and go for it.”

Much of the gap is due to funding cuts in major donor countries. The UN estimates there is about a $6 billion AIDS funding gap each year. Countries also have not coordinated a global strategy to tackle the AIDS epidemic, such as targeting treatment to groups at highest risk.

The ONE report examined funding for AIDS from the Group of Seven major developed countries, as well as the political leadership and strategy.

The United States has taken the lead in funding and tackling AIDS. President Barack Obama last year set a new target for AIDS treatments, and called on other nations to also boost their commitments.

The United Kingdom and France are not far behind, but Germany and Canada are lagging relative to their peers. And Japan and Italy are in the last two places, mainly due to Japan’s earthquake in 2011 and Italy’s economic woes.

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Global Health and Development Beat

Cholera – Authorities in the Dominican Republic remain on alert for cases of cholera and dengue.

Dengue – India’s Maharasthra state says the number of deaths caused by dengue so far this year is the highest since 2006.

Reproductive Health
– Sierra Leone’s government appears to be softening its stance on the nation’s long standing abortion law.

Mental Health
– Erin Cunningham reports in the GlobalPost on the PTSD experienced by many of the one million children living in Gaza.

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The Players

AVACSays that 2013 will be a critical year for the effort to end AIDS.

WFP – WFP’s latest update on the situation in eastern DRC and its response to the people displaced by fighting.

UN – A resolution calling for a global ban on female genital mutilation was adopted by the U.N. General Assembly’s human rights committee. It appears set to pass in December.

USAID – Administrator Raj Shah said that there is a need to address the humanitarian crisis in Syria duriing a visit to a refugee camp in Turkey.

South KoreaReaffirmed its commitment to the alleviation of poverty and achieving the Millennium Development Goals in Nigeria.

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Buzzing in the Blogs

A look into why cervical cancer is an important issue, one that is largely neglected and why it is important for gender equality in Africa. From the World Bank Africa Can blog:

Given this large burden on African women, why is not much being done to address it?
There are multiple reasons. Among 20 countries reporting cervical cancer screening activities in 2009 in Africa as a whole, only 11 had ongoing country programs, and of 49 projects initiated, only six were funded by the domestic government (SALC 2012).

This service delivery failure results in most cases from limited health system capacity to conduct widespread cytology-screening through microscopic examination of cellular specimen, accurate diagnosis of pre-cancerous lesions, and appropriate referral and treatment. This care pathway, which is common in developed countries, is work-intensive and expensive as it usually requires multiple visits, screening at regular intervals, modern laboratory infrastructure, and specialized personnel.

Taking into account the health system limitations in Africa, we would like to argue that reducing excess female mortality due to cervical cancer in this continent, particularly among HIV-infected women, is feasible through lower cost but equally effective “see and treat” cervical cancer screening procedures into existing service delivery platforms -such as maternal and child health programs or HIV/AIDS prevention and control programs. Botswana and Zambia are already starting to use this cost-effective alternative to confront cervical cancer.

A demonstration program in Botswana illustrates the point. As documented in a recent study by Doreen Ramogola-Masire and colleagues (J Acquir Immune Def Syndr, Vol. 59:3, March 2012), faced with resource limitations that hindered the expansion of cytology-based screening, the “see and treat” approach was introduced using a visual inspection acetic acid (VIA) procedure and enhance digital imaging (EDI) for cervical cancer prevention among HIV-positive women at a community-based clinic in Gaborone. Between 2009-2011, slightly over 11% of women screened were found to have low-grade lesions; 61% had a normal examination result; and 27.3% were referred for further evaluation and treatment.

In Zambia, the implementation of the ‘see-and-treat’ approach linked to HIV care has also shown that it enhances the impact of the HIV/AIDS program by preventing cervical cancer in women living longer on antiretroviral therapy (ART) and who had never been screened (Mulindi H. Mwanahamuntu et al, AIDS. 2009 March 27; 23(6): N1–N5). These results indicate that the low-cost “see and treat” cervical cancer prevention alternative is a feasible and efficient one, especially for reaching women living in distant and/or underserved regions of the countries with limited access to cytology-based screening services.

The results also show that this alternative has a significant impact on the early identification and treatment of precancerous and invasive cancerous lesions in HIV-infected women.

On the basis of the demonstrated feasibility and efficiency of the ‘see-and-treat’ cervical cancer prevention services linked to HIV, the Botswana Ministry of Health has decided to scale up the intervention by including 5 additional regions across the country. Scale-up of the see-and-treat intervention is also underway in Zambia.

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Capital Events

Wednesday

9:30 AM – Winning in the Global Market – Six Leaders Discuss Bridging Cultural Gaps

6:30 PM – Gender & Genocide: Masculinity, Femininity, & the Potentials of GBV as an Early Warning Indicator of Genocide – GMU

Friday

8:00 AM – US-ASEAN Human Rights Symposium – AU School of International Service

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By Mark Leon Goldberg and Tom Murphy

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