The Daily Impact: HIV Patient Life Expediencies Approaching Normal

December 20, 2013

New research shows that the life expectancy of people in the US and Canada living with HIV and AIDS is approaching that of those without them. From the Calgary Herald:

The study says that a 20-year old diagnosed with HIV today can expect to live into their early 70s.

A couple of decades ago, a diagnosis of HIV was a death sentence for most who received it.

But with the discovery and improvement of antiretroviral drugs, HIV has become a chronic disease for most who have access to and can afford the medication.

A leading HIV researcher, Dr. Julio Montaner, says the findings of the study are excellent news.

Montaner is director of the B.C. Centre for Excellence in HIV/AIDS, which led the research collaboration that produced the study, which is published in the journal PLoS One.

He says the longevity gains have been remarkable. In 2000, a 20-year-old newly diagnosed with HIV could expect to live another 36 years. By 2006, that figure had climbed to 51 years.

“I don’t think, in all honesty, that there has been an area of medicine that has undergone a revolutionary evolution over our lifetime as HIV has,” Montaner says.

Dr. Ann Stewart, medical director of Toronto’s Casey House, agrees.

Casey House started 25 years ago as a hospice for dying AIDS patients. As treatment has prolonged the lives of the community it serves, the facility has transitioned into a hospital that offers care for people living with HIV.

Stewart says the findings of the study mirror what Casey House staff see in their patient population. But she warned that the picture is not an “unclouded” one — HIV-positive people often develop the health problems of age faster than those who are not infected.

So heart problems, cancers and the onset of dementia that might be expected in the late 60s, 70s or even 80s in HIV-negative people can show up in the 50s for HIV-positive people, she says.

“It’s much better than it was, for sure. For sure. But it’s not without challenges,” Stewart says.

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Birth Control is Good for the Economy. Here’s How.

“For every $1 we invest in family planning, we save $4 in other areas like education, public health, and water and sanitation,” says the  Population Action International. A new inforgraphic from PAI shows just how much birth control can support the global economy (beyond its obvious benefits for women, girls, children and family).


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The Daily Impact: Philippines Launches $8 Billion Rebuilding Plan

December 19, 2013

Yesterday, the Philippines launched an $8.17 billion plan to rebuild the lives of millions made homeless by Super Typhoon Haiyan. From AFP:

philippines11_432_1A day after the nation ended its 40-day mourning period for thousands of typhoon dead, President Benigno Aquino appealed for more foreign aid and private-sector pledges to revive hundreds of devastated communities.

“The task immediately before us lies in ensuring that the communities that rise again do so stronger, better and more resilient than before,” he told foreign diplomats and aid officials in a speech at the launch of the initiative.

“We know that it is more efficient to prioritise resilience now, rather than to keep rebuilding,” he said, in a nod to the country’s location as the frontline state for Pacific storms and typhoons.

Haiyan left nearly 8,000 people dead or missing after winds of up 315 kilometres (195 miles) per hour struck an area described by the United Nations as about the size of Portugal in the central islands on November 8.

Giant tsunami-like waves created by storm surges as well as the ferocious winds wrecked 1.2 million houses, displacing 4.4 million people in some of the country’s poorest regions, according to a recovery plan released by the economic planning department.

With nearly six million jobs lost, Haiyan may also trim economic growth by 0.3 percentage points this year and next, according to the document.

Aquino said the typhoon, one of the strongest ever to hit land and already the second-deadliest natural disaster in the history of the Philippines, caused $12.9 billion in damage and destruction.

In terms of fatalities it is now second only to a tsunami which hit the major southern island of Mindanao and left between 5,000 and 8,000 people dead following a major undersea quake in 1976.

US Secretary of State John Kerry visited the typhoon-devastated central city of Tacloban on Wednesday, expressing shock at what he called “stunning” devastation.

The economic planning department said the rehabilitation plan calls for spending 360.9 billion pesos ($8.17 billion) over a four-year-period until 2017.

The government is allocating a total of 125.1 billion pesos for the effort, with the spending spread over this year and next, an expense that it said was “expected to impact on the fiscal deficit in the next two or three years”.

Foreign and local donors as well as the private sector are being asked to help, the plan said, but no breakdown was given.

“Every dollar of funding assistance will be used in as efficient and as lasting a manner as possible,” Aquino pledged Wednesday.

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Charity Guru Lists PSI as One of His Most Effective Organizations

Peter Singer is a moral philosopher on a mission: he wants people to give more, and give better to charity.

Singer published a book The Life You Can Save which details the ways that individuals can maximize the amount of good they can achieve through giving. He is a hard-nosed ethicist who forcefully argues that individuals need to think critically about the organizations and entities to which they donate. To make the biggest impact Singer says people should think globally and contribute to organizations that promote global health and economic development.

The Life You Can Save is also a website and organization that helps people make smart decisions about charitable giving. We are thrilled that Peter Singer has recommended PSI as one of his top ten most effective charities. 

You can listen to a recent interview with Singer in which he goes into detail about his philosophy of giving, and why he recommends organizations like PSI to people who want to make the greatest social impact with their donated dollar.

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Strengthening the quality of HIV prevention interventions by building the capacity of local NGOs in Nicaragua

In August of 2012, the programs receiving funds from the United States Agency for International Development (USAID) for HIV programs in Nicaragua, met with regional and local USAID representatives to formulate and define a National Prevention Strategy. The purpose of this strategy was to join efforts among implementing partners, avoid duplication, and ensure a better coverage of HIV prevention interventions in the country.

As a result of this strategy, the Pan American Social Marketing Organization (PASMO), implementing partner for the USAID Combination Prevention Program for HIV in Central America, was assigned the task of providing technical assistance and methodological coaching to all of the implementing partners and NGOs, in addition to those NGOs receiving funds from the Global Fund to Fight HIV/AIDS, Tuberculosis and Malaria.

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The Daily Impact: GlaxoSmithKline Announces End to Paying Doctors to Promote Drugs

December 18, 2013

In a groundbreaking announcement, the world’s third largest pharmaceutical firm, GlaxoSmithKline, announced it will no longer pay doctors to promote drugs. From the Guardian:

downloadGSK has committed to ending payments to doctors for recommending its drugs to other doctors at medical conferences. It will also stop linking the bonuses of sales staff to the number of drugs they sell.

Sir Andrew Witty, GSK’s chief executive, said pharmaceutical firms must end the decades-long standard practice of paying independent doctors to promote drugs, and make sure “patients’ interests always come first”.

“We recognise that we have an important role to play in providing doctors with information about our medicines, but this must be done clearly, transparently and without any perception of conflict of interest,”he said.

GSK refused to state how much money it pays doctors to promote its drugs, but a company source said it was in the region of “tens of millions of pounds a year”.

In the UK, where drug firms are forced to declare such payments, GSK paid doctors £1.9m in speaking and advisory fees last year.

GSK said the payments, which can amount to tens of thousands of pounds for a single lecture, will end by 2016. The company will also stop paying for doctors’ flights, hotel bills and other expenses to attend conferences. Last year GSK paid out £900,000 in such expenses.

The Association of the British Pharmaceutical Industry estimates that British drug firms pay £40m a year in expenses to UK doctors.

Instead of paying independent doctors for conference presentations, GSK will hire more in-house doctors. Doctors involved in clinical research will still be paid.

GSK’s commitment to stop paying doctors comes five months after it was accused of behaving like a criminal godfather in China, bribing doctors with cash and prostitutes in return for prescribing its drugs. Last year it paid a record $3bn (£1.9bn) in fines to settle claims that it tricked and bribed US doctors into prescribing children dangerous antidepressants.

The company said the changes were not linked to either scandal.

Ben Goldacre, a doctor and Guardian columnist, who helped expose drug companies’ manipulation of clinical trial data, said he expected GSK’s move would shame the rest of the industry into ending payments to doctors. However, he said the public would be “shocked and amazed” that drug firms were ever allowed to pay doctors.

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These 13 Commodities can Save 6 Million Women and Children

Today, the global health organization PATH and other members of the UN Commission on Life-Saving Commodities Advocacy Working Group launched an exciting new advocacy toolkit. In it are thirteen commodities and ten recommendations to improve global health.

Scaling Up Lifesaving Commodities for Women, Children, and Newborns, provides information about the UN Commission on Life-Saving Commodities for Women and Children (Commodities Commission), its 13 priority commodities, and examples of how its ten recommendations to improve access and availability are being applied globally and within countries.

In spite of the strong evidence showing their impact in saving lives, too often the 13 commodities are out of the reach of those individuals who need them. These medicines and health supplies cost just dollars, with the majority costing less than US$1 per dose. However, multiple barriers prevent people from accessing these commodities. The Commodities Commission report also outlines ten bold and innovative recommendations to catalyze changes in the way the 13 commodities are produced, distributed, and used, estimating that the effective implementation of the recommendations would result in saving the lives of six million women and children over five years.

The toolkit provides advocacy resources for utilizing the Commodities Commission platform to raise awareness and engage stakeholders in addressing commodity-related gaps in global and national plans, policies, and initiatives, as well as providing strategic input to advance the implementation of recommendations.

We know you are eager to know what are these thirteen commodities. Go here to read the full report. For those of you that are less patient, check out the infographic below:



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It Takes a Market to get Men to Use Condoms in Africa. Here’s How.

What can be done to increase the use of condoms by men in African countries? PSI and the United Nations Population Fund (UNFPA) teamed up over the past year to study and report on the state of play in six African countries. The results are out in six new case studies that will be presented during a  consultative meeting on the Total Market Approach that PSI and UNFPA are hosting, today and tomorrow.

During the meeting, participants will discuss the findings from the six case studies conducted in African countries. Then, representatives from ten organizations will discuss how they can work together to support the development and implementation of the Total Market Approach in national markets for male condoms and other family planning supplies.

The UNFPA sponsored case studies were carried out in the past 12 months with support from two independent researchers in Botswana, Lesotho, Mali, South Africa, Swaziland, and Uganda. All of the countries have large condom social marketing programs, are affected by HIV, and have high maternal morbidity and mortality relative to their economic development.

Content for the case studies was based on a review of the literature, seven key TMA metrics calculated from national-level data, and interviews with stakeholders. All case studies were subject to review by stakeholders, including Ministries of Health and non-governmental organizations in all six countries, UNFPA’s local and regional offices, UNFPA headquarters in New York City, PSI country and regional offices, and PSI’s headquarters in Washington DC.

Each case study describe the market for male condoms in each of the countries, and the roles of the public, social marketing, and commercial sectors in those markets.

The cases illustrate the universe of need for condoms, levels of use, socioeconomic equity among users, and the market presence of condoms for reproductive health and HIV prevention (dual protection).

They also propose a set of recommendations for improving the effectiveness, efficiency, and sustainability of condom markets.

The studies aim to inform the development of appropriate, evidence-based decisions to increase condom use equitably and sustainably through actions undertaken in the public, socially marketed, and commercial sectors.

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The Daily Impact: UN Launches $13 billion appeal for 2014

December 17, 2013

The UN launched its new appeal for $12.9 billion for its operations in 2014. Half of it will be needed for the Syrian refugee crisis. From Reuters:

unThe Syrian appeal accounted for half of an overall funding plan of $12.9 billion to help 52 million people in 17 countries, announced on Monday by U.N. emergency relief coordinator Valerie Amos at a meeting of donor countries in Geneva.

“This is the largest amount we have ever had to request at the start of the year,” she told a news conference, referring to the worldwide appeal. She said the money requested for Syria was the largest U.N. appeal ever for a single crisis.

“The increasing number of internally displaced people and refugees is generating greater needs across all sectors and straining the capacities of neighboring countries, with profound regional consequences,” the appeal said of Syria.

The United Nations sent its first delivery of humanitarian aid by air to Syria from Iraq on Sunday and said it plans to deliver more food and winter supplies to the mainly Kurdish northeast in the next 12 days.

It is seeking $2.3 billion to help 9.3 million people in Syria next year, compared with its 2013 appeal of $1.4 billion, of which only 62 percent has been received, U.N. figures show.

For five neighboring countries – Egypt, Iraq, Jordan, Lebanon and Turkey – the world body is seeking $4.2 billion to assist up to 4.1 million Syrian refugees and host communities who will be given food aid including cash or vouchers.

U.N. agencies aim to provide food, clean drinking water, shelter, education, health services and polio vaccines to Syrians inside and outside the devastated country.

The U.N. World Food Programme aims to feed 4.25 million people in Syria, where it reached only 3.4 million in November.

“This is the worst humanitarian crisis that we have seen in decades, with every day more vulnerable Syrians pushed into hunger,” Muhannad Hadi, WFP’s Syria Emergency Coordinator, said.

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How Data Drives Decisions at USAID

Impact magazine interviews Ellen Starbird, Director of the Office of Population and Reproductive Health, USAID.

IMPACT: How does USAID assess the effectiveness of its health investments?

ELLEN STARBIRD: USAID assesses the effectiveness of its health interventions by looking at trend data in health indicators that are related to the programmatic interventions that we support. For our family planning and reproductive health programs, contraceptive prevalence, improvements in birth spacing and increasing age at marriage are all measured by surveys, including the Demographic and Health Survey. Changes in these indicators can be related to our investments. USAID uses evaluation findings to inform decisions, improve program effectiveness, be accountable to stakeholders, and support organizational learning. Research tests the effectiveness of possible interventions and is used to identify high-impact practices for our family planning and reproductive health programs. Pilot studies and introduction studies test the effectiveness of interventions in specific contexts or countries. Those interventions that best “fit” a particular context (i.e., level of program development, epidemiological context, resources available, etc.) are selected.

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