Archive for the ‘HIV/AIDS’ Category
I recently discovered the UCLA Art|Global Health Center, the mission of which is to “unleash the transformative power of the arts to advance global health“. The arts have the ability to capture issues and tell a story in a way that can make a profound impact on our (social) consciousness and is not something we talk about enough as a tool. One of the more famous examples of this is the AIDS quilt which was conceived of in 1985 by an AIDS activist in memory of Harvey Milk. That quilt has had over 14 million visitors and is the largest community arts project in the world.
The UCLA center has some ongoing projects and last year opened “Make Art | Stop AIDS” that featured traditional art as well as things like condom dresses. Make Art/Stop AIDS “is organized around a series of seven interconnected and at times overlapping concerns expressed in the form of open-ended questions, some of which include direct art historical references to the epidemic: What is AIDS?; Who lives, who dies?; Condoms: what’s the issue?; Is it safe to touch?; When is the last time you cried?; What good does a red ribbon do?; Are you angry enough to do something about AIDS?; and, finally, Art is not enough. Now it’s in your hands.”
Creative art projects have the ability to move the human mind unlike the constant barrage of issues, numbers and headlines that desensitize us over time. If you have seen or heard of any interesting arts based global health projects let us know.
Adriana Bertinin’s condom dresses
Addressing HIV/AIDS-Related Grief and Healing Through Art
History of the AIDS Memorial Quilt
Condom fashion show, China
I was just sent this information (thanks to Becky!) about a new round of funding for microbicides, which comes on the heels of promising results from a trial of the PRO2000 microbicide candidate. We covered this a couple of years ago and at the time I said – the potential of this drug is revolutionary. With microbicides there was great excitement and hope, then there was failure and now there is some maturity. Okay, maybe I am overstating the case, the take home point is that we still don’t have a product and this is not cheap, easy, or quick. Developing a drug is complicated, involves huge risk, can take decades and is highly uncertain. Let’s review the drug development time line again for those of you not familiar – the graph below gives the most simplistic picture:
The early microbicide discussions took place almost 15 years ago (International Working Group on Vaginal Microbicides, source). Over half that amount of time, from 2000-2007, $1.1 Billion has already been invested in microbicide R&D! It takes anywhere from $200M to $1 Billion to bring a single novel drug to market. Let’s hope one of these compounds works and makes it through phase III. But how much will we have spent? $2 Billion, $3 billion? If it works, it will have been worth the money, however, we must ask if we took the most efficient financial route to get to the end point and if there were better financial models – that is a valid question.
The above two headlines on global health funding flows and allocation caught my attention. The original study was published in PLoS Medicine. The article has some great figures (some of which I have reproduced below). A few things immediately stick out – the amount concentrated on HIV/AIDS, TB and malaria is astounding. Second the US is providing 70% of the funding and on the surface one could argue that other countries really could be pitching in more. On that note, the Gates Foundation by itself is out funding the European Commission almost 4 to 1 – if that isn’t embarrassing I don’t know what is. Finally, the US Department of Defense is high on the list (surpassing USAID). Interesting stuff:
“HIV/AIDS, tuberculosis and malaria initiatives accounted for about 80% of the $2.5 billion that was spent on research and drug development for developing countries in 2007… However, pneumonia and diarrheal illness, which are two major causes of mortality in developing countries, received less than 6% of funding.”
“A report released by the United Nations last month suggests that inequality in New York, Washington, Atlanta and New Orleans rivals that of some cities in Africa…The life expectancy of African Americans in the United States is about the same as that of people living in China and some states of India, despite the fact that the United States is far richer than the other two countries.”
Source: UW Geography Blog
“More Black Americans are infected with HIV than the total populations of people living with HIV in seven of the 15 countries served by PEPFAR…Despite extraordinary improvements in HIV treatment, AIDS remains the leading cause of death among Black women between 25-34 years and the second leading cause of death in Black men between 35-44 years…U.S. policy treats AIDS as a foreign policy priority, but virtually ignores the epidemic among Black citizens here at home,””
Source: Louisiana Weekly
The Global Health Council has released the theme for their 2009 conference to be held in Washington, DC: “New Technologies + Proven Strategies = Healthy Communities”. I’ve been helping them with development of their CFP over the summer months – the focus is largely on ICT, but there is consideration given to other technologies also. This is an applied conference with significant international representation. In terms of a broad global health meeting, this is the best I’ve attended.
With slight modifications I lifted the below from the CIMIT Blog (note Video on their blog), certainly a needed innovation for global health:
Via CIMIT: Microfluidic CD4 Cell Counting for Resource-Limited Settings
“The HIV pandemic has created an unprecedented global health emergency. In response, the price of effective, life-saving HIV drug treatment has been reduced by 99%. More than $10 billion is now invested each year to treat people suffering from HIV and AIDS…BUT Treatment is only half the battle. “
“Of the 33 million people living with HIV worldwide, fewer than 10% have access to CD4 counts, the critical blood test used by clinicians to decide when to start treatment. Fewer than 1% have access to viral load assays, which are used for infant diagnosis and for patient monitoring. Both tests are considered essential to effective treatment. The Use Case for appropriate CD4 and viral load tests appropriate for resource-limited settings is clear”:
- Tests need to be performed by a minimally skilled health worker,
- A the true point of care,
- Reliably and inexpensively, and
- Wth reasonable accuracy and precision. The HIV pandemic thus represents an unprecedented opportunity to drive technology development in point-of-care diagnostics.
“Based on this Use Case, William Rodriguez’s lab has developed a series of technologies for an integrated CD4 cell count device, with microfluidics as the key platform…Integrating these microfluidic technologies has led to a prototype handheld device that can accurately capture CD4 cells from a 10 microliter fingerstick sample of whole blood, and accurately measure CD4 counts in under 8 minutes.”
This week’s KaiserNetwork report just hit the two hottest topics for me on HIV right now: male circumcision (Rwanda now has a formal program) and the flattening of vertical HIV funds into primary care, 30 years after the Alma Atta conference had called for a universal primary care package.
“In the two decades since AIDS began sweeping the globe, it has often been labeled as the biggest threat to international health. But with revised numbers downsizing the pandemic — along with an admission that AIDS peaked in the late 1990s — some AIDS experts are now wondering if it might be wise to shift some of the billions of dollars of AIDS money to basic health problems like clean water, family planning or diarrhea.”
“If we look at the data objectively, we are spending too much on AIDS,” said Dr. Malcolm Potts, an AIDS expert at the University of California, Berkeley, who once worked with prostitutes on the front lines of the epidemic in Ghana.
Read the full story at the KFF.
P.S. The CGD blog (Is donor spending on AIDS a “Gross Misallocation of Resources”?) highlights findings from a recent paper on global health funding for HIV, population, infectious disease control, and broad health sector support. Two key points:
- donor support for AIDS has grown from around 5% of total health commitments in 1992-3 to about 30% in 2003-5, a six-fold increase of AIDS’ share, but
- funding for general health sector support is the fastest rising category in absolute terms in the years 2003-5