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src="/web/20091211110049js_/http://blogs.cgdev.org/utm/__utm.js" type="text/javascript"></script> <div id="middle"> <div class="content"> <h1><a href="https://web.archive.org/web/20091211110049/http://blogs.cgdev.org/globalhealth">Global Health Policy</a></h1> <div class="hr"></div> <div class="hr2"></div> <div id="post-1475"> <h2> December 9, 2009 </h2> <h3><a href="https://web.archive.org/web/20091211110049/http://blogs.cgdev.org/globalhealth/2009/12/staging-pepfar-2-act-i-establishing-a-policy-framework.php" rel="bookmark" title="Permanent Link to Staging PEPFAR 2, Act I: Establishing a Policy Framework">Staging PEPFAR 2, Act I: Establishing a Policy Framework</a></h3> <h4>By <a href="https://web.archive.org/web/20091211110049/http://blogs.cgdev.org/globalhealth/author/nandini-oomman/" title="Posts by Nandini Oomman">Nandini Oomman</a> </h4> <p><p><em>This is a joint post with <a href="https://web.archive.org/web/20091211110049/http://www.cgdev.org/section/about/staff#Drog">Christina Droggitis</a> and <a href="https://web.archive.org/web/20091211110049/http://www.cgdev.org/section/about/staff#DAWE">David Wendt</a>.</em></p> <p><strong>The PEPFAR Strategy</strong><br/> PEPFAR marked this year’s World AIDS Day (Dec 1st) with the launch of their <a href="https://web.archive.org/web/20091211110049/http://www.pepfar.gov/documents/organization/133035.pdf">new five-year strategy</a>. According to the <a href="https://web.archive.org/web/20091211110049/http://www.state.gov/r/pa/prs/ps/2009/dec/132837.htm">press release</a>, this document provides a high level policy framework (not a road map or implementation plan), outlining the general direction of PEPFAR in the next five-years. More specifically the strategy provides some insight into how PEPFAR will orient its approach to treatment, care and prevention and partnerships with country governments in the fight against AIDS. Of special note are the 5 key goals and specific targets (see page 6 of the strategy) that sets PEPFAR 2 apart from the previous phase of PEPFAR in the way that policy is being articulated. <a href="https://web.archive.org/web/20091211110049/http://blogs.cgdev.org/globalhealth/2009/12/staging-pepfar-2-act-i-establishing-a-policy-framework.php#more-1475" class="more-link">More…</a></p> </p> <p class="posted"><a href="https://web.archive.org/web/20091211110049/http://blogs.cgdev.org/globalhealth/2009/12/staging-pepfar-2-act-i-establishing-a-policy-framework.php#respond" title="Comment on Staging PEPFAR 2, Act I: Establishing a Policy Framework">Comment</a></p> </div> <div class="br"><br/></div> <div id="post-1464"> <h2> December 8, 2009 </h2> <h3><a href="https://web.archive.org/web/20091211110049/http://blogs.cgdev.org/globalhealth/2009/12/how-will-pepfar-reach-4-million-aids-patients-on-treatment-by-2014-expanded-access-or-earlier-recruitment-millions-of-years-of-life-hang-in-the-balance.php" rel="bookmark" title="Permanent Link to How Will PEPFAR Reach 4 Million AIDS Patients on Treatment by 2014: Expanded Access or Earlier Recruitment? Millions of Years of Life Hang in the Balance">How Will PEPFAR Reach 4 Million AIDS Patients on Treatment by 2014: Expanded Access or Earlier Recruitment? Millions of Years of Life Hang in the Balance</a></h3> <h4>By <a href="https://web.archive.org/web/20091211110049/http://blogs.cgdev.org/globalhealth/author/mead-over/" title="Posts by Mead Over">Mead Over</a> </h4> <p><p>On December 1 the White House announced a new <a href="https://web.archive.org/web/20091211110049/http://www.pepfar.gov/documents/organization/133035.pdf">five-year strategy for PEPFAR</a> which aims to increase the number of patients PEPFAR directly supports on antiretroviral therapy from the current 2.4 million to 4 million by 2014. This quite specific policy objective is the subject of this post, which further develops the analysis in my December 1 post: <a href="https://web.archive.org/web/20091211110049/http://blogs.cgdev.org/globalhealth/2009/12/should-poor-countries-follow-who%25e2%2580%2599s-new-advice-on-when-to-start-patients-on-treatment.php">Should Poor Countries Follow WHO’s New Advice on When to Start AIDS Treatment</a>?</p> <p>PEPFAR managers can meet the new goal of increasing the number of people on treatment to 4 million by 2014 in two ways that cost about the same: they can recruit earlier, that is, start HIV infected people on treatment before they are very sick as counseled by the new WHO guidelines; OR they can expand access, that is, direct the drugs to people who have been infected longer and are therefore sicker. The second choice seems to be the more humane and equitable: give the medicine to the patients who need it most. However, because the prognosis of these patients is generally less good than that of people more recently infected, recruiting patients earlier in their illness actually averts more deaths. <a href="https://web.archive.org/web/20091211110049/http://blogs.cgdev.org/globalhealth/2009/12/how-will-pepfar-reach-4-million-aids-patients-on-treatment-by-2014-expanded-access-or-earlier-recruitment-millions-of-years-of-life-hang-in-the-balance.php#more-1464" class="more-link">More…</a></p> </p> <p class="posted"><a href="https://web.archive.org/web/20091211110049/http://blogs.cgdev.org/globalhealth/2009/12/how-will-pepfar-reach-4-million-aids-patients-on-treatment-by-2014-expanded-access-or-earlier-recruitment-millions-of-years-of-life-hang-in-the-balance.php#comments" title="Comment on How Will PEPFAR Reach 4 Million AIDS Patients on Treatment by 2014: Expanded Access or Earlier Recruitment? Millions of Years of Life Hang in the Balance">1 Comment</a></p> </div> <div class="br"><br/></div> <div id="post-1451"> <h2> December 1, 2009 </h2> <h3><a href="https://web.archive.org/web/20091211110049/http://blogs.cgdev.org/globalhealth/2009/12/should-poor-countries-follow-who%e2%80%99s-new-advice-on-when-to-start-patients-on-treatment.php" rel="bookmark" title="Permanent Link to Should Poor Countries Follow WHO’s New Advice on When to Start AIDS Treatment?">Should Poor Countries Follow WHO’s New Advice on When to Start AIDS Treatment?</a></h3> <h4>By <a href="https://web.archive.org/web/20091211110049/http://blogs.cgdev.org/globalhealth/author/mead-over/" title="Posts by Mead Over">Mead Over</a> </h4> <p><p>WHO and UNAIDS have just put poor country AIDS treatment program managers on the spot. Will they choose to follow the new WHO advice to push patients to begin treatment earlier – when many are still healthy? Or will they turn their backs on the new advice and push instead for expanded access to those in need.</p> <p>In conjunction with World AIDS Day on December 1, WHO and UNAIDS have released <a href="https://web.archive.org/web/20091211110049/http://www.who.int/mediacentre/news/releases/2009/world_aids_20091130/en/index.html">new treatment guidelines for AIDS patients</a>. Until this week, WHO’s official position has been that AIDS treatment programs should strive to start patients on antiretroviral therapy when the number of CD4 cells in their blood drops from normal levels of between 800 and a 1,000 per cubic millimeter down to 200 per mm3. The fact that poor countries have not been able to achieve this goal accounts for WHO’s current estimate that there are about 5 million people currently needing treatment, twenty percent more than the 4 million receiving it. <a href="https://web.archive.org/web/20091211110049/http://blogs.cgdev.org/globalhealth/2009/12/should-poor-countries-follow-who%e2%80%99s-new-advice-on-when-to-start-patients-on-treatment.php#more-1451" class="more-link">More…</a></p> </p> <p class="posted"><a href="https://web.archive.org/web/20091211110049/http://blogs.cgdev.org/globalhealth/2009/12/should-poor-countries-follow-who%e2%80%99s-new-advice-on-when-to-start-patients-on-treatment.php#comments" title="Comment on Should Poor Countries Follow WHO’s New Advice on When to Start AIDS Treatment?">2 Comments</a></p> </div> <div class="br"><br/></div> <div id="post-1447"> <h2> December 1, 2009 </h2> <h3><a href="https://web.archive.org/web/20091211110049/http://blogs.cgdev.org/globalhealth/2009/12/comment-on-our-drug-resistance-consultation-report.php" rel="bookmark" title="Permanent Link to Comment on Our Drug Resistance Consultation Report">Comment on Our Drug Resistance Consultation Report</a></h3> <h4>By <a href="https://web.archive.org/web/20091211110049/http://blogs.cgdev.org/globalhealth/author/rachel-nugent/" title="Posts by Rachel Nugent">Rachel Nugent</a> </h4> <p><p>We’ve brought up the topic of drug resistance many times on this blog because we think it’s an important issue that doesn’t get enough attention. Resistance plagues the ability to successfully treat diseases in both rich and poor countries and the problem continues to grow every day. More advanced drugs that treat resistant forms of diseases cost vastly more than first-line drugs, and the cure rate is lower. Experts in drug development and disease treatment are very concerned about this problem, but those concerns have not been taken up by those who make the big decisions on global health. It’s past time they were. <a href="https://web.archive.org/web/20091211110049/http://blogs.cgdev.org/globalhealth/2009/12/comment-on-our-drug-resistance-consultation-report.php#more-1447" class="more-link">More…</a></p> </p> <p class="posted"><a href="https://web.archive.org/web/20091211110049/http://blogs.cgdev.org/globalhealth/2009/12/comment-on-our-drug-resistance-consultation-report.php#respond" title="Comment on Comment on Our Drug Resistance Consultation Report">Comment</a></p> </div> <div class="br"><br/></div> <div id="post-1442"> <h2> November 20, 2009 </h2> <h3><a href="https://web.archive.org/web/20091211110049/http://blogs.cgdev.org/globalhealth/2009/11/family-planning-makes-a-comeback-with-the-u-s-global-health-initiative-but-can-we-make-it-stay.php" rel="bookmark" title="Permanent Link to Family Planning Makes a Comeback with the U.S. Global Health Initiative, But Can We Make It Stay?">Family Planning Makes a Comeback with the U.S. Global Health Initiative, But Can We Make It Stay?</a></h3> <h4>By <a href="https://web.archive.org/web/20091211110049/http://blogs.cgdev.org/globalhealth/author/nandini-oomman/" title="Posts by Nandini Oomman">Nandini Oomman</a> </h4> <p><p><em>This is a joint post with <a href="https://web.archive.org/web/20091211110049/http://www.cgdev.org/section/initiatives/_active/hivmonitor/analysis/uganda"><span>Freddie <span>Ssengooba</span></span></a>.</em></p> <p>Family planning is making news again. A new 12 million dollar family planning drive was <a href="https://web.archive.org/web/20091211110049/http://www.google.com/hostednews/afp/article/ALeqM5iUUDgNP0hqKdi9eF3IcAklg4oVKw">launched</a> by the U.S. government highlighting how the Obama administration’s funding has kick-started a contraception drive in Africa and other developing countries AND the <a href="https://web.archive.org/web/20091211110049/http://www.fpconference2009.org/">International Family Planning 2009 Conference</a> just closed in Kampala, Uganda, apparently the first such conference in 17 years! This is a sign of changing times.</p> <p>In her opening remarks at the conference, <a href="https://web.archive.org/web/20091211110049/http://faculty.jhsph.edu/Default.cfm?faculty_id=1025"><span>Amy <span>Tsui</span></span></a> of Johns Hopkins University (one of the key conference organizers) and director of the Bill and Melinda Gates Institute for Population and Reproductive Health, lamented the decline in attention to family planning over the last decade, and called for action in a new era that will focus on this critical issue. “Welcome back to Family Planning!” she said at the <a href="https://web.archive.org/web/20091211110049/http://2009fpconference.wordpress.com/category/opening-plenary">opening plenary</a>. By the end of the 3 day conference, after multiple sessions on topics ranging from integration, commodity security, male involvement in family planning, etc. <a href="https://web.archive.org/web/20091211110049/http://2009fpconference.wordpress.com/category/nov-18-talks/feed">closing comments</a><span> from Ward <span>Cates</span> (</span><a href="https://web.archive.org/web/20091211110049/http://www.fhi.org/en/index.htm">FHI</a>) suggest that we have “reached a tipping point” for family planning as it makes a comeback in this era of AIDS. The HIV/AIDS problem is nowhere near solved but where the issue fell silent/restricted in the Bush era, there is strong recognition by the Obama administration that HIV cannot be tackled without investments in family planning and reproductive health. And the message is clearly filtering across the Atlantic to Africa and other continents. <a href="https://web.archive.org/web/20091211110049/http://blogs.cgdev.org/globalhealth/2009/11/family-planning-makes-a-comeback-with-the-u-s-global-health-initiative-but-can-we-make-it-stay.php#more-1442" class="more-link">More…</a></p> </p> <p class="posted"><a href="https://web.archive.org/web/20091211110049/http://blogs.cgdev.org/globalhealth/2009/11/family-planning-makes-a-comeback-with-the-u-s-global-health-initiative-but-can-we-make-it-stay.php#comments" title="Comment on Family Planning Makes a Comeback with the U.S. Global Health Initiative, But Can We Make It Stay?">3 Comments</a></p> </div> <div class="br"><br/></div> <div id="post-1434"> <h2> November 17, 2009 </h2> <h3><a href="https://web.archive.org/web/20091211110049/http://blogs.cgdev.org/globalhealth/2009/11/how-the-global-fund-is-dealing-with-more-demand-than-supply.php" rel="bookmark" title="Permanent Link to How the Global Fund is Dealing with More Demand than Supply">How the Global Fund is Dealing with More Demand than Supply</a></h3> <h4>By <a href="https://web.archive.org/web/20091211110049/http://blogs.cgdev.org/globalhealth/author/david-wendt/" title="Posts by David Wendt">David Wendt</a> </h4> <p><p>At the Global Fund’s 20th board meeting this month in Addis Ababa, Ethiopia, the board made funding decisions for Round 9, and for the first ‘learning wave’ of their new National Strategy Applications (NSA). The NSA is an application channel where countries request funding to support strong existing national HIV/AIDS, TB, and/or Malaria strategies. There is a lot of interesting news coming out of the recent board meeting and the funding decisions, which the HIV/AIDS monitor will try to cover in a series of blogs over the coming weeks. <a href="https://web.archive.org/web/20091211110049/http://blogs.cgdev.org/globalhealth/2009/11/how-the-global-fund-is-dealing-with-more-demand-than-supply.php#more-1434" class="more-link">More…</a></p> </p> <p class="posted"><a href="https://web.archive.org/web/20091211110049/http://blogs.cgdev.org/globalhealth/2009/11/how-the-global-fund-is-dealing-with-more-demand-than-supply.php#comments" title="Comment on How the Global Fund is Dealing with More Demand than Supply">1 Comment</a></p> </div> <div class="br"><br/></div> <div id="post-1421"> <h2> November 13, 2009 </h2> <h3><a href="https://web.archive.org/web/20091211110049/http://blogs.cgdev.org/globalhealth/2009/11/health-systems-101.php" rel="bookmark" title="Permanent Link to Health Systems 101">Health Systems 101</a></h3> <h4>By <a href="https://web.archive.org/web/20091211110049/http://blogs.cgdev.org/globalhealth/author/rachel-nugent/" title="Posts by Rachel Nugent">Rachel Nugent</a> </h4> <p><p>As we’ve commented upon <a href="https://web.archive.org/web/20091211110049/http://blogs.cgdev.org/globalhealth/2009/07/wedding-bells-for-gavi-the-world-bank-and-the-global-fund.php">many times</a> in this blog, the exploding interest in health systems strengthening (HSS) has spread to many global institutions. The <a href="https://web.archive.org/web/20091211110049/http://www.internationalhealthpartnership.net/en/home">IHP+</a> and the <a href="https://web.archive.org/web/20091211110049/http://www.who.int/workforcealliance/media/news/2009/HLTF_Meeting2/en/index.html">High-Level Task Force on Innovative Financing for Health</a> both aim to strengthen health systems through MDGs 4 and 5. The World Bank, the <a href="https://web.archive.org/web/20091211110049/http://www.theglobalfund.org/en/">Global Fund</a> and <a href="https://web.archive.org/web/20091211110049/http://www.gavialliance.org/">GAVI</a> are creating a joint health systems strengthening platform, and <a href="https://web.archive.org/web/20091211110049/http://www.who.int/topics/health_systems/en/">WHO</a> is ramping up its activities on HSS, particularly on health worker issues. Targeted interventions are being delivered through health systems programming, such as USAIDs <a href="https://web.archive.org/web/20091211110049/http://www.healthsystems2020.org/">Health Systems 20/20</a>. <a href="https://web.archive.org/web/20091211110049/http://blogs.cgdev.org/globalhealth/2009/11/health-systems-101.php#more-1421" class="more-link">More…</a></p> </p> <p class="posted"><a href="https://web.archive.org/web/20091211110049/http://blogs.cgdev.org/globalhealth/2009/11/health-systems-101.php#comments" title="Comment on Health Systems 101">1 Comment</a></p> </div> <div class="br"><br/></div> <div> <div class="alignleft"><a href="https://web.archive.org/web/20091211110049/http://blogs.cgdev.org/globalhealth/page/2">« Previous Entries</a></div> <div class="alignright"></div> </div> <br/> </div> </div>  <div id="right"> <ul> <li id="text-377439231" class="widget widget_text"> <div class="textwidget"><p><a href="https://web.archive.org/web/20091211110049/http://blogs.cgdev.org/globalhealth/"><strong>Global Health Policy</strong></a> is a group blog discussing the issues facing the donor community on everything from HIV/AIDS financing to pharmaceutical R&D to broader health systems concerns. 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