http://sciencespeaksblog.org A project of the Center for Global Health Policy Fri, 24 May 2013 21:55:16 +0000 en-US hourly 1 http://wordpress.org/?v=3.5.1 Science Speaks features thoughts, news and analysis from the staff of the IDSA/HIVMA Center for Global Health Policy on the latest developments tuberculosis, HIV/AIDS and other related topics. A project of the Center for Global Health Policy Meredith Mazzotta http://sciencespeaksblog.org/wp-content/uploads/2011/04/ScienceSpeaksPodcast.jpghttp://sciencespeaksblog.org HIV, TB, AIDS, co-infection no Meredith Mazzotta mmazzotta@idsociety.org http://feedproxy.google.com/~r/ScienceSpeaksPodcast/~3/_Y9tjY8ZNuE/ http://sciencespeaksblog.org/2011/01/20/usaid%e2%80%99s-shah-taking-steps-to-improve-oversight-increase-transparency/#comments Thu, 20 Jan 2011 22:28:16 +0000 Meredith Mazzotta http://sciencespeaksblog.org/?p=3894 <table cellpadding='10'><tr><td valign='top' align='left'><em> Marking a year in at his post as Administrator of the U.S. Agency for International Development (USAID), Dr. Rajiv Shah addressed a packed audience Wednesday regarding the "Modern Development Enterprise," and detailing the agency's ambitious reform agenda - USAID Forward. Oversight and transparency will be key features. </em><table width='100%'><tr><td align=left><p><b>(<a href='http://sciencespeaksblog.org/2011/01/20/usaid%e2%80%99s-shah-taking-steps-to-improve-oversight-increase-transparency/' title='USAID's Shah taking steps to improve oversight, increase transparency'>Read more...</a>)</b></p></td></tr></table></td></tr></table><img src="http://feeds.feedburner.com/~r/ScienceSpeaksPodcast/~4/_Y9tjY8ZNuE" height="1" width="1"/> http://sciencespeaksblog.org/2011/01/20/usaid%e2%80%99s-shah-taking-steps-to-improve-oversight-increase-transparency/feed/ 0 USAID Administrator Dr. Rajiv Shah delivers a major address on The Modern Development Enterprise Wednesday. Marking a year in at his post as Administrator of the U.S. Agency for International Development (USAID), Dr. Rajiv Shah addressed a packed audience Wednesday regarding the “Modern Development Enterprise,” and detailing the agency’s ambitious reform agenda – USAID Forward. Oversight and transparency will be key features. “Every major project will require a performance evaluation conducted by third parties, not by the implementing partners themselves,” Shah said while discussing new efforts in the agency to decrease fraud and increase efficiency. The administrator vowed to release the results of these evaluations within three months of conducting them for public consumption, regardless of whether the project was successful or not. “Instead of simply reporting our results, like nearly all aid agencies do, we will collect baseline data to explain what would have happened without our interventions, so we can know for sure it was those interventions that made a difference,” Shah said. While the U.S. government does rely on contractors, Shah said, “We do not work for our contract partners; our contract partners work for us… and we will vigorously respond when fraud occurs.” Shah made clear regardless of the size of the contractor he will hold all of them to strict account, noting that USAID recently suspended one of its largest implementing partners. As part of “aggressive procurement reform,” Shah also announced that while nearly 87 percent of USAID’s assistance is competitively awarded at present, he believes they can do even better, adding that going forward any grant or contract extension that exceeds $5 million, granted without competitive process, will require his personal okay. Shah also noted how development is just as critical to U.S. economic prospects and national security as are diplomacy and defense, highlighting the successes of USAID efforts in that regard like directing farmers away from growing coca and opium poppies. Moving forward, said Shah, USAID will further support countries developing their own agricultural sectors. In five out of 20 focus countries, “We believe we can help nearly 6.5 million small farmers, mostly poor and mostly women, grow enough food to feed themselves, their families, and break the grip of hunger and poverty for tens of millions of people,” Shah said. American families are taking up the development cause as well. “When more American families give money to the relief effort in Haiti than watch the Super Bowl, that is an expression of American values,” Shah said. <table cellpadding='10'><tr><td valign='top' align='left'><em> Marking a year in at his post as Administrator of the U.S. Agency for International Development (USAID), Dr. Rajiv Shah addressed a [...] Meredith Mazzotta 2:45 USAID’s Shah taking steps to improve oversight, increase transparency no http://sciencespeaksblog.org/2011/01/20/usaid%e2%80%99s-shah-taking-steps-to-improve-oversight-increase-transparency/ http://feedproxy.google.com/~r/ScienceSpeaksPodcast/~3/Zzwh5Zbt4t4/ http://sciencespeaksblog.org/2011/01/20/112th-congress-global-health-additional-profiles-of-key-republican-house-leaders/#comments Thu, 20 Jan 2011 18:08:53 +0000 David Bryden http://sciencespeaksblog.org/?p=3880 <table cellpadding='10'><tr><td valign='top' align='left'><em> This article is a follow-up to an earlier post to Science Speaks exploring Republican members of the new Congress who are key players in global health policy and funding. Rep. Denny Rehberg (R-MT), Rep. Ileana Ros-Lehtinen (R-FL), Rep. Christopher Smith (R-NJ), Rep. Dana Rohrabacher (R-CA), and Rep. Joe Pitts (R-PA) are examined, including their voting records on key legislation such as whether or not they supported the President's Emergency Plan for AIDS Relief, or PEPFAR. </em> <table width='100%'><tr><td align=left><p><b>(<a href='http://sciencespeaksblog.org/2011/01/20/112th-congress-global-health-additional-profiles-of-key-republican-house-leaders/' title='112th Congress & Global Health: Additional Profiles of Key Republican House Leaders'>Read more...</a>)</b></p></td></tr></table></td></tr></table><img src="http://feeds.feedburner.com/~r/ScienceSpeaksPodcast/~4/Zzwh5Zbt4t4" height="1" width="1"/> http://sciencespeaksblog.org/2011/01/20/112th-congress-global-health-additional-profiles-of-key-republican-house-leaders/feed/ 1 This article is a follow up to an earlier post to Science Speaks exploring Republican members of the new Congress who are key players in global health policy and funding. Rep. Denny Rehberg (R-MT) Rep. Denny Rehberg (R-MT), Chair of the House Labor, Health and Human Services Appropriations Subcommittee: The Appropriations Committee’s Labor, Health and Human Services Subcommittee determines some important global health funding, such as funding for the National Institutes of Health, the Centers for Disease Control and Prevention, and a portion of the U.S. contribution to the Global Fund to Fight AIDS, TB and Malaria. The new chair of the subcommittee is Rep. Denny Rehberg (R-MT), who had previously served on the State and Foreign Operations Subcommittee.  Rep. Rosa DeLauro (D-CT) has been named as the ranking member on the subcommittee. Rehberg is Montana’s sole representative to the U.S. House, serving since 2001. In 2005 he raised concerns about accountability at the Global Fund.  In 2006 he travelled to Uganda and other African countries to learn about the HIV/AIDS crisis.  Rehberg has cited the work of the Rocky Mountain Technology Group located in Billings, Montana, in training Ugandans in patient monitoring technology. In 2007 Rehberg voted in favor of an amendment proposed by Rep. Joe Pitts (R-PA), which aimed to block a provision that allows the president to waive the requirement that at least 33 percent of global HIV prevention funds be spent on abstinence-until-marriage programs.  In 2008 Rehberg voted for the Lantos-Hyde bill. While Rehberg voted for the Tom Lantos and Henry J. Hyde U.S. Global Leadership Against HIV/AIDS, Tuberculosis, and Malaria Reauthorization Act (Lantos-Hyde), all of the other Republicans now on the subcommittee – except Rep. Cynthia Lummis (R-WY) who was not then in office – voted against the bill. In 2010 Rehberg proposed an amendment to the foreign aid bill that would have cut spending by $4 billion.  He also proposed an amendment to the Labor, Health and Human Services funding bill to cut spending by $13 billion. Rep. Ileana Ros-Lehtinen (R-FL) Rep. Ileana Ros-Lehtinen (R-FL), chair of the House Foreign Relations Committee: The Foreign Relations Committee is the main oversight committee that examines the operation of U.S. global health programs and considers legislation authorizing such programs, including foreign aid reform. Ros-Lehtinen, the incoming chair, represents Florida’s 18th Congressional District, which includes Miami, Little Havana, Coral Gables, Pinecrest, Miami Beach, Westchester and the Florida Keys. Priority issues for her include support for Israel, concerns about Cuba, supporting free trade and concerns about the United Nations. In 2005 Ros-Lehtinen she was a key co-sponsor of the Assistance for Orphans and Other Vulnerable Children in Developing Countries Act of 2005, which was signed into law.  She voted for the Pitts amendment in 2007. From 2007-08 Ros-Lehtinen played a major role in the reauthorization of the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), introducing her own bill that would have authorized $30 billion for the program from 2009-13, instead of the $48 billion authorization that was ultimately enacted.  The $30 billion funding level would have been close to flat funding for the AIDS program.  In 2008 she voted for the eventual compromise result that became the Lantos-Hyde bill. Ros-Lehtinen has been a champion for evidence-based policies to support prevention of HIV for persons who inject drugs.  In 2008 she and Rep. José E. Serrano (D-NY) introduced the Community AIDS and Hepatitis Prevention Act of 2008, in order to remove all restrictions on the use of federal funds for syringe exchange programs to reduce the transmission of HIV and hepatitis C. In 2010 Ros-Lehtinen expressed concern about the cost of U.S. global health programs and her sense that the PEPFAR program was losing its focus.  She has stated [...] <table cellpadding='10'><tr><td valign='top' align='left'><em> This article is a follow-up to an earlier post to Science Speaks exploring Republican members of the new Congress who are key [...] David Bryden 6:57 112th Congress & Global Health: Additional Profiles of Key Republican House Leaders no http://sciencespeaksblog.org/2011/01/20/112th-congress-global-health-additional-profiles-of-key-republican-house-leaders/ http://feedproxy.google.com/~r/ScienceSpeaksPodcast/~3/dizAPDd-uFw/ http://sciencespeaksblog.org/2011/01/19/who-issues-new-guidelines-for-tb-prevention-among-hiv-positives/#comments Wed, 19 Jan 2011 18:53:21 +0000 Meredith Mazzotta http://sciencespeaksblog.org/?p=3870 <table cellpadding='10'><tr><td valign='top' align='left'><em> The World Health Organization (WHO) has released updated guidelines for preventing TB among persons living with HIV in resource-limited countries, including the recommendation that those presenting without active TB receive at least six months of isoniazid prophylaxis treatment (IPT). TB is the most common killer of HIV positive people, and approximately 380,000 people living with HIV die from TB every year. In order to adequately identify candidates for the isoniazid therapy, a simple, standardized TB screening rule for people living with HIV in resource-constrained settings is included in the guidelines... </em><table width='100%'><tr><td align=left><p><b>(<a href='http://sciencespeaksblog.org/2011/01/19/who-issues-new-guidelines-for-tb-prevention-among-hiv-positives/' title='WHO issues new guidelines for TB prevention among HIV-positives'>Read more...</a>)</b></p></td></tr></table></td></tr></table><img src="http://feeds.feedburner.com/~r/ScienceSpeaksPodcast/~4/dizAPDd-uFw" height="1" width="1"/> http://sciencespeaksblog.org/2011/01/19/who-issues-new-guidelines-for-tb-prevention-among-hiv-positives/feed/ 2 The World Health Organization (WHO) has released updated guidelines for preventing TB among persons living with HIV in resource-limited countries, including the recommendation that those presenting without active TB receive at least six months of isoniazid prophylaxis treatment (IPT). TB is the most common killer of HIV positive people, and approximately 380,000 people living with HIV die from TB every year. In order to adequately identify candidates for the isoniazid therapy, a simple, standardized TB screening rule for people living with HIV in resource-constrained settings is included in the guidelines. A new study presented in PloS Medicine this week by lead author Haileyesus Getahun, MD, PhD, MPH, worked to identify four symptoms among HIV positive people – current cough, fever, night sweats and weight loss – that were likely to pinpoint those in need of further diagnostic assessment for TB. Those without any of these symptoms had a low probability of having TB. “Use of this algorithm should result in earlier TB diagnosis and treatment, and should allow for substantial scale-up of IPT,” according to the study abstract. In a public comment responding to the guidelines, Humphrey Fellow in the Hubert Department of Global Health at Emory University Ashraf Mohammed, PhD, and Center for Global Health Policy Scientific Advisory Board Member Carlos del Rio, MD, said “…Most countries with raging HIV/TB epidemics have not implemented TB screening, and rates of IPT use are abysmal,” while lauding the guidelines. “Having a simple algorithm for identifying patients with possible TB disease — and removing the need for [a tuberculin skin test] or a chest x-ray before starting IPT — is a giant step forward that may help reduce the burden of TB disease among HIV-infected people.” This is the first update to the guidelines in more than a decade. “Guidelines for intensified tuberculosis case-finding and isoniazid preventive therapy for people living with HIV in resource-constrained settings,” are available on the WHO website. <table cellpadding='10'><tr><td valign='top' align='left'><em> The World Health Organization (WHO) has released updated guidelines for preventing TB among persons living with HIV in [...] Meredith Mazzotta 2:21 WHO issues new guidelines for TB prevention among HIV-positives no http://sciencespeaksblog.org/2011/01/19/who-issues-new-guidelines-for-tb-prevention-among-hiv-positives/ http://feedproxy.google.com/~r/ScienceSpeaksPodcast/~3/qChT7SwDhOk/ http://sciencespeaksblog.org/2011/01/11/haiti-leans-on-aids-program-infrastructure-to-rebuild-health-system/#comments Tue, 11 Jan 2011 14:45:25 +0000 John Donnelly http://sciencespeaksblog.org/?p=3824 <table cellpadding='10'><tr><td valign='top' align='left'>One testimony to the strength of the U.S. government’s AIDS program in Haiti: Four months after the devastating 2010 earthquake, the number of those treated for AIDS was at 95 percent of pre-earthquake levels. In addition, said senior U.S. health officials in a briefing to reporters, the number of pregnant women receiving AIDS treatment increased [...]<table width='100%'><tr><td align=left><p><b>(<a href='http://sciencespeaksblog.org/2011/01/11/haiti-leans-on-aids-program-infrastructure-to-rebuild-health-system/' title='Haiti leans on AIDS program infrastructure to rebuild health system'>Read more...</a>)</b></p></td></tr></table></td></tr></table><img src="http://feeds.feedburner.com/~r/ScienceSpeaksPodcast/~4/qChT7SwDhOk" height="1" width="1"/> http://sciencespeaksblog.org/2011/01/11/haiti-leans-on-aids-program-infrastructure-to-rebuild-health-system/feed/ 5 One testimony to the strength of the U.S. government’s AIDS program in Haiti: Four months after the devastating 2010 earthquake, the number of those treated for AIDS was at 95 percent of pre-earthquake levels. In addition, said senior U.S. health officials in a briefing to reporters, the number of pregnant women receiving AIDS treatment increased to 1,900 in 2010 from 1,100 a year before.  In all, roughly 28,000 Haitians are receiving AIDS treatment with support from the President’s Emergency Plan for AIDS Relief (PEPFAR) program. Yet the officials, giving the update exactly a year after the earthquake, which the Haitian government said killed at least 250,000 people, did not skimp on the challenges still facing the government and donors. “Challenges remain and progress is fragile,” said Thomas Frieden, MD, MPH, director of the U.S. Centers for Disease Control and Prevention (CDC). The current ongoing threat is the spread of cholera. Donald Steinberg, deputy administrator of the U.S. Agency for International Development (USAID), said donors started to rebuild the health system several months after the earthquake, but then the cholera epidemic hit. Today, the country has registered 157,000 cholera cases and an estimated 3,500 people have died. But Steinberg and other U.S. officials said that the outcome would have been worse without the U.S. AIDS infrastructure, started in 2004 under PEPFAR. Steinberg said the emergency response used “in large part the PEPFAR facilities on the ground,” including everything from triage centers to food and supply distribution sites. PEPFAR has 149 facilities throughout the country and all survived the earthquake, said Ambassador Eric Goosby, U.S. global AIDS coordinator. “Our sites were engaged in a wide variety of response activities, providing disaster related medical care in some sites,” he said. “In other sites, we made food, provided water, and gave shelter. The sites really became the centers of mapping for people living in tents and shelters.” “There’s no doubt there is still much work to be done,” Goosby said. One issue outside of the cholera epidemic is evaluating whether enough has been done to treat those with tuberculosis. One study found that 67 percent of the people on the TB registries pre-earthquake were being treated four months later – a marked contrast to AIDS treatment rebounding to 95 percent pre-earthquake levels. Asked about the gap, CDC’s Frieden said there was no clear-cut answer. “The study was taken over a long period, from January through May [of 2010],” he said. “In that time, TB patients could have completed treatment, died, or moved. [Antiretroviral drugs have] more consistent follow-up. The big point in both is that they were strong systems in the country through the Haitian government and partners.” Goosby agreed. “Americans should be proud of their country’s involvement,” he said. “This anniversary of one year post-earthquake is a reminder that progress can be made.” Since the earthquake, the U.S. government, including the Defense Department, has spent more than $1 billion in Haiti to help rebuild the country. Of that, USAID has spent about $150 million for nutrition and all health issues, except the cholera response. The CDC spent $14.6 million last year. PEPFAR’s budget, interestingly, decreased to $124.1 million in 2010 from $130.5 million in 2009. <table cellpadding='10'><tr><td valign='top' align='left'>One testimony to the strength of the U.S. government’s AIDS program in Haiti: Four months after the devastating 2010 earthquake, the number [...] John Donnelly 3:40 Haiti leans on AIDS program infrastructure to rebuild health system no http://sciencespeaksblog.org/2011/01/11/haiti-leans-on-aids-program-infrastructure-to-rebuild-health-system/