Bono loves data and said so in his February TED talk, which was recently released in video. He says the promise of ending extreme poverty turns him on.
“If the trajectory continues we get to the ‘zero zone.’ For number crunchers like us, that is the erogenous zone,” says Bono. “And it’s fair to say, by now, that I am sexually aroused by the collating of data.”
Extreme poverty has been halved from 43% of the world in 1990 to 21% by 2000. The current trends show that extreme poverty could end by 2030, say the World Bank, ONE and CGD.
However, the most recent data (aka UNDP’s Human Development Report (HDR) 2013) suggests that ending extreme poverty will get harder if we don’t take more action:
“Environmental inaction, especially regarding climate change, has the potential to halt or even reverse human development progress. The number of people in extreme poverty could increase by up to 3 billion by 2050 unless environmental disasters are averted by co-ordinated global action,” says the report. Continue reading →
It’s hard to imagine Luwiza Makukula of a dozen or so years ago.
“Things were very difficult in Zambia then,” said Makukula, a soft-spoken and elegantly dressed grandmother of two I met briefly during a visit to Seattle this week. Her visit was sponsored by the anti-poverty organization RESULTS, a group which the Seattle Times’ columnist Danny Westneat once described as “the most influential anti-poverty group you’ve never heard of.” One of the reasons for this is the way RESULTS has operated for some 30 years – quietly, persistently and face-to-face.
That’s why Makukula came here from Zambia to tell her story.
“I lost my husband to HIV in 2001,” she said. “We didn’t know but after he died I started getting sick with fevers, in and out of the hospital.”
Makukula was eventually diagnosed with TB, and then found to also be HIV-positive. By then, she was in a wheelchair, suffering from exhaustion and cognitive lapses. They put her in an isolation ward that she said “felt like jail.” The drugs she needed to stay alive cost about $200 a month, in a country which at the time had an annual per capita income of about $1000.
She wasn’t alone in her deadly predicament. At the time, HIV and TB were burning a wide swath across much of southern Africa. Continue reading →
The talk the day after the Academy Awards is about Argo’s win, Jennifer Lawrence’s fall and whether or not host Seth McFarlane was funny. The show ended with a song saluting the losers of the night. Two of those losers were documentary films that covered stories of health.
Open Heart was nominated in the short form category. It tells the story of eight Rwandan children who suffer from rheumatic heart disease. They must travel to Sudan’s Salam Center in order to undergo lifesaving open-heart surgery. It includes the dual story of Rwandan cardiologist Dr. Emmanuel Rusingiza, illustrating the challenges he faces, and Italian surgeon Dr. Gino Strada, the head surgeon at the Salam Center. Continue reading →
Troubled seems to be part of the Global Fund’s official title these days.
Yesterday, Reuters reported that the head of the Global Fund, Michel Kazatchine, quit due to funding cuts. That’s not quite right. It is true that this initiative created to fight AIDS, TB and malaria has seen funding decline as donors have reneged on their promised pledges.
Kazatchine appears to have resigned largely due to the allegations of mismanagement and tolerance of corruption in an internal shake-up. Some accused donors of using these allegations — which seemed to me a bit hyped as I wrote here and here — as an excuse not to come through with the promised funds.
The subsequent failure of donors and governments to follow through on funding to the Global Fund following this flap made Canadian politician and former UN AIDS ambassador Stephen Lewis absolutely apoplectic.
All this makes the announcement today by Bill Gates at the World Economic Forum in Davos, Switzerland very welcome news to many in the global health community. Davos is the same place he and Melinda announced more than a decade ago that they were giving the same amount of money to launch the Global Alliance for Vaccines and Immunization (GAVI).
There just seems to be something the Gateses like about announcing global funds at Davos and giving that $750 million figure. Some saw GAVI as a model for the later creation of the Global Fund.
Both are collaborative international projects that award grants to poor countries based on their performance in combating diseases of poverty — one aimed at fighting the top three killers and the other aimed at boosting childhood vaccinations in poor countries.
Both have trouble with “fraud and mismanagement” which, to some extent, comes from them handing over more control of in-country operations to, uh, countries not known for doing too well at combating fraud and mismanagement. But if the subcontractor shirks on the plumbing, the contractor pays for the leaks.
With the Gates Foundation stepping in where the international community has stepped back, Boseley asks if the Global Fund risks becoming a bit too unilateral, less European. That may sound petty from an American perspective, but it’s not. These initiatives really can only succeed if they are truly multilateral.
Politics aside: Between these two funds over the past decade, more than 10 million deaths have been prevented and some disease rates in poor countries have been significantly reduced. Not a bad return.
Here’s a pretty good video from the Global Fund making its case with a little help from Bono, Bill Gates, Bill Clinton and others (many of whom who are probably now in Davos):
In a speech at the National Institutes of Health today, Secretary of State Hillary Clinton said it is time for the world to “usher in an AIDS-free generation,” calling it a new “policy priority” for the U.S.
Clinton said scientific advances have made it possible to strive for a generation in which “virtually no children” are born with HIV. She added that a “wide range of prevention tools” can help prevent the spread of the virus and that access to treatment can prevent people who are HIV-positive from passing the virus on to others.
Flickr, Gobierno de Guatemala
“Now, HIV may be with us well into the future. But the disease that it causes need not be. This is, I admit, an ambitious goal, and I recognize I am not the first person to envision it,” Clinton said, according to a transcript of today’s speech, which was described by the State Department as the first in a series of remarks from Obama administration officials leading up to World AIDS Day.
“Now we know beyond a doubt if we take a comprehensive view of our approach to the pandemic, treatment doesn’t take away from prevention. It adds to prevention,” Clinton said. “So let’s end the old debate over treatment versus prevention and embrace treatment as prevention,” she added. Continue reading →
A number of articles have marked the 30th anniversary of the discovery of AIDS by emphasizing the progress made so far against the disease and some recent scientific discoveries that raise hope.
To begin with, there is more evidence a vaccine is possible and new studies confirm that treatment IS prevention, so that expanding access to anti-HIV drugs could help stop the continuing spread of disease.
Others emphasize that the story so far is mostly a tragedy, a massive failure for the international community, as the loss of life today continues in poor countries where people lack access to these life-saving drugs.
Some 6 million people in the developing world have received the drugs due to initiatives such as the Global Fund to Fight AIDS, TB and Malaria — a big increase over the past 10 years — but more than 9 million who need them still lack access. And donors are not stepping up with new funds.
Much of the current hopefulness, expressed most forcibly by The Economist, stems from this discovery that getting everyone who is HIV-infected on treatment could largely curtail the spread of AIDS. Here are a few of those skeptical of this idea:
Tim France, in Global Health Sushi, “More Spin Than Rigour” argues that it is extremely wishful thinking to assume that we can expand treatment to all who need it in the developing world. France, based in Chiang Mai and Geneva, has worked for decades as a consultant to leading global health organizations and served as editor for leading scientific journals. He criticizes The Economist and others in the media for raising false hopes::
So why all the excitement and focus on merely the potential positives of this new data? In my view it’s because the HIV response desperately needs some good news right now.
But is the evidence surprising and powerful enough to be a “game changer” as Michel Sidibe, the director of UNAIDS declared, or “to end, or at least diminish, a bitter feud within the AIDS world over how much funding should go to treatment versus prevention,” as the Wall Street Journal has suggested?
Scientists in Seattle hope to pioneer a more “rational” approach to vaccine development, exploiting powerful computers to better identify immune system targets and reduce the huge burden (and cost) of clinical testing.
“I intend to focus first on malaria vaccines,” said Alan Aderem, an internationally recognized immunologist who will soon be taking the helm of Seattle BioMed. Aderem co-authored a paper in this week’s edition of Nature in which he outlines a new strategy aimed at discovering vaccines against HIV, TB and malaria.
Arguably, the ways in which researchers test and develop vaccines against disease today haven’t changed that much since the 18-century British physician Edward Jenner injected a young man with cowpox to see if it would protect him from smallpox. It did and, so the story goes, vaccines and the science of immunology were born.
Scientists certainly have more sophisticated tools and methods today, but testing a vaccine is still often a “shot in the dark” because of our incomplete understanding of how the immune response works. Continue reading →
A global health fund believes millions of dollars worth of its donated malaria drugs have been stolen in recent years, vastly exceeding the levels of theft previously suspected, according to confidential documents obtained by The Associated Press.
The internal investigation by the Global Fund to Fight AIDS, Tuberculosis and Malaria comes two months into a new anti-corruption program that the fund launched after an AP report detailing fraud in their grants attracted intense scrutiny from donors.
Gee, that doesn’t sound too good. Sounds like that Swiss-cheese-eating, wine-drinking bunch at the Global Fund needs to get its act together. Good thing the media is dogging it, eh?
I wrote that in response to the first story the AP did alleging “massive fraud” at the Global Fund (see the link in the pull quote above) which was — like this week’s story — based on an anonymous tipster and leaked documents.
Flickr, by AMagill
Circle of money
In the first story, it turned out that it was the Global Fund itself that, months earlier, had announced it was investigating these allegations of fraud — which represent only about 0.3 percent of its total funding.
So now this week comes a story that looks pretty similar, claiming the Global Fund has allowed the theft of “millions of dollars” of malaria drugs.
It’s portrayed as a problem that was discovered thanks to the anti-corruption investigation launched by the AP’s earlier news story.
This misleading narrative and media self-congratulation is making my head hurt.
