U.S. Should Increase Commitment To Global Fund, Opinion Piece Says

President Bush’s request last week for a $30 billion, five-year extension of the President’s Emergency Plan for AIDS Relief did not include an “acknowledgment that the U.S. must at the same time increase [its] commitment to the Global Fund To Fight AIDS, Tuberculosis and Malaria,” Rep. Barbara Lee (D-Calif.) writes in an opinion piece for The Hill. Lee writes that although PEPFAR “provides critical targeted resources in the fight against HIV/AIDS in 15 countries,” the Global Fund “provides broader support to 136 countries … that have delivered results that are measurable, tangible and very real.”

According to Lee, the Global Fund, “[u]nder the leadership” of Executive Director Michel Kazatchkine, has “laid out a plan of operation” and “stands ready to rapidly scale up [the Global Fund's] activities and take the next step toward achieving the goal of universal access to care and treatment for all.” However, Global Fund goals “will require the commitment of the international community” and the U.S., Lee writes. To help the Global Fund meet its goals, Lee suggests that Congress allocate $1.3 billion to the organization for fiscal year 2008, which would allow the Global Fund to continue its programs and add new ones.

Results from Global Fund and PEPFAR programs “have been very encouraging,” Lee writes, adding that to “achieve sustainable change and reach the goal of universal access,” the U.S. “must now plan the next phase of the global response” to HIV/AIDS, TB and malaria. Lee concludes that she is “confident” Congress will respond in a “bipartisan manner to expand” the U.S. “commitment to PEPFAR and ensure that the Global Fund remains an integral component” in the fight against HIV/AIDS (Lee, The Hill, 6/5).

C-SPAN’s “Washington Journal” on Monday included a discussion with David Gartner, policy director for the Global AIDS Alliance, about President Bush’s PEPFAR funding request (“Washington Journal,” C-SPAN, 6/4). Video of the segment is available online.

“Reprinted with permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved. Continue reading

Discrimination Against HIV-Positive Teachers Adversely Affects Education Sector In Uganda

Discrimination against HIV-positive teachers is having an adverse effect on the education sector in Uganda, the East African reports. According to the UNESCO Education Global Monitoring Report 2006, HIV/AIDS is the principal cause of teacher absenteeism and shortages, most notably in Africa. The stigma surrounding HIV/AIDS fuels teacher absenteeism, as teachers want to reduce the amount of contact they have with their colleagues and students, “whom they perceive to be pointing fingers at them,” according to the East African. A 2005 survey by Action Aid International Uganda — carried out in the three districts of Bushenyi, Kampala and Katakwi in the western, eastern and central regions among primary and post-primary male and female teachers — found that HIV-positive teachers feel pressure to excel in their positions because they believe their jobs are in jeopardy. In addition, HIV-positive teachers said harassment by other staff members keeps their morale low, the survey found. Teopista Birungi, secretary-general of the National Teachers Union, said the union is using the survey to launch “advocate campaigns” for teachers living with or affected by HIV/AIDS. Assistant Commissioner for Personnel in the Ministry of Education and Sports John Baptist Ssemakula said, “The issue of stigma is something that has to be addressed over time because it is related to attitude change,” adding, “It is not like switching a machine on and off. It requires enhanced and continuous sensitization through clear and smooth provision of scientifically proven information to demystify the conceptual minds of the public” (Musinguzi, East African, 10/17).

“Reprinted with permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved. Continue reading

Researchers Urge Wider Use Of Diarrheal Disease Control Measures

Researchers from the Johns Hopkins Bloomberg School of Public Health urge wider use of oral rehydration solution (ORS), zinc supplementation and rotavirus vaccine to reduce the deaths from diarrheal disease worldwide. Diarrheal disease kills approximately 1.5 million children under age 5 each year. The researchers’ findings and recommendations are published in the July 3 edition of The Lancet.

“New methods for prevention, management and treatment of diarrhea including an improved oral rehydration formulation, zinc supplementation and rotavirus vaccines make now the time to revitalize efforts to reduce diarrhea mortality worldwide,” writes Mathuram Santosham, lead author of the review and professor in the Bloomberg School’s Department of International Health.

ORS was developed in the 1970s as an efficient and cost-effective way to replace the body’s vital fluids lost to illness. Before oral rehydration, treatment for patients with diarrheal disease required hospital care and intravenous fluid replacement, which were unavailable and impractical in many developing countries where diarrheal disease is a major concern.

Although deaths from diarrheal disease dropped 75 percent from 1980 to 2008, diarrheal disease remains a leading cause of death for children under age 5. According to the authors, new interventions for treatment of diarrheal disease, such as an improved low osmolarity ORS, zinc supplementation and rotavirus vaccines for prevention of diarrhea provide an opportunity to revitalize diarrhea-control programs around the world. They urge international agencies, donor communities and developing countries to renew emphasis on prevention of diarrheal disease deaths.

“Unfortunately, diarrhea treatment in many countries is not a priority. Therefore, we cannot assume that diarrhea treatment will improve simply through introduction of zinc and low osmolarity oral solutions to these health systems,” the authors write. “National governments and donors should recognize the urgent need for new resources to strengthen health systems for delivery of oral rehydration solution and zinc while maintaining an adequate supply chain and training health workers.”

Additional authors of “Progress and barriers for the control of diarrheal disease” include Aruna Chandran, Sean Fitzwater, Christa Fischer-Walker, Abdullah Baqui and Robert Black of the Department of International Health at the Johns Hopkins Bloomberg School of Public Health, and Olivier Fontaine from the World Health Organization’s Department of Child and Adolescent Health Development.

Source: Johns Hopkins Bloomberg School of Public Health Continue reading

New Study Finds Long- And Short-Sleeved Physician Workwear Receive Same Amount Of Bacterial And MRSA Contamination

Governmental agencies in the United Kingdom recently instituted guidelines banning physicians’ white coats and the wearing of long-sleeved garments to decrease the transmission of bacteria within hospitals due to the belief that cuffs of long-sleeved shirts carry more bacteria. However, a new study published in the Journal of Hospital Medicine shows that after an eight-hour day, there is no difference in contamination of long- and short-sleeved shirts, or on the skin at the wearers’ wrists.

A group of researchers from the University of Colorado, USA, decided to assess the accuracy of the assumption that longer sleeves lead to more contamination by testing the uniforms of 100 physicians at Denver Health randomly assigned to wearing a freshly washed, short-sleeved uniform or their usual long-sleeved white coat. “We were surprised to find no statistical difference in contamination between the short- and long-sleeved workwear,” said lead researcher Marisha Burden, MD. “We also found bacterial contamination of newly laundered uniforms occurs within hours of putting them on.”

50 physicians were asked to start the day of the trial in a standard, freshly washed, short-sleeved uniform, and the 50 physicians wearing their usual long-sleeved white coats were not made aware of the trial date until shortly before the cultures were obtained, to ensure that they did not change or wash their coats. Cultures were taken from the physicians’ wrists, cuffs and pockets. No significant differences were found in bacteria colony counts between each style.

The researchers also found that although the newly laundered uniforms were nearly sterile prior to putting them on, by three hours of wear nearly 50% of the bacteria counted at eight hours were already present.

“By the end of an eight-hour work day, we found no data supporting the contention that long-sleeved white coats were more heavily contaminated than short-sleeved uniforms. Our data do not support discarding white coats for uniforms that are changed on a daily basis, or for requiring health care workers to avoid long-sleeved garments,” concluded Burden.

Jennifer Beal

Wiley-Blackwell Continue reading

BD Diagnostics And Bruker Collaborate To Improve Microbial Identification And Antimicrobial Susceptibility Testing

BD Diagnostics, a segment of BD (Becton, Dickinson and Company) (NYSE: BDX), and Bruker Daltonics Inc., a subsidiary of Bruker Corporation (NASDAQ: BRKR), announced an international co-development and co-marketing collaboration that will promote an emerging, integrated approach to bacterial and fungal identification and antimicrobial susceptibility testing. This new approach has the potential to transform how traditional microbiology has been performed for decades.

Through this collaboration, identification of microorganisms will be performed with the Bruker MALDI Biotyper, a mass spectrometry-based proteomic “fingerprinting” system specifically configured for rapid identification of bacteria, yeast and fungi. The MALDI Biotyper is available in a clinical version with IVD-CE mark in Europe and is for research use only (RUO) in the United States, where Bruker intends to seek FDA clearance.

BD and Bruker intend to combine the MALDI Biotyper microbial ID system with automated antimicrobial susceptibility testing on the BD Phoenix™ Microbiology System. The BD EpiCenter™ Microbiology Data Management System, which will manage patient data from both the identification and the susceptibility test systems, will facilitate this industry-first integrated approach.

The MALDI Biotyper – BD EpiCenter software integration will be further developed to optimize workflows for rapid MALDI Biotyper pathogen identification directly on positive blood cultures from the leading BD BACTECTM blood culture system. This rapid blood culture-to-ID workflow is supported by Bruker’s new MALDI Sepsityper™ consumables kit, which today is for RUO. It is expected to become clinically important in the future, as time-to-result for pathogen identification is critical to management of patients having potentially serious bloodstream infections or sepsis.

“This collaboration is ideal because the competencies of the two organizations will complement each other by providing excellent microbiology solutions for the customer,” said Jamie Condie, Vice President and General Manager, Infectious Disease, BD Diagnostics – Diagnostic Systems. “We have chosen to collaborate with Bruker because we believe that its mass spectrometry technologies are the future of microbial identification, and that the MALDI Biotyper is the first and best solution to the market. We expect this collaboration will result in enhanced clinical responsiveness while improving lab efficiency.”

“At Bruker, we are excited about this new strategic collaboration with BD because of the potential it holds to significantly advance clinical microbiology,” said Frank Laukien, Ph.D., President and CEO of Bruker Corporation. “Working with a worldwide leader in microbiology and infectious disease will enable us to further expand the groundbreaking MALDI Biotyper molecular method for microbial ID to its full extent.”

Microbial identification and antimicrobial susceptibility testing is the end-point of the major work a microbiology lab performs on a daily basis. After culturing and isolating bacteria and fungi from patient specimens, organisms need to be identified and tested to determine which drugs will inhibit or stop their growth. The Bruker MALDI Biotyper allows highly accurate, rapid and cost-effective identification through a process in which organisms are identified by the unique spectrum of the major proteins and peptides that constitute their makeup. The accuracy and benefits of the MALDI Biotyper have been well documented in over 30 peer-reviewed articles.

Antimicrobial susceptibility testing is conducted via traditional automated systems such as the BD Phoenix System. The combination of the two leading technologies, the BD Phoenix System and the MALDI Biotyper, and the data management through the BD EpiCenter System, will provide laboratorians with a groundbreaking new approach to identification and susceptibility testing, which will reduce the turnaround time for critical diagnostic results, while also improving laboratory efficiency and costs.


BD Diagnostics

Bruker Daltonics Continue reading

Bird flu vaccine within months, say Australian scientists

Australian scientists have announced that they expect to produce a trial vaccine within months. This vaccine will protect chickens from the deadly bird flu (avian flu).

A small portion of the flu genetic material would be delivered to poultry. This would stimulate the bird’s immune response.

The scientists work at the Commonwealth Scientific and Industrial Research Organisation (CSIRO).

The vaccine will be created using a delivery system which cuts the time normally taken to develop a new vaccine. The system is called Adenoviral Vector Delivery System (AVDS) and was devised by the animal health group Imugene.

Warwick Lamb, Managing Director of Imugene, said that the CSIRO research team had been working with the AVDS and its use with poultry for over ten years. He said that they have the relevant experience with chicken viruses.

He said vaccines based on the AVDS only used a portion of the viral structure of the flu virus, making them safer than a live attenuated vaccine approach.

An official from CSIRO said that this vaccine will provide a good base from which to develop other vaccines to treat future outbreaks (if this vaccine arrives too late to help the present outbreak). Continue reading

HIV Testing By African-American Physicians Still Affected By Stigma

The predominant barrier of routine HIV testing by African-American frontline care physicians is social stigma, according to a investigation assigned by Janssen Therapeutics, Division of Janssen Products, LP, in conjunction with the National Medical Association (NMA). Even though most physicians surveyed (93%) believed HIV was either very serious or a crisis in the African-American community, findings indicated that as little as one-third of all patients in these physician practices were tested in the past year.

The number of individuals living with HIV infection is at its highest in the United States. Almost half of all new HIV infections are accounted for by African-Americans, who also represent a higher proportion of new cases in comparison with other races and ethnicities. Since September 2006, the Centers of Disease Control and Prevention (CDC) has advised diagnostic HIV testing and voluntary HIV screening to be included in routine clinical care in all healthcare settings.

Wilbert C. Jordan, MD, MPH, Medical Director of the OASIS Clinic of King/Drew Medical Center and member of the NMA said:

“These findings tell us that despite HIV education efforts, the stigma surrounding the disease is still very strong and is a significant barrier to routine testing among African-American doctors.

With African Americans more likely to contract HIV than any other ethnic group, this is particularly concerning as the study uncovered that most patients decide to get tested based on their physicians recommendation. Its crucial that we educate doctors and patients by providing the resources they need to make HIV testing a routine practice.”
Testing Recommendations Tend to be Prompted by Risky Behaviors
Physicians surveyed estimated that 70% of patients got tested within the past year due to physicians’ recommendations, however, the physicians surveyed often use a risk-based testing method, recommending HIV testing for people based on perceived high-risk behaviors, which include multiple sex partners (89%), injection drug use (85%), suspected prostitution (77%), homosexuality (77%), and previous incarceration (70%). 86% of physicians found it is easiest to raise HIV testing with patients who are believed to be at risk.
Variance in Testing Based on Physician Demographics
36% of all physicians investigated were classified as high testers, routinely testing over 25% of their patients for the disease. The physicians tended to test routinely for all sexually active patients, those under 40, females and were more likely to be specialized in obstetrics and gynecology.
Recommendations by Physicians to Increase Routine HIV Testing
Physicians investigated suggested solutions to help boost routine testing in the primary care setting. Their suggestions included patient-focused communication emphasizing the importance of getting tested, for instance in-office posters and brochures (52%) and increased media attention (51%), further training on testing (44%) and the accessibility of accurate in-office prepackaged HIV tests (42%). Several physicians said that having a government order requiring routine HIV testing would enable them to test more patients (43%), despite the 2006 CDC recommendations for HIV testing.

Cedric Bright, MD, President of the NMA said:

“Early detection of HIV is critical, and thats why its important to raise awareness of the need for annual HIV testing as part of routine blood work.

The NMA supports and encourages its physicians in the primary care arena to adopt annual HIV testing of their patients. Together we can help make a difference in the fight against HIV.”
Survey Methodology
At the NMA Conference or via email, a total of 502 surveys were completed by African-American physicians online, 65% were NMA members. The survey consisted of 38 survey questions and 11 screening questions. The online panel surveys were gathered in two stages, late July through to early August 2010, and the second from mid-October through early November 2010. The intercept surveys from the NMA Conference were gathered in early August 2010, while in mid-September to mid-October the post conference email survey data was collected.

Grace Rattue

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Former French Foreign Minister Douste-Blazy Appointed To Serve As Special U.N. Adviser On Innovative Funding For MDGs

United Nations Secretary-General Ban Ki-moon has appointed former French foreign minister Philippe Douste-Blazy as special adviser on innovative financing for the U.N. Millennium Development Goals, U.N. deputy spokesperson Marie Okabe announced Tuesday, the AP/International Herald Tribune reports (AP/International Herald Tribune, 2/20). Because “official development assistance is still insufficient to achieve” the MDGs — which include curbing the spread of HIV/AIDS, tuberculosis, malaria and other diseases — Ban “sees the urgency for innovative sources of funding to be developed and promoted worldwide to fill this critical gap,” Okabe said in a statement.

Douste-Blazy currently serves as chair of the executive board of UNITAID, the international drug purchasing facility that uses airline tax revenues for programs in developing countries. Douste-Blazy will be tasked with promoting UNITAID and finding other sources of alternative funding to achieve the MDGs.

Douste-Blazy said that he plans to bring more countries on board to finance the MDGs through a mandatory airfare tax or through voluntary contributions by airline passengers. He also cited online gambling among other alternative types of financing. “Many people are working on innovative financing,” Douste-Blazy said, adding, “We now need to provide coordination” (AFP/Tocqueville Connection, 2/19).

Douste-Blazy also said that he plans to organize a global conference in 2009 that will focus on development financing from individuals, local officials, foundations, nongovernmental organizations, faith-based groups and businesses. “We want to organize little by little a worldwide citizen movement, with citizens, with private companies, besides states, to set up innovative financing,” Douste-Blazy said. He noted that one of his priorities will be the “traceability” of money so that donors can track how their donations are spent (Worsnip, Reuters, 2/19).

Reprinted with kind permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation© 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved. Continue reading

South Africa Launches Unprecedented Campaign For HIV/AIDS Treatment, Testing, Prevention

South African President Jacob Zuma on Sunday launched a national HIV/AIDS treatment, testing and prevention campaign, which United Nations officials are calling the largest and quickest expansion of HIV/AIDS services a nation has ever attempted, the New York Times reports. South Africa has the highest number of HIV-positive residents in the world at an estimated 5.7 million.

The government in the past month enabled 519 health facilities to dispense antiretroviral drugs, more than all years combined since the government began providing the medications in 2004. It also trained hundreds of nurses to prescribe antiretrovirals and plans to train thousands more at each of the nation’s 4,333 public clinics.

According to the South African Finance Ministry, the expanded access to the drugs will add one million individuals to the nation’s treatment programs within the next few years. The government has budgeted an extra $1 billion toward the heavier caseload, but its “understaffed public health system and the ballooning cost of treating millions of people for life will pose daunting challenges,” the New York Times reports (Dugger, New York Times, 4/25).

In addition to increased treatment access, the campaign aims to test 15 million of the nation’s 47 million residents by June 2011, the Los Angeles Times reports (Dixon, Los Angeles Times, 4/26). As part of the effort, government clinics will offer every patient an HIV test, and the government will provide pharmacies with testing kits for one year at no cost (New York Times, 4/25).

The government also plans to distribute 1.5 billion condoms this year, compared with 450 million last year (Los Angeles Times, 4/26). Zuma said the nation also will launch a nationwide drive to circumcise millions of men. Three years ago, the World Health Organization recommended circumcision as a way to decrease a man’s risk of contracting HIV by more than half (New York Times, 4/25).

Sunday’s announcement underscores the different approaches of Zuma and his predecessor, Thabo Mbeki, to the nation’s HIV/AIDS epidemic (Los Angeles Times, 4/26). Mbeki questioned whether HIV causes AIDS and suggested that antiretrovirals are harmful.

Although Zuma has “broken sharply” with Mbeki by confronting HIV/AIDS, his political career has not been without controversy on the issue, the New York Times reports (New York Times, 4/25). During his 2006 rape trial, Zuma drew criticism from HIV/AIDS activists after he said he’d had unprotected extramarital sex (Los Angeles Times, 4/26). Earlier this year, he again admitted having unprotected sex with a much younger woman (New York Times, 4/25).

Reprinted with kind permission from nationalpartnership. You can view the entire Daily Women’s Health Policy Report, search the archives, or sign up for email delivery here. The Daily Women’s Health Policy Report is a free service of the National Partnership for Women & Families, published by The Advisory Board Company.

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Black Clergy ‘Committed’ To Addressing HIV/AIDS Epidemic In Community, Opinion Piece Says

The Fort Worth Star-Telegram’s “recent series on HIV/AIDS accuses [black clergy] of being unaware, inert and unconcerned about the AIDS pandemic” and did not note a “very important truth: The church is changing in response to this challenge, and people of faith are making a difference,” Valda Jean Combs, a local pastor who heads the FullProof HIV Ministry, writes in a Star-Telegram opinion piece.

According to Combs, “Once educated on the depth and breadth of the challenge,” the black religious community has “become aware of the truth about HIV and the truth about transmission, risk factors and the devastating toll the disease is taking on” the black community and has reached out to those “people who are hurting, meeting them where they are, every single day.” She notes that the World AIDS Day Service in 2006, the “Seven Days … Seven Churches” initiative in 2007, and the Black Church Week of Prayer in 2008 are “proof that the Black Church is committed to this struggle.”

The series also “made no attempt to gauge support for HIV/AIDS initiatives among local black elected officials,” who as “community leaders, … have a responsibility to shine a light on community challenges,” Combs writes. She adds that “there is often a deafening silence among [local] black elected officials about the pandemic.”

She continues, “The Star-Telegram could have written about the dearth of [blacks] employed in decision-making positions by AIDS organizations in Fort Worth” or addressed the reasons why outreach efforts have been ineffective, instead of “repeat[ing] the same trite accusations that have been lodged against the Black Church since the beginning of this epidemic.” According to Combs, some HIV/AIDS organizations have a history of difficulty hiring and retaining black workers, which “translates to an inability to plan culturally sensitive effective programs targeting” the black community.

Combs says she hopes the paper will “dig deeper, ask the hard questions and hold our collective feet to the fire.” She concludes, “And while you’re at it, visit some of the ‘silent’ churches in Fort Worth. I think you might be compelled to write a different story next time” (Combs, Fort Worth Star-Telegram, 9/8).

Reprinted with kind permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation.

© 2008 Advisory Board Company and Kaiser Family Foundation. All rights reserved. Continue reading