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30 June 2017 VOLUME 18 ISSUE 26

Media Coverage

  • This updated fact sheet lists U.S. government positions and officials related to global health operations, including links to agencies and officials' profiles, when available.

    June 29, 2017
    Kaiser Family Foundation
  • Sue Desmond-Hellmann, CEO, Bill & Melinda Gates Foundation, was drawn to one particular item in President Donald Trump’s proposed budget – the massive cuts to foreign aid....Desmond-Hellmann says she is concerned that if the cuts came into fruition, it could stymie the progress of the world’s largest philanthropic organizations to eradicate diseases like polio and promote family planning for women.

    June 29, 2017
    Politico
  • A standing ovation for the Fogarty [International Center] kicked off the recent Consortium of Universities for Global Health annual meeting....Early in his tenure as director of the National Institute of Allergy and Infectious Diseases, Dr. Anthony Fauci appreciated the globality of infectious diseases and set out to organize his institute accordingly: "Global health is integral to everything we do at NIAID....If you look at public health leaders...throughout the world, it's stunning how many were Fogarty trainees."

    June 29, 2017
    Global Health Matters
  • Andrew Owen and Steve Rannard, two professors at the University of Liverpool, are leading efforts to use nanotechnology to improve delivery of HIV drug treatments so they're more effective and less expensive....[Their] research...over the last 8 years has so far proven that nanotechnology can be used to reduce dosage in half "and still get the same amount of drug exposure...; you can make more drugs and therefore treat more patients," said Owen.

    June 28, 2017
    The Body
  • A generic of Dolutegravir (DTG), first approved in the United States in 2013, is being given to 20,000 patients in Kenya before being rolled out in Nigeria and Uganda later this year, with the backing of the health agency UNITAID. DTG is the drug of choice for people with HIV in high-income countries who have never taken antiretroviral therapy before and for those who have developed resistance to other treatment.

    June 28, 2017
    reuters
  • A new discussion paper released by ICASO and EANNASO suggests that the Global Fund might not be investing enough money in HIV prevention in Africa to meet its targets....The paper confronts the reality that the benchmark of investing “a quarter for prevention” is not being met, and progress on HIV prevention has stalled as a result. Indeed, since 2010, the number of new adult HIV infections has remained unchanged, with an estimated 1.9 million occurring globally each year.

    June 27, 2017
    Aidspan
  • The White House has issued an earnest statement attributed to President Trump about HIV/AIDS in America. It is technically accurate, apolitical, and strikes just the right notes in terms of being somber and optimistic at the same time....But coming on the heels of the resignation of six members of his Presidential Advisory Council on HIV/AIDS last week, the words took on more significance. Some commentators...took the new statement as an attempt at extending a sort of olive branch.

    June 27, 2017
    Washington Post
  • Anthony Fauci seemed surprised at the suggestion that he might do something other than what he’s been doing since he began leading...[NIAID] in 1984—trying to protect people from diseases like Ebola, Zika, and HIV. This is despite the fact that some of Trump’s policy proposals seem to directly contradict his efforts....I asked if he was daunted by all these developments and...how he planned to do his work in spite of them. An edited version of our conversation...follows.

    June 26, 2017
    The Atlantic
  • Despite frequent insults, threats and attacks, sex workers...are helping to save the lives of their clients from the Central African nation's biggest killer - HIV. Sex workers are persuading these men to take free HIV tests in mobile clinics, set up inside or nearby brothels and run by teams of doctors, nurses, social workers and lab technicians, in a drive to tackle the prevalence of the virus which causes AIDS.

    June 26, 2017
    Reuters
  • [T]he Cochrane Library...is a collection of databases containing high quality systemic reviews and other evidence to inform decisions about health care....Now...funding from the South African Medical Research Council...has procured a national licence that provides “one-click” access to the Cochrane Library for everyone in South Africa....It’s a chance for practitioners, policymakers and patients to get up-to-date, scientifically rigorous information about health care.

    June 25, 2017
    The Conversation

Published Research

  • We propose a functional framework for HIV/AIDS-related BSSR, highlighting 4 primary BSSR domains: 1) understanding vulnerable populations and contexts of risk (Basic BSSR); 2) improving behavioral and social factor approaches to risk reduction, prevention, and care (Elemental BSSR); 3) strengthening design and outcomes of biomedically focused research in HIV/AIDS treatment and prevention (Supportive BSSR); and 4) contributing building blocks to integrated HIV/AIDS prevention and treatment approaches (Integrative BSSR).

    August 1, 2017
    JAIDS
  • Studies of long-term survival of HIV infection...are important in preparing for a demographic shift in the epidemic. But further close observations of the ageing populations of people living with HIV in various settings are needed to better understand the interaction between ageing, infection, treatment, and comorbidities [as well as] new infections, and...target testing to those at risk, even if this is not a population in which health programmes regularly consider such risk factors.

    July 1, 2017
    Lancet HIV
  • The pharmacokinetics and preliminary safety of VRC01-N pod-IVRs were evaluated in a rhesus macaque model. The devices sustained VRC01-N release for up to 21 days at controlled rates....No adverse safety indications were observed. These findings indicate that pod-IVRs are promising devices for the delivery of the candidate topical microbicide VRC01-N against HIV-1 infection and merit further preclinical evaluation.

    July 1, 2017
    Antimicrob Agents Chemother
  • Proven interventions, most notably pre-exposure prophylaxis have been limited in rollout and impact. Treatment as prevention has the promise to improve clinical outcomes but remains uncertain as a prevention tool to reduce population-level HIV incidence.

    June 30, 2017
    JIAS
  • Recent reports from the Iranian Ministry of Health warn that there has been a nearly three-fold increase in the sexual transmission of HIV in Iran....during the past decade...[and] that sexual transmission is the main route of infection among Iranian women,...[suggesting] that Iran's society is facing an alarming shift from HIV infection through syringes shared among injection drug users to sexual transmission,....while there is no substantial notice or action from officials because of conservative societal norms.

    June 29, 2017
    Lancet HIV
  • In 2012, Makerere University, Johns Hopkins University, and Mulago National Referral Hospital, with NIH support, undertook operational research at Mulago PMTCT/PNC clinics....[D]uring the intervention, the proportion of referred mothers in need of family planning increased by 30.4 percentage points, FP uptake by over 31 percentage points, [and] over 57% of mothers took up Depo-Provera injectable-FP. The study provides additional evidence on utilization of peer mothers in HIV care [and] improves health services uptake including family planning.

    June 27, 2017
    BMC Health Services Research
  • WHO, along with multiple countries, is now embracing commitment to reduce the MTCT of HIV and/or syphilis to elimination levels....This will require political advocacy and commitment from experts in HIV, syphilis, maternal child health, health policy, program implementation, monitoring and evaluation....Countries will need to strengthen surveillance and laboratory systems, provide programmatic services to even the hardest to reach populations, and ensure that their program is based on core human rights, gender, and community engagement.

    June 27, 2017
    PLoS Med
  • A number of barriers frustrate efforts to take the response to STIs to scale, including insufficient incidence data and disease surveillance, and political resistance to scientifically-proven and often cost-effective interventions and approaches....This paper applies an analytical approach to global strategy that includes investigation of 3 domains: process, programmatic, and political. Key questions are proposed to guide exploration of these domains to help identify and address barriers to, and leverage solutions for, policy success.

    June 27, 2017
    PLoS Med
  • There is inequity in access to HPV vaccines, and populations with the largest burden of HPV-related diseases have the least access to the vaccines....[However],...several factors are combining to accelerate uptake and coverage, most notably...increased policy attention to STI and cervical cancer prevention and control, ongoing support from the Gavi Alliance to low-income countries, continued downward pressure on HPV vaccine prices, [and] a reduced number of doses and more flexible schedules.

    June 27, 2017
    PLoS Med
  • This retrospective study included adults initiating HAART before 2004 at 8 sites in Argentina, Brazil, Chile, Haiti, Honduras, and Mexico. Patient status...was assessed at 6-month intervals for 10 years, along with CD4 count and HIV-1 viral load for patients in care....Despite advanced disease and predominant use of older antiretrovirals, a large percentage of early HAART initiators in this Latin American cohort were alive and in care with sustained virologic suppression and progressive immune recovery after 10 years.

    June 26, 2017
    PLoS ONE
  • One of the most important factors influencing adherence and retention was the strength of women’s support systems. In contrast to women in-care, most out-of-care women lacked emotional and financial support from male partners, received minimal counseling from providers at initiation, lacked designated guardians to assist with medication refills or clinic appointments, and were highly mobile....The most common reasons women re-started treatment...were due to providers’ counseling and encouragement and mother’s desire to be healthy.

    June 21, 2017
    PLoS ONE
  • The healthy vaginal microbiota is typically characterized by the predominance of Lactobacillus species....thought to protect against pathogens through a variety of mechanisms....Decreased bacterial diversity in the gut has been linked to a number of pathologic conditions, whereas increased vaginal bacterial diversity has been associated with a variety of poor patient outcomes including...acquisition and spread of sexually transmitted infections.... Klatt et al. add to this list a decrease in the efficacy of the vaginal antiretroviral gel tenofovir to prevent HIV acquisition.

    June 2, 2017
    Science
  • We investigated whether vaginal microbiota modulated tenofovir gel microbicide efficacy in the CAPRISA 004 trial....Tenofovir reduced HIV incidence by 61% in Lactobacillus-dominant women but only 18% in women with non-Lactobacillus bacteria, a threefold difference in efficacy....This study provides evidence linking vaginal bacteria to microbicide efficacy through tenofovir depletion via bacterial metabolism.

    June 2, 2017
    Science
  • In 2011, the WHO, with funding from Global Affairs Canada, began support to 6 implementation research projects in Malawi, Nigeria, and Zimbabwe....Five of the studies were cluster randomized controlled trials, and 1 adopted a matched cohort design. Here, we summarize some main findings and key lessons learned. We also consider some broader implications, remaining knowledge gaps, and how implementation research is integral to, and essential for, global guideline development and to inform HIV/AIDS strategies.

    June 1, 2017
    JAIDS

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