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Health & Medicine Archive

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PRESIDENT'S EMERGENCY PLAN FOR AIDS RELIEF.
U.S. Government Accountability Office. July 15, 2009.
Full Text: [PDF format, 64 pages]

The President's Emergency Plan for AIDS Relief (PEPFAR), first authorized in 2003 at $15 billion for 5 years, was reauthorized in 2008 at $48 billion through 2013. PEPFAR supports HIV/AIDS prevention, treatment, and care services, primarily in Africa as well as in Asia and the Caribbean. The Office of the U.S. Global AIDS Coordinator (OGAC) leads implementation of PEPFAR. The Department of Health and Human Services' Centers for Disease Control and Prevention (CDC) and the U.S. Agency for International Development (USAID) are among PEPFAR's primary implementing agencies. In this report, responding to a legislative directive, GAO examined practices used in (1) selecting organizations to implement PEPFAR activities and (2) overseeing these organizations' PEPFAR activities.

 

FEVER PITCH: MOSQUITO-BORN DENGUE FEVER THREAT SPREADING IN THE AMERICAS.
Natural Resources Defense Council. Kim Knowlton et al. July 8, 2009.
Full Text: [PDF format, 22 pages]

Two types of mosquitoes capable of transmitting the dengue fever virus are invading Southern and Mid-Atlantic states, creating conditions more favorable for an outbreak, according to a report released today by the Natural Resources Defense Council. Areas of the United States previously inhospitable to the disease now support populations of mosquitoes capable of carrying the virus - a problem that may worsen with global warming. An estimated 173.5 million Americans live in counties that now contain one or both of the mosquito species.

 

THE GLOBAL ECONOMIC CRISIS AND HIV PREVENTION AND TREATMENT PROGRAMMES: VULNERABILITIES AND IMPACT.
World Bank; Joint United Nations Program on HIV/AIDS (UNAIDS). June 2009
Full Text: [PDF format, 40 pages]

According to the report the financial crises that started in the most developed economies has become a global economic crisis which threatens gains in health and poverty reduction in developing countries.

 

PANDEMIC FLU PREPAREDNESS: LESSONS FROM THE FRONTLINES.
Trust for America's Health, Center for Biosecurity, and Robert Wood Johnson Foundation. June 4, 2009.
Full Text: [PDF format, 24 pages]

The report finds that the initial response to the H1N1 outbreak showed strong coordination and communication and an ability to adapt to changing circumstances from U.S. officials, but it also shows how quickly the nation's core public health capacity would be overwhelmed if an outbreak were more severe or widespread.

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INFLUENZA PANDEMIC: INCREASED AGENCY ACCOUNTABILITY COULD HELP PROTECT FEDERAL EMPLOYEES SERVING THE PUBLIC IN THE EVENT OF A PANDEMIC.
U.S. Government Accountability Office. June 16, 2009.
Full Text: [PDF format, 48 pages]

GAO surveyed the 24 agencies employing nearly all federal workers to gain an overview of government wide pandemic influenza preparedness efforts and found that a wide range of pandemic planning activities are under way. However, as of early 2009, several agencies reported that they were still developing their pandemic plans and their measures to protect their workforce.

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U.S. OBESITY TRENDS 1985-2008.
Centers for Disease Control and Prevention. July 8, 2009.
Full Text: [HTML format with links]

The proportion of U.S. adults who are obese increased to 26.1 percent in 2008 compared to 25.6 percent in 2007. The data come from CDC's Behavioral Risk Factor Surveillance System (BRFSS), a state-based phone survey that collects health information from adults aged 18 and over. In six states, Alabama, Mississippi, Oklahoma, South Carolina, Tennessee and West Virginia, adult obesity prevalence was 30 percent or more. Thirty-two states, including those six, had obesity prevalence of 25 percent or more. Only one state, Colorado, had a prevalence of obesity less than 20 percent. But no state showed a significant decrease in obesity prevalence from 2007 to 2008.

 

DEPRESSION IN PARENTS, PARENTING, AND CHILDREN: OPPORTUNITIES IN IMPROVE IDENTIFICATION, TREATMENT, AND PREVENTION.
National Research Council and Institute of Medicine. June 2009.
Full Text: [HTML format with link to PDF file]

Health and social service professionals who care for adults with depression should not only tackle their clients' physical and mental health, but also detect and prevent possible spillover effects on their children, says the report. To achieve this new family-focused model of depression care, federal and state agencies, nonprofits, and the private sector will have to experiment with nontraditional ways of organizing, paying for, and delivering services, said the committee that wrote the report.

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EMERGING HEALTH CARE ISSUES: FOLLOW-ON BIOLOGIC DRUG COMPETITION.
Federal Trade Commission. June 2009.
Full Text: [PDF format, 120 pages]

The report examines whether the price of biologic drugs, products manufactured using living tissues and microorganisms, could be reduced by competition from so-called "follow-on biologics" (FOBs). FOBs are like generic drugs, but with significant differences. Biologics are increasingly used to treat arthritis, cancer, diabetes, and other diseases. No pathway currently exists for such FOBs to enter the market and compete with their pioneer counterparts. The FTC's Report concludes that providing the U.S. Food and Drug Administration (FDA) with the authority to approve such FOBs would be an efficient way to bring these lower-priced drugs to market.

 

PUTTING WOMEN'S HEALTH CARE DISPARITIES ON THE MAP: EXAMINING RACIAL AND ETHNIC DISPARITIES AT THE STATE LEVEL.
Kaiser Family Foundation. June 2009.
Full Text: [PDF format, 112 pages]

The report documents the persistence of disparities on 25 indicators between white women and women of color, including rates of diseases such as diabetes, heart disease, AIDS and cancer, as well as insurance coverage and health screenings. It also documents disparities in the factors that influence health and access to care, such as income and education. Women of color fared worse than white women on most measures and in some cases the disparities were stark.

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THE EFFECTS OF PROPOSALS TO INCREASE COST SHARING IN TRICARE.
Congressional Budget Office. June 2009.
Full Text: [PDF format, 34 pages]

With the growth of health care costs outstripping the rate of growth of the economy, many policymakers worry that the current TRICARE program, which provides health care for the uniformed services, military retirees, and their families, will become unaffordable in the future. In its budget submissions for 2007, 2008, and 2009, the Department of Defense (DoD) proposed that the enrollment fees, deductibles, and copayments of some TRICARE beneficiaries be increased to encourage more efficient use of the system and to reduce medical spending. The President's budget request for fiscal year 2010 did not include a similar proposal, but the issue of how to address the military's growing health care costs remains unresolved.

 

THE 2009 HEALTH CONFIDENCE SURVEY: PUBLIC OPINION ON HEALTH REFORM VARIES.
Employee Benefit Research Institute. July 2009.
Full Text: [PDF format, 20 pages]

The report indicates that Americans have already formed strong opinions regarding various aspects of health reform, even before details have been released regarding various key factors. These issues include health insurance market reform, the availability of a public plan option, mandates on employers and individuals, subsidized coverage for the low-income population, changes to the tax treatment of job-based health benefits, and regulatory oversight of health care.

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GAME CHANGER: INVESTING IN DIGITAL PLAY TO ADVANCE CHILDREN'S LEARNING AND HEALTH.
Robert Wood Johnson Foundation and Joan Ganz Cooney Center. Ann My Thai et al. June 23, 2009.
Full Text: [PDF format, 64 pages]

The study provides recommendations for the media industry, government, philanthropy and academia to harness the appeal of digital games to improve children's health and learning. It focuses especially on the vital connections that games and digital media can make in promoting children's potential. Among the promising games reviewed are Sesame Street's Color Me Hungry, featuring the Muppet Cookie Monster and Dance Dance Revolution, a mass-market game used in hundreds of schools nationwide. These efforts are helping young children learn about nutrition, healthy habits and exercise.

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SELECTION, WEAR, AND TEAR: THE HEALTH OF HISPANICS AND HISPANIC IMMIGRANTS IN THE UNITED STATES.
RAND Corporation. Ricardo Basurto-Davila. June 24, 2009.
Full Text: [PDF format, 139 pages]

The study discusses issues surrounding the health of Hispanics in general , and of Hispanic immigrants in particular.

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MASSACHUSETTS MIRACLE OR MASSACHUSETTS MISERABLE: WHAT THE FAILURE OF "MASSACHUSETTS MODEL" TELLS US ABOUT HEALTH CARE REFORM.
Cato Institute. Michael Tanner. June 9, 2009.
Full Text: [PDF format, 12 pages]

When Massachusetts passed its pioneering health care reforms in 2006, critics warned that they would result in a slow but steady spiral downward toward a government-run health care system. Three years later, those predictions appear to be coming true, says the author.

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PANDEMIC INFLUENZA: A GUIDE TO RECENT INSTITUTE OF MEDICINE STUDIES AND WORKSHOPS.
Institute of Medicine of the National Academies. May 4, 2009.
Full Text: [PDF format, 5 pages]

In the past several years, the Institute of Medicine has gathered experts to consider major policy issues related to pandemic influenza and other infectious disease threats. The products of these activities include reports and workshop summaries that discuss many dimensions of pandemic planning and response. The overview highlights action and information that could be useful for near-term implementation.

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SWINE FLU (H1N1 VIRUS) SURVEY.
Harvard Opinion Research Program, Harvard School of Public Health. Robert J. Blendon et al. Web posted May 1, 2009.
Full Text: [PDF format, 7 pages]

Following the declaration of a public health emergency due to the new H1N1 virus, also known as swine flu, the Harvard Opinion Research Program at the Harvard School of Public Health conducted a poll about how concerned Americans are about the outbreak, how they are responding and what they believe about transmission, prevention and treatment.

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COMPENDIUM OF MEASURES TO PREVENT DISEASE ASSOCIATED WITH ANIMALS IN PUBLIC SETTING 2009.
National Association of State Public Health Veterinarians, Inc. May 1, 2009.
Full Text: [HTML format, various paging]

Certain venues encourage or permit the public to be in contact with animals, resulting in millions of human-animal interactions each year. These settings include county or state fairs, petting zoos, animal swap meets, pet stores, zoologic institutions, circuses, carnivals, educational farms, livestock-birthing exhibits, educational exhibits at schools and child-care facilities, and wildlife photo opportunities. Although human-animal contact has many benefits, many human health problems are associated with these settings, including infectious diseases, exposure to rabies, and injuries. Such infections have substantial medical, public health, legal, and economic effects.

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HARD TIMES IN THE HEARTLAND.
U.S. Department of Health and Human Services. May 4, 2009.
Full Text: [PDF format, 5 pages]

The study outlines the health care challenges facing rural communities. The report was developed by HHS staff from across the department and comes on the same day Director of the White House Office of Health Reform Nancy-Ann DeParle, HRSA Administrator Mary Wakefield, and Representative Mike Ross will hold a meeting with Americans from rural communities as part of the ongoing series of White House Health Care Stakeholder Discussions.

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DO ELECTRONIC HEALTH RECORDS HELP OF HINDER MEDICAL EDUCATION?
PLoS Medicine. Jonathan U. Peled et al. May 12, 2009.
Full Text: [HTML format, various paging]

Many countries worldwide are digitizing patients' medical records. In the United States, the recent economic stimulus package ("the American Recovery and Reinvestment Act of 2009"), signed into law by President Obama, includes $US17 billion in incentives for health providers to switch to electronic health records (EHRs). The package also includes $US2 billion for the development of EHR standards and best-practice guidelines. What impact will the rise of EHRs have upon medical education? The debate examines both the threats and opportunities.

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WOMEN AT RISK: WHY MANY WOMEN ARE FORGOING NEEDED HEALTH CARE.
Commonwealth Fund. Sheila D. Rustgi et al. May 11, 2009.
Full Text: [PDF format, 12 pages]

Women are more likely than men to feel the pinch of rising health costs and eroding health benefits, with about half (52%) of working-age women reporting problems accessing needed care because of costs, compared to 39 percent of men, the study finds. Women who are insured but have inadequate coverage are especially vulnerable: 69 percent of underinsured women have problems accessing care because of costs, compared to half (49%) of underinsured men.

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HEALTHCARE EQUALITY INDEX: CREATING A NATIONAL STANDARD FOR EQUAL TREATMENT OF LESBIAN, GAY, BISEXUAL AND TRANSGENDER PATIENTS AND THEIR FAMILIES.
Human Rights Campaign Foundation. May 12, 2009.
Full Text: [PDF format, 48 pages]

A key finding in the 2009 Healthcare Equality Index is the dramatic disparity between the number of patient non-discrimination policies inclusive of sexual orientation and those inclusive of gender identity. Less than seven percent of participating facilities protect patients from discrimination based on gender identity, while nearly three-quarters of participants provide these protections based on sexual orientation. The finding is symptomatic of the healthcare discrimination faced by transgender Americans every day, from the explicit denial of healthcare services to insensitive remarks by medical staff.

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BIOLOGICS IN PERSPECTIVE: THE CASE FOR GENERIC BIOLOGIC DRUGS.
AARP Public Policy Institute. Leigh Purvis. May 2009.
Full Text: [PDF format, 2 pages]

Spending on biologic drugs is growing nearly twice as quickly as spending on traditionally developed "small molecule" drugs. One factor in the increase in spending on biologics is the lack of a statutory pathway to approve generic, or bio-equivalent, biologic drugs. Given the substantial out-of-pocket costs that can be associated with using biologic drugs, many patients will face impeded access until generic biologic drugs become available.

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FEDERAL AND STATE CIGARETTE EXCISE TAXES UNITED STATES, 1995-2009.
Centers for Disease Control and Prevention. May 22, 2009.
Full Text: [HTML format, various paging]

On April 1, 2009, the largest federal cigarette excise tax increase in history went into effect, bringing the combined federal and average state excise tax for cigarettes to $2.21 per pack and achieving the Healthy People 2010 (HP2010) objective (27-21a) to increase the combined federal and average state cigarette excise tax to at least $2 per pack. The report summarizes changes in the federal excise tax, as well as state excise taxes for all 50 states and the District of Columbia (DC) from December 31, 1995 to April 1, 2009.

 

HEALTH CARE WORKERS IN PERIL: PREPARING TO PROTECT WORKER HEALTH AND SAFETY DURING PANDEMIC INFLUENZA.
American Federation of State, County and Municipal Employees. April 30, 2009.
Full Text: [PDF format, 14 pages]

A union survey of more than 100 health care facilities across the country reveals that many are not adequately prepared to protect workers' health and safety during an influenza pandemic. The report concludes that workers face a very high risk of becoming infected when caring for patients with pandemic flu unless adequate health and safety measures are in place in advance of a pandemic.

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FINANCIAL AND HEALTH BURDENS OF CHRONIC CONDITIONS GROW.
Center for Studying Health System Change. Ha T. Tu and Genna R. Cohen. April 2009.
Full Text: [PDF format, 6 pages]

Almost 72 million working-age Americans, 18-64 years old, live with chronic conditions, such as diabetes, asthma or depression. For the more than 20 million chronically ill adults with medical bill problems in 2007, one in four went without needed medical care, half put off care and more than half went without a prescription medication because of cost concerns.

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THE COSTS OF INACTION: THE URGENT NEED FOR HEALTH REFORM.
U.S. Department of Health and Human Reform. March 2009.
Full Text: [PDF format, 7 pages]

Americans across the country are demanding comprehensive health reform and cannot afford to wait any longer, according to the study. More and more Americans find themselves uninsured. Those Americans fortunate enough to have health insurance often don't get the quality care they need and deserve. The study highlights the flaws in the health care system and demonstrates the cost of maintaining the status quo.

 

SMOKERS CAN'T BLOW OFF STRESS.
Pew Social & Demographic Trends. Wendy Wang and Paul Taylor. April 8, 2009.
Full Text: [HTML format, various paging]

Ask cigarette smokers why they light up and one answer you're likely to hear is that it relieves stress. But if that's the goal, it's not at all clear that cigarettes deliver the goods. Half (50%) of all smokers say they "frequently" experience stress in their daily lives, compared with just 35% of those who once smoked and have now quit and 31% of those who never smoked, according to the survey.

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PUBLIC HEALTH IN AFRICA: A REPORT OF THE CSIS GLOBAL HEALTH POLICY CENTER.
Jennifer G. Cooke. Center For Strategic & International studies (CSIS). April 2009
Full Text: [PDF format, 16 pages]

According to the report Sub-Saharan Africa is - and for the forseeable future will remain - an enduring preoccupation and target of global public health policies and interventions. In the past decade, the global HIV/AIDS pandemic has spurred a historic and unprecedented mobilization of attention and resources flowing in Africa.

 

MAPPING THE SPREAD OF MALARIA DRUG RESISTANCE.
PLoS Medicine. T. Anderson. April 14, 2009.
Full Text: [HTML format, various paging]

Drug resistance is a recurrent theme in the history of infectious disease control. In the case of malaria, resistance to all but one of the five major classes of drugs is widespread. Such resistance occurs because of the strong selection pressure associated with giving patients anti-malarial drugs. The author argues that the most effective way to stall resistance would therefore be to eliminate selection by halting drug treatment, but this is rarely a feasible option. Hence alternative approaches to managing resistance are needed.

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TRENDS IN TUBERCULOSIS - UNITED STATES, 2008.
Centers for Diseases Control and Prevention. March 19, 2009.
Full Text: [HTML format, various paging]
In 2008, the number of TB cases and annual TB rate reached all-time lows in the United States. After the resurgence of TB during 1985-1992, the annual TB rate has steadily decreased. However, since 2000, the pace of that decline has slowed. To hasten the decline of TB in the United States, intensified efforts are required to address the disproportionately high rates of TB that persist among foreign-born persons and racial/ethnic minorities.

 

INFORMATION, EXTERNALITIES AND SOCIOECONOMICS OF MALARIA IN HONDURAS: A PRELIMINARY ANALYSIS.
Inter-American Development Bank. Maria Victoria Aviles and Jose Cuesta. Web posted March 2009.
Full Text: [PDF format, 19 pages]
The paper explores how different levels of knowledge correlate with desirable preventive and curative practices against malaria in Honduras. It also analyzes "information externalities" associated with non-specific malaria health services, communicational campaigns and organized community networks. Differences in behavior across groups with different levels of proficiency were found statistically significant. While information externalities exist, they nonetheless do not deliver adequate levels of knowledge proficiency to induce desirable anti-malaria behavior. [Note: contains copyrighted material]

 

DEADLY IN PINK: NEW REPORT WARNS BIG TOBACCO HAS STEPPED UP TARGETING OF WOMEN AND GIRLS.
Campaign for Tobacco-Free Kids, American Heart Association, and American Lung Association. February 18, 2009.
Full Text: [PDF format, 36 pages]
The tobacco industry has unleashed its most aggressive marketing campaigns aimed at women and girls in over a decade, according to a report issued today by a coalition of public health organizations. The report warns that these new marketing campaigns are putting the health of women and girls at risk and urges Congress to regulate tobacco marketing by passing legislation granting the U.S. Food and Drug Administration (FDA) authority over tobacco products. [Note: contains copyrighted material]

 

HEALTH, UNITED STATES, 2008 WITH SPECIAL FEATURE ON THE HEALTH OF YOUNG ADULTS.
National Center for Health Statistics. Web posted February 18, 2009.
Full Text: [PDF format, 604 pages]
Charts & Tables: [HTML format with links]
Young adults in the United States aged 18-29 face a number of health challenges, including increases in obesity, high injury rates, and lack of insurance coverage compared to older adults, according to the latest report. It includes a compilation of health data from a number of sources within the federal government and in the private sector. It also features a special section on adults aged 18 to 29, a group making many life choices including decisions about education, marriage, childbearing, and health behaviors such as tobacco and alcohol use, which will affect both their future economic and health status.

 

RECOVERY ACT (ARRA): COMMUNITY HEALTH CENTER GRANTS BY STATE.
U.S. Department of Health and Human Services. March 5, 2009.
Full Text: [HTML format, various paging]
President Obama has announced the release of $155 million authorized by the American Recovery and Reinvestment Act that will support 126 new health centers. These health centers will help people in need, many with no health insurance, obtain access to comprehensive primary and preventive health care services. "We have acted quickly to put Recovery Act dollars to good use in communities across America," said President Obama. "The construction and expansion of health centers will create thousands of new jobs, help provide health care to an estimated 750,000 Americans across the country who wouldn't have access to care without these centers, and take another step toward an affordable, accessible health care system." [Note: contains copyrighted material]

 

HEALTH CARE, HEALTH INSURANCE, AND THE RELATIVE INCOME OF THE ELDERLY AND NONELDERLY.
Center for Retirement Research, Boston College. Gary Burtless and Pavel Svaton. March 2009.
Full Text: [PDF format, 60 pages]
Most American families are covered by an insurance plan that pays for some or all of the health care they consume. Only a comparatively small percentage of families pay for the full cost of insurance out of their cash incomes. As health care has claimed a growing share of consumption, the percentage of care that is financed out of household incomes has declined. Because health care consumption is more important for some groups in the population than others, the growth in spending and changes in the payment system for medical care have reduced the value of standard income measures for assessing relative incomes across age groups and across the income distribution. More than a seventh of total personal consumption now consists of health care that is purchased with government insurance and employer contributions to employee health plans. Standard income measures imply that households with an aged household head have significantly lower average and median incomes than households with a head who is less than 55. [Note: contains copyrighted material]

 

PROGRESS TOWARD MEASLES ELIMINATION - EUROPEAN REGION, 2005-2008.
Centers for Disease Control and Prevention. February 20, 2009.
Full Text: [HTML format, various paging]
During 2005-2008, measles incidence in Europe declined to its lowest level to date. The decline was attributable to high vaccination coverage achieved through 2-dose MCV routine vaccination schedules and implementation of SIAs. However, since 2007, as the outbreaks in eastern parts of Europe subsided, measles resurgence occurred in some Western European countries because of persistent suboptimal coverage with MCV and problems with vaccine acceptance. Ongoing transmission in Western Europe has been linked to multiple introductions of measles virus into other regions, including the United States, where indigenous measles has been eliminated.

 

DOES THE DOCTOR NEED A BOSS?
Cato Institute. Arnold Kling and Michael F. Cannon. Web posted February 2009.
Full Text: [PDF format, 12 pages]
The traditional model of medical delivery, in which the doctor is trained, respected, and compensated as an independent craftsman, is anachronistic, according to the report. Patients with multiple diagnoses require someone who can organize the efforts of multiple medical professionals. At least two forces stand in the way of robust competition from corporate health care providers. First is the regime of third-party fee-for-service payment, which is heavily entrenched by Medicare, Medicaid, and the regulatory and tax distortions that tilt private health insurance in the same direction. Second, state licensing regulations make it difficult for corporations to design optimal work flows for health care delivery. [Note: contains copyrighted material]

 

PROGRESS TOWARD POLIOMYELITIS ERADICATION: AFGHANISTAN AND PAKISTAN, 2008.
Centers for Disease Control and Prevention. March 6, 2009.
Full Text: [HTML format, various paging]
During 2008, despite continued intensive polio eradication activities in Afghanistan and Pakistan, WPV1 and WPV3 continued to circulate in the two shared transmission zones of both countries. In addition, WPV1 was reintroduced into previously polio-free areas of northern Punjab Province, Pakistan. However, most of Afghanistan continues to be free of endemic WPV transmission. In addition to continued support from the international polio eradication partnership, interruption of WPV transmission in Afghanistan and Pakistan will require overcoming one of the most important remaining challenges in polio eradication globally: the barriers to access and vaccination of children in large, remote, and security-compromised areas.

 

THE U.S. COMMITMENT TO GLOBAL HEALTH: RECOMMENDATIONS FOR THE NEW ADMINISTRATION.
Institute of Medicine. January 30, 2009.
Full Text: [HTML format, with links to PDF files]

The Institute suggests that the U.S. should intensify its commitment to global health in the next four years by increasing funding and placing greater importance on health when setting overall U.S. foreign policy. Improving health is the responsibility of the United States as a global leader, and should be recognized as a goal with significant long-term diplomatic, economic, and security benefits for the U.S.

 

LIFE (EVALUATION), HIV/AIDS, AND DEATH IN AFRICA.
National Bureau of Economic Research. Angus Deaton et al. January 2009.
Full Text: [PDF format, 46 pages]

The data from the Gallup World Poll and the Demographic and Health Surveys are used to investigate how subjective wellbeing (SWB) is affected by mortality in sub-Saharan Africa, including mortality from HIV/AIDS. The Gallup data provide direct evidence on Africans' own emotional and evaluative responses to high levels of infection and of mortality. A life evaluation measure is relatively insensitive to the deaths of immediate family, which suggests a low value of life. There are much larger effects on experiential measures, such as sadness and depression, which suggest much larger values of life.

 

THE EFFECT OF REGULATION ON PHARMACEUTICAL REVENUES: EXPERIENCE IN NINETEEN COUNTRIES.
RAND Corporation. Neeraj Sood et al. Web posted January 28, 2009.
Full Text: [PDF format, 14 pages]

The report describes pharmaceutical regulations in nineteen developed countries from 1992 to 2004 and analyzes how different regulations affect pharmaceutical revenues. First, there has been a trend toward increased regulation. Second, most regulations reduce pharmaceutical revenues significantly. Third, since 1994, most countries adopting new regulations already had some regulation in place. The report finds that incremental regulation of this kind had a smaller impact on costs. However, introducing new regulations in a largely unregulated market, such as the United States, could greatly reduce pharmaceutical revenues.

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THE WORLD CAN'T WAIT: MORE FUNDING NEEDED FOR RESEARCH ON NEGLECTED INFECTIOUS DISEASES.
Families USA. December 26, 2008.
Full Text: [PDF format, 68 pages]

The report reveals that the National Institutes of Health (NIH), which accounts for about 78 percent of the nation's public funding for medical research, spent less than 1 percent of its fiscal year 2007 budget on diseases that are prevalent among more than a quarter of the world's population. The eight diseases, African sleeping sickness, Buruli ulcer, Chagas disease, cholera, dengue, leishmaniasis, malaria, and tuberculosis, in the report are classified by the scientific community as "neglected infectious diseases" because of their high prevalence in impoverished and marginalized populations in the developing world and because of the limited funds allocated for research on them.

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THE CASE FOR PUBLIC PLAN CHOICE IN NATIONAL HEALTH REFORM: KEY TO COST CONTROL AND QUALITY COVERAGE.
Institute for America's Future. Jacob S. Hacker. December 18, 2008.
Full Text: [PDF format, 27 pages]

A health care system that contains costs and drives value must include a good public plan if the broad goals of reform, universal insurance and improved value, are to be achieved. Private insurance and public insurance have distinct strengths and weaknesses, and thus should be encouraged to compete side by side to attract enrollees on a level playing field that rewards plans that deliver better value and health to their enrollees, according to the report.

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COST SHARING FOR HEALTH CARE: FRANCE, GERMANY, AND SWITZERLAND.
Kaiser Family Foundation. January 12, 2009.
Full Text: [PDF format, 25 pages]

As policymakers in the United States weigh options for reform to the nation's health care system, the level of cost sharing that consumers face when they receive services covered by their health plans is a major consideration, especially for those with serious health conditions. The brief examines how three European countries, France, Germany, and Switzerland, have dealt with cost sharing in their health systems. It provides an overview of each country's health care system, its cost-sharing policies, and the cost-sharing exemptions and limits that help protect people with low incomes, certain medical conditions or high medical costs, and other characteristics from burdensome, excessive costs.

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AA09009
Watkins, David I. 25 YEARS LATER: THE AIDS VACCINE SEARCH GOES ON. Scientific American, October 2008
Full Text: [HTML format, 5 pages]

Repeated failures in the quest for an AIDS vaccine have sent investigators back to the drawing board. HIV has defeated the best efforts of vaccine scientists because the virus evades and undermines the immune system. If HIV infection can't now be prevented, a second goal of vaccine makers is to reduce the virus's spread and the severity of illness it causes. Researchers are already returning to basic science to follow new leads.

 

Courage and hope: stories from teachers living with HIV in sub-Saharan Africa.
Worldbank. December 2008
Full Text: [pdf format, 86 pages]

There are currently around 122,000 teachers in sub-Saharan Africa who are living with Human Immunodeficiency Virus (HIV), the vast majority of whom have not sought testing and do not know their HIV status. Stigma remains the greatest challenge and the major barrier to accessing and providing assistance to these teachers. The stories documented here give voice to the real life experiences of 12 HIV-positive teachers, five of whom are women, from Burkina Faso, Cameroon, Ghana, Kenya, Mozambique, Rwanda, Senegal, Tanzania (both Mainland and Zanzibar) and Zambia.

 

THE WORLD HEALTH REPORT 2008: PRIMARY HEALTH CARE - NOW MORE THAN EVER.
World Health Organisation (WHO), October 2008
Full Text: [pdf format, 148 pages]

WHO hopes to start a global conversation on the effectiveness of primary health care as a way of reorienting national health systems. As the report notes, health systems will not naturally gravitate towards greater fairness and efficiency. Deliberate policy decisions are needed. The evidence and arguments set out in the report should help in this task.

 

POTENTIAL HEALTH RISKS OF EXPOSURE TO NOISE FROM PERSONAL MUSIC PLAYERS AND MOBILE PHONE INCLUDING A MUSIC PLAYING FUNCTION.
Scientific Committee on Emerging and Newly Identified Health Risks, European Commission. Konrad Ydzinski and Thomas Jung. Web posted October 15, 2008.
Full Text:[PDF format, 81 pages]

Listening to personal music players at a high volume over a sustained period can lead to permanent hearing damage, according to an opinion of the EU Scientific Committee on Emerging and Newly Identified Health Risks (SCENIHR). The scientific opinion shows that 5-10% of personal music player listeners risk permanent hearing loss, if they listen to a personal music player for more than one hour per day each week at high volume settings for at least 5 years.

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CHILDREN'S ENVIRONMENTAL HEALTH: 2008.
U.S. Environmental Protection Agency. Web posted October 11, 2008.
Full Text: [PDF format, 32 pages]

The publication outlines national efforts to protect children from environmental risks over the last year. The agency has funded research on how the environment affects children's health, promoted the education of health care providers, published information about how climate change affects children's health, and assembled data to quantify the extent of children's health issues. Issues in the report include childhood asthma, lead poisoning, exposure to the sun, children and chemicals, integrated pest management, Pediatric Environmental Health Specialty Units and research findings.

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PREVENTION OF RICKETS AND VITAMIN D DEFICIECNY IN INFANTS, CHILDREN, AND ADOLESCENTS.
American Academy of Pediatrics. Carol L. Wagner and Frank R. Greer. Web posted October 13, 2008.
Full Text: [PDF format, 11 pages]

Rickets in infants attributable to inadequate vitamin D intake and decreased exposure to sunlight continues to be reported in the United States. There are also concerns for vitamin D deficiency in older children and adolescents. Because there are limited natural dietary sources of vitamin D and adequate sunshine exposure, due to concern for the risk of skin cancer, the recommendations to ensure adequate vitamin D status have been revised to include all infants, including those who are exclusively breastfed and older children and adolescents.

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WORLD MALARIA REPORT 2008.
World Health Organization, United Nations. Web posted September 26, 2008.
Full Text: [PDF format, 215 pages]

Half of the world's population is at risk of malaria and an estimated 247 million cases led to nearly 881 000 deaths in 2006. The advent of long-lasting insecticidal nets and artemisinin-based combination therapy, plus a revival of support for indoor residual spraying of insecticide, presents a new opportunity for large-scale malaria control. The report describes the global distribution of cases and deaths, how WHO-recommended control strategies have been adopted and implemented in endemic countries, sources of funding for malaria control, and recent evidence that prevention and treatment can alleviate the burden of disease.

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U.S. POLICY REGARDING PANDEMIC-INFLUENZA VACCINES.
Congressional Budget Office, Congress of the United States. Web posted September 15, 2008.
Full Text: [PDF format, 56 pages]

The paper focuses on the U.S. government's role, in the development of new vaccines and the capacity to manufacture them. It provides information on progress and on the potential cost of achieving vaccine-related goals, the continuing expenditures that are likely to be needed to maintain preparedness, and the experience of other countries in preparing for a possible pandemic. The work is based on a review of the academic literature, on industry data, and on interviews with government and industry experts who are working to improve the response of vaccine producers to a potential influenza pandemic.

 

AA08303
Binns, Corey TACKLING HIV. Stanford Social Innovation Review, Vol. 6, no. 3, Summer 2008, pp. 73-74

Full text available from your nearest American Library

Grassroot Soccer is a U.S.-based charitable organization which uses soccer's popularity in sub-Saharan Africa to help educate adolescents there about HIV and AIDS. Dealing with partners across sub-Saharan Africa, Grassroot Soccer educates tens of thousands of adolescents. Binns notes that Grassroot Soccer's efforts are critical; out of 29.4 million people living in sub-Saharan Africa with HIV/AIDS, 10 million are between the ages of 15 and 24, and 3 million are under the age of 15. Grassroot Soccer's 20-hour workshops are discussions which often center around a soccer ball, or use a soccer ball as prop. Participants discuss the effects and dangers of HIV/AIDS, how to avoid contracting it, and how to not stigmatize those with HIV/AIDS. At the end of the program, there is a graduation ceremony attended by many community leaders, and the graduation ceremony is often at a professional soccer game or tournament. The graduates of the program are encouraged to teach others about HIV/AIDS.

 

FOOD PRICES AND THE AIDS RESPONSE.
International Food Policy Research Institute. Stuart Gillespie. August 2008.
Full Text: [PDF format, 2 pages]

A combination of new and ongoing forces is driving global food prices. Hunger and HIV often coexist and interact. According to the World Food Programme, 22 of 30 “high-risk countries” in need of external food assistance are in sub-Saharan Africa, many of which have serious AIDS epidemics. In southern Africa where AIDS is hyper endemic, high levels of income inequality and population mobility are among the key drivers of the epidemic, factors that are likely to be further affected by food price shocks. Households and communities continue to struggle as multiple shocks and stresses, social, economic, political, environmental, and health-related, threaten their livelihood bases.

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ENTITLEMENTS: NOT JUST A HEALTH CARE PROBLEM.
American Enterprise Institute for Public Policy Research. Andrew G. Biggs. Web posted August 23, 2008.
Full Text: [HTML format, various paging]

A new consensus on entitlement reform has developed in Washington: rising per-capita health care spending is the only real crisis besetting the government’s entitlement programs, while America’s aging population and Social Security play minor roles. Using standard accounting practices and including all major government entitlement programs, population aging will play an equal role with health care cost growth over the next seventy-five years and a significantly larger role than health spending over the next few decades. While rising health care spending is indeed a pressing issue, discounting population aging leaves out half the problem and ignores half the potential solutions.

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SEIZING THE OPPORTUNITY ON AIDS AND HEALTH SYSTEMS.
Center for Global Development. Nandini Oomman. August 5, 2008.
Full Text: [PDF format, 72 pages]

Donors spend billions of dollars to fight HIV/AIDS in developing countries, but poor integration between donors and host country health systems risks undermining international efforts to prevent and treat AIDS. The report finds that the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), the Global Fund to Fight AIDS, Tuberculosis and Malaria, and the World Bank’s Multi-Country AIDS Program for Africa have helped establish AIDS-specific systems and processes distinct from those of other health programs. At the same time, these AIDS-specific processes use many of the same resources as a country’s broader health system

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INTERNATIONAL MONETARY FUND PROGRAMS AND TUBERCULOSIS OUTCOMES IN POST-COMMUNIST COUNTRIES.
PLoS Medicine. David Stuckler et al. Web posted July 23, 2008.
Full Text: [PDF format, 12 pages]

The study finds that the International Monetary Fund (IMF) economic reform programs are associated with worsened tuberculosis incidence, prevalence, and mortality rates in post-communist Eastern European and former Soviet countries, independent of other political, socioeconomic, demographic, and health changes in these countries.

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Groopman, Jerome SUPERBUGS: THE NEW GENERATION OF RESISTANT INFECTIONS IS ALMOST IMPOSSIBLE TO TREAT
(New Yorker, Vol. 84, No. 24, August 11 & 18, 2008, pp. 46-55)
Full Text: [HTML format, 10 pages]

Perhaps not an article to read if you have medical treatment scheduled: a good place to get infected by superbugs -- multidrug-resistant bacteria -- is hospital. Before the development of antibiotics, pneumonia was the number 1 cause of death in the U.S., and amputation was sometimes the only cure for infected wounds. That changed in the 1930s, but much of the world is now facing a return to the preantibiotic era. It hasn't helped that many doctors have routinely prescribed antibiotics for viral infections, and that antibiotics play a big role in agribusiness. Dr. Robert Moellering, a leading expert on antibiotic resistance, notes gloomily that while we may be able to slow this resistance down, "it's unlikely that we will ever be able to conquer it."

 

WORLDWIDE PREVALENCE OF ANAEMIA 1993-2005.
World Health Organization United Nations. Web posted August 26, 2008.
Full Text: [PDF format, 51 pages]

Anemia is a public health problem that affects populations in both rich and poor countries. Its primary cause is iron deficiency, but a number of other conditions, such as malaria, parasitic infection, other nutritional deficiencies, and haemoglobinopathies are also responsible, often in combination. The report provides estimates of the prevalence of anemia at country, regional and global levels for all population groups: preschool-age children, school-age children, pregnant and non-pregnant women, men, and elderly.

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MEDICAL TOURISM: CONSUMERS IN SEARCH OF VALUE.
Deloitte Center for Health Solutions. Web posted August 8, 2008.
Full Text: [PDF format, 32 pages]

The impact of rising U.S. health care costs is prompting increasing numbers of consumers to consider outbound medical tourism as a viable care option. In 2007, an estimated 750,000 Americans traveled abroad for medical care; this number is anticipated to increase to 6 million by 2010. Concurrently, inbound medical tourism and medical tourism across state lines continue to present opportunities for specialty hubs offering treatments unavailable elsewhere in the world or in a community setting.

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STRONG AS THE WEAKEST LINK: MEDICAL RESPONSE TO A CATASTROPHIC EVENT.
National Health Policy Forum. Eileen Salinsky. Web posted August 14, 2008.
Full Text: [PDF format, 30 pages]

Natural disasters and acts of terrorism have placed a spotlight on the ability of health care providers to surge in response to catastrophic conditions. The paper reviews the status of efforts to develop the capacity and capabilities of the health care system to respond to disasters and other mass casualty events. Strategies for adapting routine medical practices and protocols to the demands posed by extraordinary circumstances and scarce resources are summarized. Existing federal roles, responsibilities, and assets relative to the contributions of state and local government and the private sector are described, including specific programmatic activities such as the Strategic National Stockpile, the National Disaster Medical System, and the Hospital Preparedness Program.

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F AS IN FAT: HOW OBESITY POLICIES ARE FAILING IN AMERICA 2008.
Trust of America’s Health. Jeffrey Levi et al. Web posted August 24, 2008.
Full Text: [PDF format, 144 pages]

The study reports that the rates of obesity in the United States have grown in 37 states. Although many promising programs have emerged to promote healthy eating and exercise, they are not preventing the spread of obesity. More than 25 percent of adults are obese in 28 states, while more than 20 percent of adults are obese in every state except Colorado. Moreover, not one state showed a decrease in numbers of obese people. The authors recommend that the federal government convene a partnership of state and local governments, businesses, and schools to implement a strategy to tackle obesity.

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VOICES OF ALZHEIMER’S DISEASE.
Alzheimer’s Association. Peter Reed et al. Web posted August 27, 2008.
Full Text: [PDF format, 36 pages]

Hundreds of people living in the early stage of Alzheimer’s stated that the stigma associated with the disease is one of their top concerns during town hall meetings that the Alzheimer’s Association held across the nation.

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TUBERCULOSIS: INTERNATIONAL EFFORTS AND ISSUES FOR CONGRESS. Congressional Research Service, RL34246, Library of Congress. Tiaji Salaam-Blyther. Web posted June 22, 2008.
Full Text: [PDF format, 30 pages]

Infectious diseases are estimated to cause more than 25% of all deaths around the world. International air travel and trade have complicated efforts to detect and contain infectious diseases. People could cross borders carrying a highly contagious disease before an infectious agent causes symptoms. World Health Organization (WHO) indicates that the global incidence of TB per capita peaked around 2003 and since then, incidence per 100,000 population stabilized in Europe and declined in all five WHO regions, although the number of new cases increased between 2005 and 2006 in Africa, the Middle East, Europe, and Southeast Asia. In sub-Saharan Africa, weak health systems, minimal access to health facilities, insufficient staffing and little human resource development, ill-equipped and substandard laboratories, and human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) co-infection have limited countries’ ability to contain TB.

 

ANALYSES AND EFFECTS OF GLOBAL CHANGE ON HUMAN HEALTH AND WELFARE AND HUMAN SYSTEMS. U.S. Environmental Protection Agency. Janet L. Gamble et al. Web posted July 19, 2008.
Full Text: [PDF format, 284 pages]

The report discusses the potential impacts of climate change on human health, human welfare, and communities. The factors include the elderly, the poor, children, and people with chronic medical conditions. The report also identifies adaptation strategies to help respond to the challenges of a changing climate and identifies near- and long-term research goals for addressing data and knowledge gaps.

 

TOWARD A GLOBAL VIEW OF ALCOHOL, TOBACCO, CANNABIS, AND COCAINE USE: FINDINGS FROM THE WHO WORLD HEALTH SURVEYS. PLoS Medicine. Louisa Degenhardt et al. Web posted July 2, 2008.
Full Text: [PDF format, 15 pages]

The study presents novel data on the epidemiology drug use from representative, cross-national samples representing all regions of the world. Clear differences in drug use exist across the regions of the world, with the U.S.’s estimated to have among the highest levels of both legal and illegal drug use among all countries surveyed. These differences may be closing in more recent birth cohorts, with higher levels of drug use seen among young adults across countries. Drug use is related to income, but does not appear to be simply related to drug policy, since countries with more stringent policies towards illegal drug use did not have lower levels of such drug use than countries with more liberal policies.
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FINANCING THE U.S. HEALTH SYSTEM: ISSUES AND OPTIONS FOR CHANGE. Bipartisan Policy Center. Meena Seshamani et al. Web posted June 26, 2008.
Full Text: [PDF format, 36 pages]

Health reform proposals across the spectrum have included changes in how the U.S. health system is financed. The goals of such changes range from using financial incentives to promote system goals, and replacing insufficient financing mechanisms with more sustainable ones, to increasing federal subsidies for a reformed health system. The paper examines the implications of different options for financing the health system. It describes recently proposed policies, including continuing current financing and redirecting health spending to more effective uses, rolling back high-income tax cuts, modifying the current tax exclusion for health benefits, a play-or-pay model, and a value-added tax.
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SAFER WATER FOR BETTER HEALTH. World Health Organization, United Nations. Annette Pruss-Ostun et al. Web posted June 29, 2008.
Full Text: [PDF format, 60 pages]

The study, which is the first-ever report depicting country-by-country estimates of the burden of disease due to water, sanitation and hygiene, highlights how much disease could be prevented through increased access to safe water and better hygiene. The overview provides the epidemiological evidence and economic arguments for fully integrating water, sanitation and hygiene in countries’ disease reduction strategies. It also provides the basis for preventive action by all relevant sectors managing critical water resources and services in support of public health efforts. Lack of safe water, sanitation and hygiene remains one of the world’s most urgent health issues.
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A COMPARISON OF THE HEALTH SYSTEM IN CHINA AND INDIA. RAND Corporation. Sai Ma and Neeraj Sood. June 2008.
Full Text: [PDF format, 60 pages]

China and India have rapidly developing economies and large populations. Over the past 50 years, both countries have also made substantial gains in health, including increased life expectancy, reduced infant mortality, and the eradication of several diseases. Yet, despite these gains, the health status of residents of China and India still lags that of other populations, and the health gains in each country have been uneven across subpopulations. Although the two nations’ health systems have a great deal in common, they also display fundamental differences. A comparison illuminates the challenges that are common to both and also underscore the unique challenges each faces.
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GEOLOGICAL PREDICTORS AND DEVELOPMENT OUTCOMES OF PERSISTENT CHILDHOOD OVERWEIGHT. Economic Research Service, U.S. Department of Agriculture. Sara Gable et al. June 13, 2008.
Full Text: [PDF format, 42 pages]

Child obesity poses short- and long-term health risks and may have negative social and economic consequences in adulthood. The study uses data on 8,000 children followed from kindergarten through third grade as part of the Early Childhood Longitudinal Study-Kindergarten Class to examine predictors of persistent childhood overweight and associated academic and socio emotional outcomes. Results show that socioeconomic status, gender, race, and behavioral and environmental factors influence risk of persistent overweight. The odds of children being overweight increased 3 percent for each additional hour of television that they watched per week and 9 percent for each family meal per week that they did not experience.

 

EXPLORING THE LINKS BETWEEN HIV/AIDS, SOCIAL CAPITAL, AND DEVELOPMENT. World Bank. Antonio C. David and Carmen A. Li. Web posted July 23, 2008.
Full Text: [PDF format, 31 pages]

The study quantifies the impact of the HIV/AIDS epidemic on social capital with cross-country data. Using data from the World Values Survey, the authors estimate reduced-form regressions of prevalence, institutional quality, social distance, and economic indicators, which are the main determinants of social capital controlling for HIV. The results indicate that HIV prevalence affects social capital negatively. Moving from a country with a relatively low level of HIV prevalence, such as Estonia, to a country with a relatively high level, such as Uganda, there is a more than 11 percent point decline in social capital.
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THE GLOBAL FUND TO FIGHT AIDS, TUBERCULOSIS, AND MALARIA: PROGRESS REPORT AND ISSUES FOR CONGRESS.
Congressional Research Service, RL33396, Library of Congress. Tiaji Salaam-Blyther. Web posted May 27, 2008.
Full Text [PDF format, 22 pages]

The Global Fund to Fight AIDS, Tuberculosis, and Malaria is an independent foundation that seeks to gather and disburse new resources in developing countries aimed at countering the three diseases. The Fund is a financing vehicle, not an implementing agency, with the United States as the largest single contributor to the Global Fund. This report discusses the Fund’s progress to date.

 

THE WORLD BANK’S COMMITMENT TO HIV/AIDS IN AFRICA. World Bank. May 2008.
Full Text [PDF format, 146 pages].

The World Bank is committed to support Sub-Saharan Africa in responding to the HIV/AIDS epidemic. This Agenda for Action (AFA) is a road map for the next five years to guide Bank management and staff in fulfilling that commitment. It underscores the lessons learned and outlines a line of action. About 22.5 million Africans are HIV positive, and AIDS is the leading cause of premature death on the continent. HIV/AIDS affects young people and women disproportionately. As a result of the epidemic, an estimated 11.4 million children under age 18 have lost at least one parent. Its impact on households, human capital, the private sector, and the public sector undermines the alleviation of poverty, the Bank’s overarching mandate.

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WORLD HEALTH STATISTICS 2008.
World Health Organization, United Nations. Web posted May 26, 2008.
Full Text [PDF format, 115 pages]

World Health Statistics 2008 presents the most recent health statistics for WHO’s 193 Member States. This edition includes 10 highlights in health statistics, as well as an expanded set of over 70 key health indicators. It includes, for the first time, trend data where the statistics are available and of acceptable quality.

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SEXUAL & REPRODUCTIVE HEALTH IN THE MIDDLE EAST AND NORTH AFRICA.
Population Reference Bureau. Farzaneh Roudi-Fahimi and Lori Ashford. May 2008.
Full Text [PDF format, 45 pages]

Sexual and reproductive health is a broad concept encompassing health and well-being in matters related to sexual relations, pregnancies, and births. The report brings together the latest available data on sexual and reproductive health for countries in the MENA region. Cultural sensitivities and taboos surrounding sexuality are particularly pronounced in the MENA region, and make the role of the media vital in providing objective information about sexual and reproductive health matters. The media has the power to break the culture of silence that surrounds sexual and reproductive health, a silence that all too often prevents people from seeking information and care and prevents governments from putting the issues on their development agendas.

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EVIDENCE ON THE COSTS AND BENEFITS OF HEALTH INFORMATION TECHNOLOGY.
Congressional Budget Office. May 12, 2008.
Full Text [PDF format, 48 pages]

Information plays a key role in health care. Providers such as physicians and hospitals generate and process information as they provide care to patients. Managing that information and using it productively pose a continuing challenge, particularly in light of the complexity of the U.S. health care sector. Health information technology (health IT) has the potential to increase the efficiency of the health sector by helping providers manage information. It could also improve the quality of health care and, ultimately, the outcomes of that care for patients. The term “health IT” generally refers to computer applications for the practice of medicine.

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MEDICAID MANAGED CARE FOR CHILDREN IN CHILD WELFARE.
Center for Health Care Strategies, Inc. Kamala Allen. Web posted May 21, 2008. Full Text [PDF format, 8 pages]

Children in the child welfare system have an extremely high prevalence of physical and behavioral health problems. This issue brief examines the complex physical and behavioral health care needs and associated costs for children in child welfare and outlines critical opportunities and challenges within Medicaid to better manage care for this high-risk, high-cost population

.

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QUICK HEALTH FACTS 2008: A COMPILATION OF SELECTED STATE DATA.
AARP Public Policy Institute. Leigh Purvis and Lynda Flowers. Web posted May 11, 2008.
Full Text [PDF format, 66 pages]

The report looks at each state’s health care by providing comparable state-level and national data for over 30 indicators. Data are presented for each state and the District of Columbia in regard to demographics, Medicare, Medicaid, and health insurance coverage.

 

RECENT WORLDWIDE RESEARCH ON ANIMAL POX VIRUSES.
Open Source Center. Alfred D. Steinberg. Web posted on June 8, 2008.
Full Text [PDF format, 96 pages]

There has been concern regarding the level of persistent immunity against smallpox in individuals vaccinated decades ago. A certain level of confusion has been introduced by variable results regarding the degree of residual immunity from different studies in various countries. Some studies have shown that substantial antibody levels against vaccinia virus in a number of individuals, whereas other studies describe less robust immunity. However, short of a recurrence of smallpox or the emergence of a new aggressive Orthopoxvirus, people who are not immune should not be given the old vaccinia smallpox vaccine. That historical vaccine is too toxic, inducing unacceptable adverse reactions in many people. A newer vaccine with far fewer side effects might be acceptable as a relatively routine immunogen should one be required.

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STATE OF THE WORLD’S MOTHERS 2008: CLOSING THE SURVIVAL GAP FOR CHILDREN UNDER 5.
Save the Children. Web posted June 2008.
Full Text [PDF format, 56 pages]

Worldwide, more than 200 million children under age 5 do not get the basic health care they need. This contributes to nearly 10 million children dying needlessly every year from highly preventable or treatable ailments such as diarrhea and pneumonia. While there has been significant progress in reducing the overall death toll among children under age 5 in recent decades, death rates among the poorest of the poor have not improved nearly so well, and in some countries they have gotten worse. These widening health care inequities unfairly condemn millions of the world’s poorest children to early death or a lifetime of ill health. The report examines where the health care gaps between the poorest and best-off children are widest, and where they are smallest. It examines how millions of children’s lives could be saved by ensuring all children get essential, low-cost health care.

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GLOBAL HIV/AIDS: A MORE COUNTRY-BASED APPROACH COULD IMPROVE ALLOCATION OF PEPFAR FUNDING.
U.S. Government Accountability Office. Web posted April 29, 2008.
Full Text: [pdf format, 73 pages]

The President's Emergency Plan for AIDS Relief (PEPFAR) provides assistance for combating HIV/AIDS around the world, with global targets for prevention, treatment, and care. The "Leadership Against HIV/AIDS, TB and Malaria Act of 2003," which authorized the $15 billion program, contains directives to guide the Office of the U.S. Global AIDS Coordinator's allocation of this funding. The act expires in September 2008. The President has announced his intention to ask Congress to authorize $30 billion for these efforts for the next 5 years.

 

ROLLING BACK MALARIA: RHETORIC AND REALITY IN THE FIGHT AGAINST A DEADLY KILLER.
Health Policy Outlook, American Enterprise Institute. Roger Bate. Web posted May 5, 2008.
Full Text: [pdf format, 9 pages].

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For the past thirty years, the fight against malaria has been long on rhetoric and short on action. The Roll Back Malaria (RBM) partnership, launched by the World Health Organization (WHO) ten years ago in 1998, continued this trend. However, since 2005, U.S. government made striving efforts in improving malaria control. While significant problems still remain, for the first time since the 1960s, malaria is being fought effectively on a global scale.

 

GEOGRAPHY MATTERS: CHILD WELL-BEING IN THE STATES.
Every Child Matters Education Fund. Web posted May 7, 2008.
Full Text: [pdf format, 13 pages].

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Across the United States, where a child is born and raised can make a large difference to their chances of getting and staying healthy and then surviving to adulthood, according to the study. Such inequalities affect all Americans, rich and poor alike, and weaken both our economy and our democracy.

 

COUNTDOWN TO 2015: MATERNAL, NEWBORN AND CHILD SURVIVAL.
United Nations. Web posted April 22, 2008.
Full Text: [pdf format, 111pages]

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Countdown to 2015 aims to advance a few of the Millennium Development Goals, including Goal 4: Reduce child mortality and Goal 5: Improve maternal health. It lays out its Principles as Focus on coverage, Focus on effective interventions, Maintain a country orientation, and Build on existing goals and monitoring efforts. The main focus of action is on the 68 priority countries which make up 97% of the world's maternal and child deaths.

 

PUBLIC HEALTH WORKFORCE SHORTAGE IMPERIL NATION'S HEALTH.
Center for Studying Health System Change. Debra A. Draper et al. Web posted April 26, 2008.
Full Text: [pdf format, 8 pages]

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Significant new federal funding flowed to state and local agencies to bolster public health activities and emergency preparedness after the 9/11 terrorist attacks. But initial emphasis on shoring up the nation's public health system has faded. Local health departments face a mounting workforce crisis as they struggle to recruit, train and retain qualified workers to meet their communities' needs. Local public health agencies have pursued strategies to improve workforce monitoring and planning, recruitment, retention, development and training, and academic linkages. However, little progress has been made to alleviate the shortages. Without additional support to address workforce issues, including the recruitment of the next generation of public health leaders, it is unlikely that local public health agencies will succeed in meeting growing community need.

 

THE GRASS IS NOT ALWAYS GREENER: A LOOK AT NATIONAL HEALTH CARE SYSTEMS AROUND THE WORLD.
Cato Institute, Policy Analysis #613. Michael Tanner. March 18, 2008.
Full Text: [pdf format, 48 pages]

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Critics of the U.S. health care system frequently point to other countries as models for reform. They point out that many countries spend far less on health care than the United States yet seem to enjoy better health outcomes. Nonetheless, the broad and growing trend around the world is movement away from centralized government control and the introduction of more market-oriented features.

 

THE REVERSAL OF FORTUNES: TRENDS IN COUNTY MORTALITY AND CROSS-COUNTY MORTALITY DISPARITIES IN THE UNITED STATES.
Public Library of Science Medicine. Majid Ezzati et al. April 2008.
Full Text: [pdf format, 12 pages]

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Even though average life expectancy has steadily increased in the United States, there is limited information on long term mortality trends in the US counties. There was a steady increase in mortality inequality across the US counties between 1983 and 1999, resulting from increase in mortality among the worst-off segment of the population. Female mortality increased in a large number of counties, mainly due to chronic diseases related to smoking, overweight and obesity, and high blood pressure.

 

INFLUENZA PANDEMIC: EFFORTS UNDER WAY TO ADDRESS CONSTRAINTS ON USING ANTIVIRALS AND VACCINES TO FORESTALL A PANDEMIC.
United States Government Accountability Office (GAO-08-92) December 21, 2007
Full Report: [pdf format, 76 pages]

Individual countries and international organizations have developed and begun to implement a strategy for forestalling (that is, containing, delaying, or minimizing the impact of) the onset of a pandemic. Individual countries and international organizations have developed and begun to implement a strategy for forestalling (that is, containing, delaying, or minimizing the impact of) the onset of a pandemic. Antivirals and vaccines may help forestall a pandemic. GAO was asked to examine (1) constraints upon the use of antivirals and vaccines to forestall a pandemic and (2) efforts under way to overcome these constraints. HHS stressed that vaccines and antivirals must be viewed in a larger context. State and HHS commented that the term "forestall" is ambiguous and misleading. However, GAO has used the word in a way that is consistent with WHO's use of the term. The effectiveness of antivirals could be limited if they are used more than 48 hours after the onset of symptoms or by the emergence of strains resistant to antivirals. Due to the time required to identify the virus and develop and manufacture a pandemic vaccine--20 to 23 weeks according to HHS--such vaccines are likely to play little or no role in efforts to forestall a pandemic in its initial phases. The availability of antivirals and vaccines in a pandemic could be inadequate due to limited production, distribution, and administration capacity. WHO has stated that it is unlikely that sufficient quantities of antivirals will be available in any country at the onset of a pandemic. New methods for developing vaccines are being studied in order to reduce the amount of vaccine that is needed and to increase the number of strains against which it is effective. Pre-pandemic vaccines, which are formulated to target influenza strains that have the potential to cause a pandemic, are being developed.

 

THE BUSINESS OF HEALTH IN AFRICA: PARTNERING WITH THE PRIVATE SECTOR TO IMPROVE PEOPLE'S LIVES.
International Finance Corporation, World Bank. Web posted December 18, 2007.
Full Report: [pdf format, 154 pages]

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Health care in Sub-Saharan Africa is the worst in the world. Few countries in the region spend $34-$40 per person per year to provide basic health care. This study estimates that over the next ten years, $25-$30 billion of new investment will be needed in health care assets; i.e., hospitals and clinics, to meet health care demands. The report also highlights the role played by the private sector and identifies policy changes that governments and international donors must make to close the health care gap in Sub-Saharan Africa.

 

GLOBAL CANCER FACTS & FIGURES: ESTIMATED NUMBER OF NEW CANCER CASES BY WORLD AREA, 2007.
American Cancer Society. Web posted December 17, 2007.
Full Report: [pdf format, 52 pages]

Cancer is classified as "a group of diseases characterized by uncontrolled growth and spread of abnormal cells" that can result in death. Worldwide one in eight deaths is due to cancer-more than AIDS, tuberculosis, and malaria combined. This report estimates that there will be 12 million new cancer cases in 2007. The report presents these estimations by geographic area and by cancer type.

 

PRIORITIES, AND DONORS: THE KAISER/PEW GLOBAL HEALTH SURVEY.
Kaiser Family Foundation and the Pew Global Attitudes Project. Web posted December 13, 2007.
Full Report: [pdf format, 80 pages]

This survey examines how people perceive and prioritize health in their countries. People in 47 countries were polled and asked to share their views on health as a priority for their government and in their own lives. This report provides the results of this survey and examines public health priorities in low and middle income countries. Some of these priorities are: preventing and treating HIV, fighting hunger, and accessing health care.

 

MASS MEDIA, STIGMA, AND DISCLOSURE OF HIV TEST RESULTS: MULTILEVEL ANALYSIS IN THE EASTERN CAPE, SOUTH AFRICA.
P L Hutchinson, X Mahlalela, Josh Yukich. AIDS Education and Prevention. New York: Dec 2007. Vol. 19, Iss. 6; pg. 489-510

Full text available from your nearest American Library

Mass Media have been a critical part of the global response to HIV/AIDS by increasing awareness, providing essential information, promoting health behaviors and encouraging condom use ... HIV/AIDS stigma is often rooted in the fear on infection but is also commonly associated with negative cultural stereotype and attitude towards sex. Recent research in KwaZulu-Natal indicate that disclosure of HIV status in uncommon, the consequences of disclosure can be severe, as in the case of GUGU Dlamini who was killed in the township for making a public disclosure of World AIDS Day in 1998. Numerous studies have examined the uptake of HIV risk reduction strategies such as the use of condoms, using multilevel models.

 

THE CHECKLIST Gawande, Atul New Yorker, Vol. 83, No. 39, December 10, 2007, pp. 86-95
Full text: [Available from Publisher's Website]

The human body can now survive conditions that had once been uniformly fatal, such as a ruptured colon, a massive heart attack or 30 minutes in an icy fishpond, thanks mainly to intensive care. However, as Gawande (author of COMPLICATIONS and BETTER, both in our Rosa Parks Library in Soweto) notes, "For every drowned and pulseless child rescued by intensive care, there are many who don't make it" -- often because a simple step is forgotten: "Intensive-care medicine has become the art of managing extreme complexity". Enter Peter Pronovost, a critical-care specialist at Johns Hopkins Hospital, who has pioneered a checklist that has saved many lives and millions of dollars. Naturally, there is considerable resistance among medical practitioners to the notion that a form can make a difference; and that it probably the main reason for Gawande writing this article.

 

AIDS EPIDEMIC UPDATE.
Joint United Nations Programme on HIV/AIDS, World Health Organization (WHO). Web posted November 20, 2007.
Full Report: [pdf format, 60 pages]

[Note: Contains copyrighted material.]

This report, using enhanced and expanded methodology, provides a better understanding of the global HIV epidemic. The data show that as a result of HIV programs, the global HIV prevalence (the percentage of people living with HIV) has leveled off and new infections have fallen. However, in 2007, 33.2 million people have HIV; 2.5 million became infected; and 2.1 million died.

 

CDC HIV PREVENTION STRATEGIC PLAN: EXTENDED THROUGH 2010.
Center for Disease Control (CDC), U.S. Department of Health and Human Services. October 2007.
Full REport: [pdf format, 157 pages]

HIV continues to be a significant health problem in the U.S. The CDC will intensify its efforts to address the epidemic among African Americans and "men who have sex with men (MSM)" by using new HIV testing recommendations and forming new partnerships with community leaders. The CDC will also continue to devote most of its resources to strategies, programs, and research; and it will work to expand proven interventions and develop new approaches for the most affected groups in the U.S.

 

ESTIMATING THE GLOBAL HEALTH IMPACT OF IMPROVED DIAGNOSTIC TOOLS FOR THE DEVELOPING WORLD.
Research Brief, RAND Corporation. Web posted November 14, 2007.
Full Text: [pdf format, 5 pages]

[Note: Contains copyrighted material.]

This brief summarizes research that assessed how higher-quality and more-accessible clinical diagnostic tests for a number of common diseases such as tuberculosis, malaria, HIV/AIDS, and bacterial pneumonia could save lives.

The key findings are as followings:

• New diagnostic tools could save millions of lives each year in the developing world;
• Tests should be easy to use and widely accessible;
• Access to treatment is critical; and
• New diagnostic tools would reduce the overuse of antibiotics.

 

2007 AIDS EPIDEMIC UPDATE
The Joint United Nations Programme on HIV/AIDS [UNAIDS], December 2007
Full Text: [pdf format, 60 pages]

The 2007 AIDS epidemic update reports on the latest developments in the global AIDS epidemic. It provides the most recent estimates of the AIDS epidemic and explores new findings and trends in the epidemic's evolution.

 

MOSQUITOES: THE LONG-TERM EFFECTS OF MALARIA ERADICATION IN INDIA.
David Cutler, Winnie Fung, Michael Kremer, and Monica Singhal. Faculty Research Working Papers Series, John F. Kennedy School of Government, Harvard University. Web posted October 26, 2007.
Full Text: [pdf format, 33 pages]

[Note: Contains copyrighted material.]

This study examined the effects of malaria on educational attainment in India. The results indicated that with malaria eradication, a gain of 12 percent occurred in both literacy and primary school completion. The results were not present in urban areas nor can they be "explained by convergence across areas." Additionally, the gains occurred for men and women across castes and tribes.

 

COMBATING THE TWIN EPIDEMICS OF HIV/AIDS AND ADDICTION.
David A. Fiellin, Traci C. Green, and Robert Heimer. Task Force on HIV/AIDS, Center for Strategic and International Studies (CSIS). Web posted October 15, 2007.
Full Text: [pdf format, 24 pages]

[Note: Contains copyrighted material.]

"In recent years, the international community has responded to the growing HIV/AIDS epidemic with bold commitments to provide universally available treatment and prevention services. The United States is the single largest supporter of international HIV programs, with $4.5 billion in assistance for HIV/AIDS, tuberculosis, and malaria programs approved in FY2007." This report concentrates on injection drug use as the primary driver of HIV/AIDS. HIV/AIDS injection drug may affect 4 million people in 114 countries.

 

CHINA'S RESPONSE TO HIV/AIDS AND U.S.-CHINA COLLABORATION.
Xiaoqing Lu and Bates Gill. Task Force on HIV/AIDS, Center for Strategic and International Studies (CSIS). Web posted October 10, 2007.
Full Text: [pdf format, 17 pages]

[Note: Contains copyrighted material.]

China presents one of the most difficult challenges to the worldwide HIV/AIDS epidemic primarily due to its slow initial response. China's attention to the HIV/AIDS epidemic expanded after the acute respiratory syndrome (SARS) outbreak. The U.S. government has actively funded HIV/AIDS programs in China through the U.S. Agency of International Development, the Department of Health and Human Services, the Department of Labor, and multilateral, international organizations such as the UN and the Global Fund.

 

HIV/AIDS IN RUSSIA: COMMITMENT, RESOURCES, MOMENTUM, CHALLENGES.
Judyth Twigg. Task Force on HIV/AIDS, Center for Strategic and International Studies (CSIS). Web posted October 15, 2007.
Full Text: [pdf format, 29 pages]

[Note: Contains copyrighted material.]

Over the last few years, the HIV/AIDS epidemic has taken unexpected and poorly understood turns. Russia's "declared political commitment to tackling the virus and its consequences is strong at the moment, but a history of denial and neglect call the sustainability of recently allocated policy attention and financial resources into question. Even in a resource-rich environment, Russia's capacity to spend money effectively and with unintended negative consequences remains uncertain." This report shows that the international community has played a significant role in shaping Russia's response to HIV/AIDS, and the authors stresses that a strong U.S. presence is important for success.

 

PRIORITIES FOR ACTION: GENDER AND PEPFAR REAUTHORIZATION.
Janet Fleischman. Task Force on HIV/AIDS, Center for Strategic and International Studies (CSIS). Web posted September 20, 2007.
Full Text: [pdf format, 15 pages]

[Note: Contains copyrighted material.]

"This is a defining moment for U.S. AIDS policy. . ." The President's Emergency Plan for AIDS Relief (PEPFAR) expires in September 2008. The number of HIV infections among women and girls continues to rise in every region of the world; and, according to the author, PEPFAR must make gender a central component of U.S. AIDS policy.

This paper focuses on gender strategies and programs for success in the fight against AIDS. These strategies are based on existing data, interviews with policymakers, and research conducted in the field.

 

U.S. INVESTMENT IN GLOBAL HEALTH RESEARCH.
Emily Connelly and Christine Hunt, compilers. Research America. Web posted October 4, 2007.
Full Text: [pdf format, 4 pages]

[Note: Contains copyrighted material.]

The U.S. is the world's leading investor in science and research. The U.S. also leads in research in global health. This report tracks and analyzes the 2006 U.S. investments in global health research.

The U.S. spent approximately $9.3 billion on global health research in 2006, and 8% of the total ($116 billion) came from private and public entities. According to a recent poll, a majority of Americans (80%) think it is important for the U.S. to improve global health.

 

GLOBAL AGE-FRIENDLY CITIES: A GUIDE.
World Health Organization (WHO). Web posted October 1, 2007.
Full Text: [pdf format, 82 pages]

[Note: Contains copyrighted material.]

Population aging and urbanization are two global trends that are shaping the 21st century. Age-friendly cities encourage active aging opportunities for health, participation, and security. These cities adapt structures and services to be accessible and inclusive to older people. This Guide encourages city policymakers to become more age-friendly and to "tap the potential that older people represent for humanity."

 

NEGLECTED DISEASES: A HUMAN RIGHTS ANALYSIS.
Paul Hunt, Rébecca Steward; Judith Bueno de Mesquita, and Lisa Oldring. Social, Economic and Behavioral (SEB) Research, World Health Organization (WHO]. Web posted August 18, 2007.
Full Text: [pdf format, 64 pages]

[Note: Contains copyrighted material.]

As defined in this report, neglected diseases are those primarily "affecting people living in poverty in developing countries" usually in rural areas. There is a link between neglected diseases and human rights-"neglected diseases are more likely to occur where human rights, such as the rights to health, education and housing are not guaranteed." Neglected diseases are also often found where violations of human rights and freedoms are common.

This report aims to help practitioners with understanding human rights, how human rights abuses cause and result from neglected diseases, and how human rights approaches can contribute to the fight against these diseases.

 

MATERNAL MORTALITY IN 2005: ESTIMATES DEVELOPED BY WHO, UNICEF, UNFPA, AND THE WORLD BANK.
World Health Organization (WHO), U.N. Children's Fund (UNICEF), U.N. Population Fund (UNFPA), and World Bank. Web posted October 11, 2007.
Full Text: [pdf format, 46 pages]

[Note: Contains copyrighted material.]

Improving maternal health and reducing maternal mortality have been key concerns since the late 1980s. Of the estimated 536,000 maternal deaths in 2005, 99% of them occurred in developing countries and more than half occurred in sub-Saharan Africa. These estimates clearly show a need for improved action to reduce maternal mortality.

 

MALARIA: DISEASE IMPACTS AND LONG-RUN INCOME DIFFERENCES.
Douglas Gollin and Christian Zimmermann. Discussion Paper, Institute for the Study of Labor (IZA). August 2007.
Full Text: [pdf format, 34 pages]

[Note: Contains copyrighted material.]

"The World Health Organization (WHO) reports that malaria, a parasitic disease transmitted by mosquitoes, causes over 300 million episodes of 'acute illness' and more than one million deaths annually. Most of the deaths occur in poor countries of the tropics, and especially sub-Saharan Africa. Some researchers have suggested that ecological differences associated with malaria prevalence are perhaps the most important reason why some countries today are rich and others poor." This paper explores that premise.

 

GLOBAL MALARIA PROGRAMME: INSECTICIDE TREATED MOSQUITO NETS: A POSITION STATEMENT.
World Health Organization (WHO). Web posted August 20, 2007.
Full Text: [pdf format, 12 pages]

[Note: Contains copyrighted material.]

This World Health Organization (WHO) Global Malaria Programme Position (GMP) Statement is a shift in guidance on malaria prevention: "The WHO/GMP calls upon National Malaria Control Programmes and their partners to purchase only long-lasting insecticidal nets (LLINS)." National programs should set priorities for geographical distribution. The Statement adds that the "best opportunity for rapidly scaling-up malaria prevention is free or highly subsidized LLIN distribution . . . This GMP Position is not exclusive of other approaches."

 

POPULATION AGING IN SUB-SAHARAN AFRICA: DEMOGRAPHIC DIMENSIONS 2006.
Victoria A. Velkoff and Paul R. Kowal. Current Population Reports, U.S. Census Bureau, U.S. Department of Commerce. Web posted August 20, 2007.
Full Text: [pdf format, 47 pages]

In 2006, 64 percent of the world's population was aged 60 or older and lived in developing countries. This group will increase to 73 percent by 2030. In 2006, there were 35 million people in Sub-Saharan Africa who were aged 60 or older. This report focuses on the demographic aspects of aging in this region. There is also a special section that examines the impact of HIV/AIDS on the aging population.

 

IMPROVING HEALTH SYSTEM PREPAREDNESS FOR TERRORISM AND MASS CASUALTY EVENTS: RECOMMENDATIONS FOR ACTION.
Jim Lyznicki. AMA/APHA Linkages Leadership Summit, American Medical Association (AMA) and American Public Health Association (APHA). July 2007.
Full Text: [pdf format, 54 pages]

After September 11, efforts to improve systems responsible for protecting and ensuring health, safety, and well-being of individuals during a disaster were intensified. Currently, the U.S. emergency health care system faces significant challenges such as hospital overcrowding, eroding trauma systems, inadequate funding, escalating liability costs, and uninsured patients.

This report is a call for action and makes the following recommendations:

• Ensure adequate funding for critical infrastructure;
• A sufficient, proficient, and responsive work force is available; and
• A fully integrated and interoperable health care and public health systems is required.

These recommendations need to be reviewed and refined continually.

[Note: Contains copyrighted material.]

CHILD HEALTH USA: 2006.
Maternal and Child Health Bureau, Health Resources and Services Administration, U.S. Department of Health and Human Services. Web posted July 27, 2007.
Full Text: [pdf format, 70 pages]

This is the 17th annual report on the health status of American children. The report contains more than 50 health status and health care indicators, provides graphical and textual summaries of the data, and addresses long term health care needs.

The first section of the report presents statistics on the well-being of children; the second section contains vital statistics and health behavior information; the third section includes information on health care financing and new health care policies; and the final section has state and city data.

 

DEMOGRAPHY OF HIV/AIDS IN CHINA: A REPORT OF THE TASK FORCE ON HIV/AIDS.
Bates Gill, Yanzhong Huang, and Xiaoqing Lu. Task Force on HIV/AIDS, Center for Strategic and International Studies (CSIS). Web posted July 24, 2007.
Full Text: [pdf format, 45 pages]

The impact of the Chinese HIV epidemic has been hard to ascertain because most Chinese HIV patients are in marginalized, at-risk, hard-to-reach populations. The government's response to the epidemic improved significantly in 2003 when new regulations were implemented. This report reviews these regulations, examines international assistance, and assesses gaps in the government's programs.

[Note: Contains copyrighted material.]

 

AA07282
Serafini, Marilyn RAPIDLY SPREADING THREATS National Journal, Vol. 39, no. 27, July 7, 2007, p. 22-26
Full Text: [Available from the publisher's website]

Dangerous diseases such as dengue fever and malaria are spreading beyond their traditional territories and into higher elevations. Some scientists list global warming as an important factor and predict that the situation could get worse in the coming decades. As climate change expands the reach of such "tropical" illnesses, the author says, some pharmaceutical companies and government agencies are starting to pay attention. Novartis is one of those companies, founding the Institute for Tropical Diseases in Singapore to focus on dengue fever, malaria and other diseases. At the Centers for Disease Control and Prevention, the National Center for Environmental Health is preparing a series of workshops on heat waves, vector-borne diseases (spread by mosquitoes, ticks and fleas), waterborne diseases and health communications. The National Institutes of Health is examining the effects of exposure to ultraviolet rays, air pollution and vector- and waterborne diseases.

 

 

WHO RESEARCH INTO GLOBAL HAZARDS OF TRAVEL (WRIGHT) PROJECT: FINAL REPORT OF PHASE I.
WHO Research Into Global Hazards of Travel Project, World Health Organization (WHO). Web posted June 29, 2007.
Full Report: [pdf format, 29 pages]

The objective of the WRIGHT project was to confirm an increased risk of venous thromboembolism (VTE) by air travel, determine the magnitude, ascertain if other factors were involved, and study the effect of preventive measures. The findings of the study indicate that the risk of VTE almost doubles after a flight, or other form of travel, of four or more hours. Other contributing factors of VTE are obesity, height extremes, oral contraceptives, and blood abnormalities.

[Note: Contains copyrighted material.]

 

PUBLIC POLICY AND THE CHALLENGE OF CHRONIC NONCOMMUNICABLE DISEASES.
Olusoji Adeyi, Owen Smith, and Sylvia Robles. International Bank for Reconstruction and Development, World Bank. Web posted June 28, 2007.
Full Report: [pdf format, 218 pages]

"Since the early 1990s, the importance of chronic noncommunicable diseases (NCDs) to global health has gained increased recognition. This report contains an agenda for action in response to the growing economic, social, and health problems posed by NCDs. Its objective is to enable the World Bank and its clients to examine and, where appropriate, strategically shift their approaches to public policy as a tool to prevent and control NCDs."

[Note: Contains copyrighted material.]

 

THE AFRICA MULTI-COUNTRY AIDS PROGRAM: 2000-2006: RESULTS OF THE WORLD BANK'S RESPONSE TO A DEVELOPMENT CRISIS.
Marelize Görgens-Albino, Nadeem Mohammad, David Blankhart, and Oluwole Odutolu. Global AIDS Monitoring and Evaluation Team, Global HIV/AIDS Program, World Bank. Web posted June 22, 2007.
Full Report: [pdf format, 188 pages]

This study explains the results of the World Bank's Multi-Country HIV/AIDS program (MAP) in Africa and documents MAP's contribution over the past five years. The study uses data from countries' surveys and programs. The study also proposes a new Results Scorecard and Generic Results Framework to better measure and report results of the HIV/AIDS programs.

[Note: Contains copyrighted material.]

 

BAD MEDICINE IN THE MARKET.
Roger Bate and Kathryn Boateng. Health Policy Outlook, American Enterprise Institute for Public Policy Research. Web posted June 19, 2007.
Full Text: [html format, var. pagings]

Counterfeit medicines are a threat to global health. They can cause mental and physical damage-even death. Additionally, fake drugs can breed resistance making standard drugs useless. No area of the world is unaffected by counterfeit medicines, but evidence shows that the problem is most severe in developing and emerging-market countries.

The authors believe that the risks of counterfeit medicines have been underestimated. They urge multilateral organizations such as the World Health Organization (WHO) to expose the problem more vigorously, help countries tightened regulations, and develop more effective methods of detection.

[Note: Contains copyrighted material.]

 

HIV/AIDS AND SOCIAL CAPITAL IN A CROSS-SECTION OF COUNTRIES.
Antonio C. David. World Bank Policy Research Working Paper, World Bank. June 2007.
Full Report: [pdf format, 21 pages]

"This paper attempts to quantify the impact of the HIV/AIDS epidemic on social capital with cross-country data . . . The results obtained indicate that HIV prevalence affects social capital negatively . . . If one moves from a country with a relatively low level of HIV prevalence such as Estonia to a country with a high level such as Zimbabwe, one would observe an approximate 8% decline in social capital. These results are robust in a number of dimensions and highlight the empirical importance of an additional mechanism through which HIV/AIDS hinders the development process."

[Note: Contains copyrighted material.]

 

EXTENSIVELY DRUG-RESISTANT TUBERCULOSIS (XDR-TB): QUARANTINE AND ISOLATION.
Kathleen S. Swendiman and Nancy Lee Jones. Congressional Research Service (CRS), Library of Congress. June 5, 2007.
Full Report: [pdf format, 6 pages]

"The recent international saga of a traveler with XDR-TB, a drug-resistant form of tuberculosis, has placed a spotlight on existing mechanisms to contain contagious disease threats and raised numerous legal and public-health issues. This report will briefly address the existing law relating to quarantine and isolation, with an emphasis on the interaction of state and federal laws and international agreements."

 

IMMIGRANTS IN THE U.S. HEALTH CARE SYSTEM: FIVE MYTHS THAT MISINFORM THE AMERICAN PUBLIC.
Meredith L. King. Center for American Progress. June 7, 2007.
Full Report: [pdf format, 14 pages]

Many Americans believe that immigrants are a burden to the health care system. This paper examines the five most popular myths of immigrants and health care. These myths are: (1) the public health care system is overburdened with documented and undocumented immigrants; (2) immigrants use large quantities of limited health care resources; (3) immigrants come to the U.S. for its health care services; (4) restricting health care access to immigrants will have no affect on Americans; and (5) undocumented immigrants are "free-riders."

[Note: Contains copyrighted material.]

 

REPORT OF THE EXECUTIVE DIRECTOR OF THE JOINT UNITED NATIONS PROGRAMME ON HIV/AIDS (UNAIDS).
Joint United Nations Programme on HIV/AIDS (UNAIDS), Economic and Social Council, United Nations. May 7, 2007.
Full Report: [pdf format, 19 pages]

The AIDS epidemic remains concrete and complex. Since 2005, funding, programming and reporting have improved significantly. The move toward universal access to prevention, treatment, care, and support has created a country-focused approach. Coverage, quality of monitoring, and surveillance have also increased substantially resulting in better and more specific information at the country level.

Prevention is the mainstay of response; but removing the stigma, discrimination, inequality of women, and marginalization of people living with HIV is the primary goal of universal access.

[Note: Contains copyrighted material.]

 

PANDEMIC INFLUENZA PREPAREDNESS AND RESPONSE GUIDANCE FOR HEALTHCARE WORKERS AND HEALTHCARE EMPLOYERS.
Occupational Safety and Health Administration, U.S. Department of Labor. May 2007.
Full Report: [pdf format 104 pages]

A pandemic is a global disease outbreak, and a flu pandemic occurs when a new virus emerges where there is no immunity and no vaccine. A severe flu pandemic could cause a number of illnesses, deaths, social disruptions, and economic losses. In order to mitigate the effects of a flu pandemic, collaboration between state and federal healthcare professionals is vital. "The goal of this document is to help healthcare workers and employers prepare for and respond to an influenza pandemic."

 

REPORT OF THE EXECUTIVE DIRECTOR OF THE JOINT UNITED NATIONS PROGRAMME ON HIV/AIDS (UNAIDS).
Joint United Nations Programme on HIV/AIDS (UNAIDS), Economic and Social Council, United Nations. May 7, 2007.
Full Report: [pdf format, 19 pages]

The AIDS epidemic remains concrete and complex. Since 2005, funding, programming and reporting have improved significantly. The move toward universal access to prevention, treatment, care, and support has created a country-focused approach. Coverage, quality of monitoring, and surveillance have also increased substantially resulting in better and more specific information at the country level.

Prevention is the mainstay of response; but removing the stigma, discrimination, inequality of women, and marginalization of people living with HIV is the primary goal of universal access.

[Note: Contains copyrighted material.]

 

GLOBAL HEALTH: GLOBAL FUND TO FIGHT AIDS, TB AND MALARIA HAS IMPROVED ITS DOCUMENTATION OF FUNDING DECISIONS BUT NEEDS STANDARDIZED OVERSIGHT EXPECTATIONS AND ASSESSMENTS.
U.S. General Accountability Office (GAO). Web posted May 7, 2007.
Full Report: [pdf format, 49 pages]

"The Global Fund to Fight AIDS, Tuberculosis and Malaria has approved about $7 billion in grants to developing countries; the U.S. has contributed $1.9 billion." In 2003, Congress asked the GAO to report on the Fund every 2 years. This report assesses the Fund's documentation of its performance-based information, implementation of the risk assessment model, and oversight of the "local fund agents" (LFAs). GAO recommends that the Fund's Board establish standardized expectation for performance and require systematic assessments of LFA performance.

 

AA07202
Evan Ratliff FIRST BLOOD Wired, vol. 15, no. 5, May 2007, pp. 116-125
Full text

In the more than 25 years since first identification of HIV, the virus that causes AIDS, scientists have traced the origin of the virus and concluded that the killer disease evolved in humans after exposure to the simian immunodeficiency virus (SIV). It is thought that a hunter contracted the virus through exposure to the blood of his kill, and the non-lethal SIV mutated to become HIV. Biologist Nathan Wolfe and a team of hunters, field workers and laboratory scientists are now conducting a broad blood sampling collection and analysis to see if they can find the as-yet-unknown virus that may take a similar path to evolve into the next human pandemic. Wolfe's work, with funding from the National Institutes of Health, has been underway for several years with the participation of 4,000 bushmeat hunters in sub-Saharan Africa. So far, they have found that the viral animal-to-human transmission that created AIDS was not a unique event. The blood samples reveal that as many as 1 percent of hunters are infected with an animal virus. Though they are not experiencing adverse symptoms presently, the finding reveals that mutations of harmful virus could occur along this path of transmission with greater frequency than previously understood. If the work does identify the next potential killer virus, Ratliff writes, it could form the basis of a new public health model that would emphasize prevention of disease rather than reaction to it.

 

HEALTH STATUS OF AFRICAN AMERICAN MEN IN THE UNITED STATES: FACT SHEET.
Race, Ethnicity and Health Care, The Henry J. Kaiser Family Foundation. Web posted April 26, 2007.
Full Report: [pdf format, 2 pages]

There are 17.3 million African American men in the U.S. or 48% of all African Americans. These men tend to have the worst health indicators of all racial/ethnic groups, male or female. This fact sheet compares the health status of African American men to other groups.

[Note: Contains copyrighted material.]

 

MEETING THE LONG-TERM CARE NEEDS OF THE BABY BOOMERS: HOW CHANGING FAMILIES WILL AFFECT PAID HELPERS AND INSTITUTIONS.
Richard W. Johnson, Desmond Toohey, and Joshua M. Wiener. The Retirement Project, Discussion Paper, The Urban Institute. May 2007.
Full Report: [pdf format, 61 pages]

The aging population will most likely cause a surge in long-term health care needs. In this paper, long-term care is defined when physical or mental disabilities impair ones capacity to perform life's everyday activities. This study projects the number and percentage of people age 65 and older who will need long-term care services. The analysis used models of current long-term care with simulations of size and characteristics of the future population. This report summarizes the results and makes recommendations.

 

VACCINATING TO PROTECT A VULNERABLE SUBPOPULATION.
Jonathan Dushoff, Joshua B. Plotkin, Cecile Viboud, Lone Simonsen, Mark Miller, Mark Loeb, and David J.D. Earn. Research Article, PLoS Medicine. Web posted May 22, 2007.
Full Report: [pdf format, 7 pages]

Epidemic influenza causes serious mortality in temperate countries each winter. Schoolchildren are critical in the spread of influenza virus, and the elderly and very young are most vulnerable. Consequently, it is unclear how best to focus prevention efforts. This study investigated the question of how to protect a population when one group is effective at spreading disease and another group is more vulnerable.

The authors recommend changing the vaccination strategy, but this change should be approached with caution. Their concern is that "while switching vaccines to more active groups may protect vulnerable groups in many cases; switching too much vaccine, or switching vaccine under slightly different conditions, may lead to large increases in disease in vulnerable groups."

[Note: Contains copyrighted material.]

 

STATE OF THE WORLD'S MOTHERS 2007: SAVING THE LIVES OF CHILDREN UNDER 5.
Save the Children. Web posted May 8, 2007.
Full Report: [pdf format, 70 pages]

This is the eighth annual State of the World's Mothers report. "The focus is on the 28,000 children under age 5 who die every day from easily preventable or treatable causes and the tragic fact that basic, lifesaving remedies still are not reaching millions of mothers and children in need. This report helps to bring attention to low-cost solutions that have the greatest potential to save lives. It also identifies countries that are succeeding in tackling this problem, showing that effective solutions to this challenge are affordable-even in the world's poorest countries." This report analyzes 140 countries and shows the best place and the worst place to be a mother or a child.

[Note: Contains copyrighted material.]

 

YOUNG SOUTH AFRICANS, BROADCAST MEDIA, AND HIV/AIDS AWARENESS: RESULTS OF A NATIONAL SURVEY.
Public Opinion and Media Research Program, Program for Health and Development in South Africa, South African Broadcasting Corporation, The Henry J. Kaiser Family Foundation. March 26, 2007.
Full Report: [pdf format, 61 pages]

[Note: Contains copyrighted material.]

This survey was conducted to better understand and gauge "the attitudes of young South Africans towards the media's role in HIV prevention and education." It also helped broadcasters and other players develop HIV/AIDS messaging and programming that would appeal to South African youths. This paper presents the key findings of the survey.

 

GLOBAL HEALTH: GLOBAL FUND TO FIGHT AIDS, TB AND MALARIA HAS IMPROVED ITS DOCUMENTATION OF FUNDING DECISIONS BUT NEEDS STANDARDIZED OVERSIGHT EXPECTATIONS AND ASSESSMENTS.
United States Government Accountability Office (GAO). May 7, 2007
Full Report: [pdf format, 49 pages]

The Global Fund to Fight AIDS, Tuberculosis and Malaria has approved about $7 billion in grants to developing countries; the U.S. has contributed $1.9 billion.

This report assesses the Global Fund's:

• documentation of information used to support performance-based funding decisions,
• progress in implementing a risk assessment model and early warning system, and
• oversight of the performance of "local fund agents" (LFAs), which monitor grant progress in recipient countries.

Global Fund has improved its documentation for decisions to disburse funds and renew grants. The Global Fund now requires that fund portfolio managers more consistently document factors, such as grant ratings and contextual information that support disbursement and grant renewal decisions.

 

ADVANCING U.S. LEADERSHIP ON GLOBAL HIV/AIDS: OPPORTUNITIES IN THE PEPFAR REAUTHORIZATION PROCESS.
By J. Stephen Morrison, Allen Moore, Jennifer Cooke. Center for Strategic and International Studies (CSIS). May 2007
Full Report: [pdf format, 12 pages]

PEPFAR's first five-year phase will come to an end in 2008, and congressional reauthorization of the program will begin in 2007. A congressionally mandate study of PEPFAR implementation completed by the Institute of Medicine (IOM) in March 2007 concluded that the program's most important early accomplishment has been "to demostrate that HIV/AIDS services, particularly treatment can be rapidly scaled up in resource constrained countries, something that many had doubted could be done".

 

PANDEMIC FLU AND THE POTENTIAL FOR U.S. ECONOMIC RECESSION: A STATE-BY-STATE ANALYSIS.
Jeffrey Levi, Misha Segal and Laura Segal. Issue Report, Trust for American's Health. Web posted March 23, 2007.
Full Report: [pdf format, 92 pages]

[Note: Contains copyrighted material.]

This study projects the economic consequences on a state-by-state basis of a flu epidemic. The economic models used were drawn from the Congressional Budget Office (CBO), the Australian National University (ANU) and the Lowry Institute for International Policy, and the BMO Nesbitt Burns. CBO estimates that a flu pandemic would cause a 4.25 percent drop in annual Gross Domestic Product (GDP); ANU/Lowry quotes a 5.50 percent loss; and BMO Newbitt shows a 6.00 percent decrease. The Trust for American's Heath (TFAH) used these assumptions to assess the potential impact on each state's economy.

 

GLOBAL TUBERCULOSIS CONTROL: SURVEILLANCE, PLANNING, FINANCE: WHO REPORT 2007.
World Health Organization. Web posted March 23, 2007.
Full Report: [pdf format, 277 pages]

[Note: Contains copyrighted material.]

According to this report, tuberculosis (TB) is still a major cause of death worldwide, but the epidemic appears to be on the decline-the incidence rate has stabilized or is in decline in all six World Health Organization (WHO) regions. This report reviews and expands on the continued struggle to eradicate TB through strategic planning, financial analysis, and performance evaluation.

 

RESTORING FISCAL SANITY 2007: THE HEALTH SPENDING CHALLENGE.
Alice M. Rivlin and Joseph R. Antos, editors. Brookings Institution Press. Web posted March 26, 2007.
Full Report: [pdf format, 252 pages]

[Note: Contains copyrighted material.]

"This book examines the health spending crisis and calls for a broad agenda of experimentation and reform to slow health care spending growth." The authors provide suggestions to reform federal health care programs that could reduce the growth in spending, increase efficiency and effectiveness of care, and enhance health outcomes. The authors see this proposal as a "catalyst for improvements of the whole health system."

 

AA07021
THE CHALLENGE OF GLOBAL HEALTH.
Garrett, Laurie. Foreign Affairs, vol. 86, no. 1, January/February 2007, pp. 14-38
View article on ProQuest (password required)

The recent spate of high-profile donors such as Warren Buffett and Bill and Melinda Gates pledging millions to improve health conditions in developing countries has been cause for praise and hope. However, author Laurie Garrett cautions, the tendency of large donors to focus funds on narrow, disease-specific problems such as HIV/AIDS, malaria and TB exacerbates the failing public health infrastructure in poor countries. These factors include bureaucratic corruption, oversight and coordination deficiencies in the receiving countries, and the "brain drain" of health care personnel to wealthy countries. She urges using maternal and child health as the critical baseline marker for judging the general effectiveness of any health initiative, and highlights the need for innovative approaches that encourage self-sufficiency rather than dependency on donors. One example cited is the "Doc-in-a-Box," a prototype mobile delivery system built from abandoned shipping containers that could have linked networks for information-sharing and inventory and quality control. Operated as franchises that could generate modest salaries, this initiative would provide an incentive to retain critically-needed doctors and nurses in poorer countries.

 

AIDS VACCINES: THE NEXT FRONTIERS.
AIDS Vaccine Advocacy Coalition (AVAC). Web posted December 29, 2006.
Full Report [pdf format, 60 pages]

[Note: Contains copyrighted material.]

The next two years are critical for the AIDS vaccine field. Many research trials will have been completed which means information will become available to support collaboration on how to handle the new challenges being offered and how to map out future pathways. An infusion of new funds will stimulate product development as well as provide opportunities to explore issues of access and delivery. The report outlines nine items that AVAC feels are most important to AIDS vaccine delivery.

 

SOCIAL HEALTH INSURANCE REEXAMINED.
Adam Wagstaff. Policy Research Working Paper 4111, Development Research Group, The World Bank. January 2007.
Full Report [pdf format, 27 pages]

[Note: Contains copyrighted material.]

Social health insurance (SHI) is coming back. Some countries relying on tax finance are introducing SHI while others are extending already existing programs. Europe, on the other hand, is reducing payroll-financed programs and turning toward general revenues. "This paper examines how SHI fares in health care delivery, revenue collection, covering the formal sector, and its impacts on the labor market."

 

PERSONAL JOURNEYS OF WOMEN WITH HIV/AIDS.
Monroe, Sylvester, Ebony December 2006, pp. 154-158
Full Text (ProQuest: password required)

[Note: Contains copyrighted material.]

At first it was "just a gay white men's disease," largely ignored by African-Americans and practically everybody else in the 1980s. The widely publicized deaths of Hollywood hunk Rock Hudson (1985) and a courageous White teenager named Ryan White (1990) tugged at hearts, but did little to dispel that perception. Even when African American celebrities like ABC News anchorman Max Robinson died and Magic Johnson revealed that he had contracted the dreaded infection, denial still clouded Black America's eyes. But 25 years and 25 million lost lives after the onset of HIV/AIDS, the fastest-growing group of victims are distinctly darker now and increasingly not involved in homosexuality or intravenous drug use at all. Indeed, African Americans-particularly black women of all ages, every walk of life and from every corner of the country-have replaced gay white men as the new face of HIV/AIDS in America.

 

ONE-ON-ONE WITH MUSA NJOKO: A SOUTH AFRICAN WOMAN SPEAKS TO THE WORLD.
Berry, Jeff. Positively Aware November/December 2006, pp. 19-20

Full text available from your nearest American Library

Musa Njoko, featured on the cover of this issue, is an advocate for women living with HIV who lives in Durban, South Africa. Ms. Njoko spoke at the XVI International AIDS Conference in Toronto in August 2006, and she sat down with the author to share her thoughts on the epidemic.

 

AIDS EPIDEMIC UPDATE.
World Health Organization. December 2006. Web posted November 21, 2006.
Full Report: [pdf format, 94 pages]

[Note: Contains copyrighted material.]

Although promising developments have been made in recent years, the number of people living with HIV continues to grow. A total of 39.5 million people are living with HIV worldwide in 2006 including 4.3 million adults and children newly infected in 2006 (a concentration of the newly infected are young adults aged 15-24 years old. Sub-Saharan Africa continues to bear the brunt of the global epidemic with 63% of all adults and children with HIV and almost three quarters of all adult and child deaths are due to AIDS. In the past two years, the number of people living with HIV increased in every region of the world with the most striking increases in East Asia and Eastern Europe-over 21% higher than 2004.

Access to treatment and care has greatly improved over the past several years resulting in an estimated increase of a cumulative total of over two million life years gained since 2002.

 

ABSTINENCE EDUCATION: EFFORTS TO ASSESS THE ACCURACY AND EFFECTIVENESS OF FEDERALLY FUNDED PROGRAMS.
United States Government Accountability Office (GAO). November 15, 2006.
Full Report: [pdf format, 62 pages]

Abstinence-until-marriage education programs, also referred to as abstinence-only education programs, teach adolescents to abstain from sexual activity until marriage in order to avoid risks of unintended pregnancy, sexually-transmitted diseases (STDs), and related health problems. The content of federally funded abstinence-until-marriage programs is required to be consistent with several principles, such as teaching that a mutually faithful monogamous relationship in the context of marriage is the expected standard of human sexual activity, and that abstinence from sexual activity is the only certain way to avoid STDs. Abstinence-until-marriage education programs are delivered by a variety of entities, including schools, human service agencies, faith-based organizations, youth development groups, and pregnancy crisis centers. Instructors can incorporate a variety of educational materials into their abstinence-until-marriage education programs, including textbooks, student manuals, brochures, slide presentations, and videos.

In this report, GAO is evaluates 1) efforts by HHS and states to assess the scientific accuracy of materials used in these programs and 2) efforts by HHS, states, and researchers to assess the effectiveness of these programs. GAO reviewed documents and interviewed Department of Health and Human Services (HHS) officials in the Administration for Children and Families (ACF) and the Office of Population Affairs (OPA) that award grants for these program.

GAO found that efforts by HHS and states to assess the scientific accuracy of materials used in abstinence-until-marriage education programs have been limited. This is because HHS's ACF-which awards grants to two programs that account for the largest portion of federal spending on abstinence-until-marriage education-does not review its grantees' education materials for scientific accuracy and does not require grantees of either program to review their own materials for scientific accuracy. In contrast, OPA does review the scientific accuracy of grantees' proposed educational materials. GAO recommends that the Secretary of HHS develop procedures to help assure the accuracy of such materials used in programs administered by ACF.

 

HEALTH UNITED STATES, 2006.
United States Department of Health and Human Services (HHS), Centers for Disease Control and Prevention (CDC). November 15, 2006.
Full Report: [pdf format, 559 pages]

Table of Contents: [sections in pdf format, various pagings]

 

[Note: The URL for the Table of Contents is the same as for the Full Report. Just click on the box under the title that reads "Click here to go to Table of Contents" and the Table of Contents will open up.]

[Note: Contains copyrighted material.]

Health, United States is an annual report on trends in health statistics. The 2006 edition includes a number of significant health findings:

• Life expectancy at birth reached a record 77.9 years in 2004, up from 77.5 in 2003 and from 75.4 in 1990. Since 1990, the gap in life expectancy between men and women has narrowed from seven to just over five (5.2) years. At birth, life expectancy for females is just over 80 years and nearly 75 for males. The gap in life expectancy between white and black Americans also has narrowed from seven years in 1990 to five years in 2004. Infant mortality fell to 6.8 deaths per 1,000 live births in 2004, down from 6.9 deaths per 1,000 live births in 2003.
• Heart disease remains the leading killer, but deaths from heart disease fell 16 percent between 2000 and 2004, and deaths from cancer - the number two killer - dropped 8 percent. The age-adjusted death rate for heart disease was 217 deaths per 100,000 in 2004; for cancer the rate was 186 per 100,000.
• Diabetes poses a growing threat, especially among older adults. Eleven percent of adults aged 40-59 years, and 23 percent of those 60 and older have diabetes.

This year's edition of Health, United States has a special focus on pain. Highlights of the findings on pain include:

• One in four U.S. adults say they suffered a day-long bout of pain in the past month, and one in 10 say the pain lasted a year or more.
• Low back pain is among the most common complaints, along with migraine or severe headache, and joint pain, aching or stiffness. The knee is the joint that causes the most pain, according to the report. Hospitalization rates for knee replacement procedures rose nearly 90 percent between 1992-93 and 2003-04 among those 65 and older
• Almost three-fifths of adults 65 and older with pain said it had lasted for one year or more.
• More than one-quarter of adults interviewed said they had experienced low back pain in the past three months.
• Fifteen percent of adults experienced migraine or severe headache in the past three months. Adults ages 18-44 were almost three times as likely as adults 65 and older to report migraines or severe headaches.

 

MEASURING HIV RISK IN THE U.S. POPULATION AGED 15-44: RESULTS FROM CYCLE 6 OF THE NATIONAL SURVEY OF FAMILY GROWTH.
John E. Anderson, William D. Mosher, and Anjani Chandra. United States Department of Health and Human Services, Centers for Disease Control and Prevention (CDC), National Center for Health Statistics (NCHS). October 23, 2006.
Full Report: [pdf format, 28 pages]

This CDC report provides reliable national estimates of some basic statistics on certain types of sexual and drug use behavior, in order to estimate the size and characteristics of populations at elevated risk for acquiring or transmitting human immunodeficiency virus or HIV, the virus that causes acquired immunodeficiency syndrome (AIDS).

Included in the findings of this survey report are the following statistical highlights:

• Among males and females 15-44 years of age, 8.9 percent were at risk of HIV because of their sexual behavior in the last 12 months. As defined for this report, persons at "behavioral risk of HIV" include those who had five or more opposite-sex partners in the last year, persons who had sex with an injecting drug user, persons who had sex with an HIV-infected person, those who exchanged sex for money or drugs, men who had sex with other men, and women who had sex with a man who has sex with men.
• Drug-related risk in the past year (illicit drug injection or use of crack cocaine) put 1.5 percent at risk of HIV, and together sexual or drug risk in the past year was reported by 9.9 percent of persons 15-44 years of age. In total, 11.9 percent were estimated to be at increased risk for HIV by having reported sexual or drug-related risk behavior or having reported treatment for a sexually transmitted disease (STD) in the past year. This results in an estimate of 14.4 million persons at increased risk of HIV in the age group 15-44.
• Males reported higher proportions at risk than females. For example, 13.0 percent of males 15-44 were estimated to be at risk through reported sexual behavior or drug use or having been treated for an STD compared with 10.8 percent of females.

 

THE STATE OF [HIV/AIDS] BUSINESS COALITIONS IN SUB-SAHARAN AFRICA.
Francesca Boldrini and Chris Trimble. World Economic Forum. September 2006; Web-posted November 1, 2006
Full Report: [pdf format, 36 pages]

[Note: Contains copyrighted material.]

This report illustrates how 27 countries are creating and supporting coalitions with businesses to address HIV/AIDS. At least 20 coalitions exist in sub-Saharan Africa today, with more than 16 having been established in the last five years, as demands for these programs have grown. The study provides guidance to new coalitions and those soon to be formed; shares best practices; benefits; achievements; and highlights key challenges facing coalitions.

Most of the coalitions spend the largest proportion of their time and effort supporting company action to combat HIV/AIDS in the workplace. Such efforts range from developing country-specific toolkits to implementing tailored employee training programs. One major question mark is the financial sustainability of coalitions. One of the most important challenges reported by coalitions is the heavy reliance on unpredictable funding. The report recommends that all stakeholders - business coalitions, businesses and international partners - work together to clarify the long-term vision of coalitions and understand what priority actions are required to make it work.

There are separate country profiles on the coalitions in Botswana, Cameroon, Cote d'Ivoire, Democratic Republic of the Congo, Ethiopia, Ghana, Kenya, Malawi, Mali, Mauritania, Namibia, Nigeria, Rwanda, Swaziland, Tanzania, Uganda, Zambia and Zimbabwe.

 

REVISED RECOMMENDATIONS FOR HIV TESTING OF ADULTS, ADOLESCENTS, AND PREGNANT WOMEN IN HEALTH-CARE SETTINGS.
United States Department of Health and Human Services, Centers for Disease Control (CDC). September 22, 2006.
Full Report: [html format, 27 printed pages]

The Centers for Disease Control's (CDC's) revised recommendations for HIV testing in healthcare settings aim to make HIV testing a routine part of medical care, and expand the gains made in diagnosing HIV infection among pregnant women. The Recommendations replace CDC's 1993 Recommendations for HIV Testing Services for Inpatients and Outpatients in Acute-Care Settings and they update portions of CDC's 2001 Revised Guidelines for HIV Counseling, Testing, and Referral and Revised Recommendations for HIV Screening of Pregnant Women.

The revised recommendations for patients in all healthcare settings are:

• HIV screening (another term for broad-based testing) for patients in all healthcare settings, after the patient is notified that testing will be performed -- unless the patient declines (opt-out screening).
• HIV testing -- at least once a year -- of people at high risk for HIV infection.
• Screening should be incorporated into the general consent for medical care; separate written consent is not recommended.
• Prevention counseling should not be required with HIV diagnostic testing, or as part of HIV screening programs in healthcare settings.

Additional key differences in the Recommendations for pregnant women in healthcare settings are:

• Including HIV screening in the routine panel of prenatal screening tests for all pregnant women -- unless the patient declines (opt-out screening).
• Repeat screening in the third trimester in certain jurisdictions with elevated rates of HIV infection among pregnant women.

 

ONLINE HEALTH SEARCH 2006.
Susannah Fox. Pew Internet and American Life Project. October 29, 2006
Full Report: [pdf format, 22 pages]

According to this new report, eighty percent of U.S. internet users, or roughly 113 million adults, have searched for information on at least one of the seventeen health topics listed in the study. Most internet users start at a general search engine when researching health and medical advice online. Certain groups of internet users are the most likely to have sought health information online: women, internet users younger than 65, college graduates, those with more online experience, and those with broadband access at home.

Fifteen percent of online health information seekers say they "always" check the source and date of the health information they find online, while another 10 percent say they do so "most of the time." Three-quarters say they check the source and date "only sometimes," "hardly ever," or "never," which translates to about 85 million Americans gathering health advice online without consistently examining the quality indicators of the information they find. Most health seekers are pleased about what they find online, but some are frustrated or confused.

Among the internet users who say their last search had any kind of impact:

• Fifty-eight percent say the information they found in their last search affected a decision about how to treat an illness or condition.
• Fifty-five percent say the information changed their overall approach to maintaining their health or the health of someone they help take care of.
• Fifty-four percent say the information led them to ask a doctor new questions or to get a second opinion from another doctor.

 

AIDS IN SOUTH ASIA: UNDERSTANDING AND RESPONDING TO A HETEROGENEOUS EPIDEMIC.
Stephen Moses, James F. Blanchard, Han Kang, Faran Emmanuel, Sushena Reza Paul, Marissa L. Becker, David Wilson, and Mariam Claeson. World Bank. August 2006.
Full Report: [pdf format, 131 pages]
Table of Contents: [chapters in pdf format, various pagings]
Executive Summary: [pdf format, 6 pages]

[Note: Contains copyrighted material.]

According to the new report, more than 5.5 million people are infected with HIV in South Asia, with the epidemic increasingly driven by the region's flourishing sex industry and injection drug use. South Asia's HIV and AIDS epidemic can be expected to grow rapidly unless the eight countries in the region, especially India, can saturate high-risk groups such as sex workers and their clients, injecting drug users, and men having sex with men, with better HIV prevention measures.

Contributing regional risk factors include widespread stigma and discrimination, poverty and inequality, illiteracy, the low social status of women, trafficking of women into commercial sex, porous borders, widespread migration, high levels of mobility, cultural restrictions on discussing sex-related issues, high rates of sexually transmitted infections, and limited condom use.

The report says halting the spread of the epidemic will depend on a two-pronged approach:

• First, establishing effective prevention programs for groups at increased risk of HIV infection such as sex workers and their clients, injection drug users, and men who have sex with men; and
• Second, resolving the social and economic drivers of the epidemic such as poverty, stigma, and sex trafficking of women.

 

PREVENTING HIV/AIDS IN YOUNG PEOPLE: A SYSTEMATIC REVIEW OF THE EVIDENCE FROM DEVELOPING COUNTRIES.
David A. Ross, Bruce Dick and Jane Ferguson, Editors. World Health Organization (WHO). Web-posted August 16, 2006.
Full Report: [pdf format, 357 pages]

[Note: Contains copyrighted material.]

The increasing rate of HIV/AIDS infections in young people is alarming: 15-24 year olds account for 50% of new cases. Every day five to six thousand youths become infected, most of them in developing countries. This report provides evidence-based recommendations for policy-makers, program managers and researchers to guide efforts towards meeting the UN goals on HIV/AIDS and young people. These goals aim to decrease prevalence and vulnerability, and to increase access to information, skills and services.

Contributors to this volume studied interventions being implemented and/or considered for decreasing HIV prevalence among young people, and compared these with the threshold of evidence required to recommend a particular type of intervention for widespread use. For each course of action considered, the researchers made decisions as to whether the threshold had been fully met, partially met, not met but had encouraging characteristics, or indicated a lack of effectiveness.

The report provides a systematic review of the effectiveness of interventions provided through schools, health services, mass media, communities, and other outlets. The report concludes that these interventions fall into three categories:

• "Go" -- Evidence threshold has been met. There is sufficient evidence to recommend widespread implementation on a large scale now, as long as there is careful monitoring of coverage, quality and cost, and operations research is implemented to better understand the mechanisms of action.
• "Ready" - Evidence threshold has been partially met. Evidence suggests interventions are effective, but large-scale implementation must be accompanied by further evaluation and operations research to clarify impact and mechanisms of action.
• "Steady" - Evidence threshold has not been met. Some of the evidence is promising but further development, pilot-testing and evaluation are needed before it can be determined whether these interventions should move into the "Ready" category or "Do not go" category.
• "Do not go" - Strong evidence exists of lack of effectiveness or of harm.

 

ZERO TOLERANCE: STOP THE VIOLENCE AGAINST WOMEN AND CHILDREN, STOP HIV/AIDS.
Lisa Schechtman. Global AIDS Alliance (GAA). August 1, 2006.
Full Report: [pdf format, 48 pages]

[Note: Contains copyrighted material.]

Worldwide, violence against women and children is playing a critical role in driving the spread of HIV/AIDS. In this report, the Global AIDS Alliance (GAA) outlines a Zero Tolerance framework for addressing the epidemic of violence, including increased funding commitments from donor and affected country governments and multilateral institutions. This advocacy brief states that establishing zero tolerance for violence is a matter of basic respect for human rights, particularly those of women, including sexual and reproductive rights.

Violence is linked to HIV. Women who have experienced violence may be up to three times more likely to acquire HIV. In addition to behavioral risk factors, there are direct consequences of unprotected forced or coerced sex, and this is compounded by global HIV/AIDS policies that fail to take seriously the realities facing women and girls. Fear of violence can prevent women from seeking counseling and testing, disclosing their HIV status, and receiving treatment when it is needed.

The author of this document describes a framework for a comprehensive response to violence against women and children, including the political and financial resources that would be needed for full implementation. The report outlines essential elements in any such framework:

• Political Commitment and Resource Mobilization
• Legal and Judicial Reform
• Health Sector Reform
• Education Sector Reform
• Community Mobilization for Zero Tolerance
• Mass Marketing for Social Change

 

INFECTIOUS DISEASE AND NATIONAL SECURITY: STRATEGIC INFORMATION NEEDS.
Gary Cecchine and Melinda Moore. RAND. Web-posted August 16, 2006.
Full Report: [pdf format, 127 pages]

[Note: Contains copyrighted material.]

In recent years the global community has suffered from newly emerged infectious diseases and from diseases once thought to be in decline. It now faces the threat of a human influenza pandemic arising from the recently emerged avian influenza H5N1 virus. The pace of global travel, migration, and commerce has increased dramatically in recent decades, elevating the risk of a global infectious disease outbreak. The spread of infectious disease can have significant effects on U.S. and world security, destabilizing nations and regions through direct mortality and morbidity, resulting in staggering economic and social loss.

This study, conducted from July through October 2005, examines infectious disease within the context of national security and assesses the need for, and adequacy of, information that will enable U.S. policymakers to prevent and respond to such threats. At the center of this research is a review of the link between infectious disease and national security, as well as interviews with policymakers and other stakeholders to assess their information needs. This report includes a list of sources providing public health information and surveillance of infectious diseases worldwide.

Appendix C lists 234 online sources related to the detection, surveillance, and dissemination of information on infectious diseases and infectious disease outbreaks. The list, which includes multilateral organizations, U.S. organizations and foreign organizations, is not intended to be exhaustive, but serves to demonstrate the variety of open- and restricted-access sources available for information. For each organization listed, there are brief descriptions and website addresses.

 

PUBLIC HEALTH AND INTERNATIONAL SECURITY: THE CASE OF INDIA.
By Pramit Mitra and Teresita C. Schaffer. Center for Strategic and International Studies (CSIS). July 2006.
Full Report: [pdf format, 25 pages]

[Note: Contains copyrighted material.]

This report summarizes a conference on "Public Health and International Security" that took place on May 2, 2006. Conferees looked at both the Indian and international contexts for an integrated approach to public health.

The conference report presents numerous findings, including:

• "This is a critical time for India's fight against HIV/AIDS. While there has been a moderate slowdown in the prevalence rate in Tamil Nadu, the HIV/AIDS epidemic is now spreading to urban areas and to previously unaffected states like Bihar and Uttar Pradesh."
• "U.S.-India engagement on health issues is progressing at a rapid pace. Along with positive developments in the bilateral relationship, improving India's health infrastructure continues to be a priority area for the U.S. government."
• India needs to increase efforts to: develop an integrated disease surveillance and control system; insure participation of the public and private sectors in public health issues; and create strong linkages among clinical care, research, and public health institutions.

 

TARIFFS, CORRUPTION AND OTHER IMPEDIMENTS TO MEDICINAL ACCESS IN DEVELOPING COUNTRIES: FIELD EVIDENCE.
Roger Bate, Kathryn Boateng, Lorraine Mooney, Richard Tren. American Enterprise Institute; Africa Fighting Malaria. August 2006.
Full Report: [pdf format, 36 pages]

[Note: Contains copyrighted material.]

The American Enterprise Institute (AEI) and Africa Fighting Malaria (AFM) collaborated on this report that investigates what impact corruption and import tariffs have on access to medicines in poor countries. According to the World Health Organization, approximately one-third of the world's population lacks access to essential medicine and proper medical treatment. Drawing upon extensive evidence from surveys and accounts from the field, the report examines the impact of tariffs, taxes and other markups on imported medicines and medical products provided to lesser-developed countries by pharmaceutical companies, not-for-profit groups, for-profit corporations, multilateral and bilateral aid, and health agencies.

The authors conclude that efforts to reform the current system of government-revenue generation through tariffs collection, may meet resistance in many developing countries -- especially those with systemic corruption and domestic production. However, governments that take steps to eliminate tariffs, could in fact expedite health care delivery and consequently improve the well-being of their people.

 

EUROPEAN PHILANTHROPY AND HIV/AIDS: A REPORT BY THE EUROPEAN HIV/AIDS FUNDERS GROUP
Peter Laugharn and Eric Lief, Center for Strategic and International Studies (CSIS). August 16, 2006
Full Report: [pdf format, 40 pages]

This report by the European HIV/AIDS Funders Group (EFG) is an analysis of information on 2005 HIV/AIDS spending by European foundations, trusts and charities. It provides information to the international community on European philanthropic HIV/AIDS spending, with the object of guiding a true multi-party, multi-sectoral response to the HIV/AIDS pandemic.

 

IFJ [INTERNATIONAL FEDERATION OF JOURNALISTS] RESEARCH FINDINGS ON REPORTING HIV/AIDS IN SIX COUNTRIES IN AFRICA AND ASIA.
International Federation of Journalists (IFJ). July 2006
Full Report: [pdf format, 81 pages]

[Note: Contains copyrighted material.]

The research for this report, which focused on six countries in Africa and Asia, indicates that HIV/AIDS reporting in affected regions is improving, but that there is still significant work to be done. The research, including media monitoring which examined 356 articles that mentioned HIV/AIDS over the two-week monitoring periods in Africa and Asia, uncovered sensational reportage and terminology such as "deadly disease," "HIV holocaust," "scourge," and "deepest wound in society". Images were more likely to be seen as sensational. The researchers also noted that the complicated issue of confidentiality when identifying people living with HIV/AIDS, was a problem for media.

A significant proportion of journalists and NGOs surveyed said that HIV/AIDS reporting in their country could be sensational and derogatory, although coverage of HIV/AIDS orphans tended to be sympathetic, and coverage of medical breakthroughs tended to be neutral. Despite low levels of literacy among the populations most at risk of contracting HIV/AIDS, the research found greater coverage of HIV/AIDS stories in print media rather than in broadcast media. Of the 356 stories sampled over the two-week monitoring periods, 281 (79%) were from the print media and 75 (21%) from the broadcast media. The authors of the report call on media and journalist organizations to institute wide-ranging, regular and sustained training programs for journalists and editors on reporting HIV/AIDS.

Country reports included in the report are from Cambodia, India, Nigeria, Philippines, South Africa, and Zambia.

 

INTEGRATING REPRODUCTIVE HEALTH AND HIV/AIDS PROGRAMS: STRATEGIC OPPORTUNITIES FOR PEPFAR [U.S. PRESIDENT'S EMERGENCY PLAN FOR AIDS RELIEF]. A Report of the CSIS Task Force on HIV/AIDS.
Janet Fleischman. Center for Strategic and International Studies (CSIS). July 2006.
Full Report: [pdf format, 36 pages]

[Note: Contains copyrighted material.]

The CSIS Task Force on HIV/AIDS is co-chaired by Senators Bill Frist (R-Tenn.) and Russell Feingold (D-Wis.) and is funded by the Bill and Melinda Gates Foundation. In the wake of increasing consensus that women and girls need to be the focus of anti-AIDS efforts, this Task Force report urges policymakers to integrate HIV/AIDS services into reproductive health (RP) and family planning (FP) services.

Among the recommendations the Task Force makes are:

• PEPFAR country teams should include women's health advocates and networks of women living with HIV/AIDS in programming and resource allocation decisions.
• The State Department's Office of the Global AIDS Coordinator (OGAC) should bring to the attention of the U.S. government and the U.S. public this growing body of evidence supporting integrated strategies, and build support for a streamlined approach that successfully addresses both reproductive health and HIV imperatives, to the benefit of both.
• PEPFAR should broaden its approach to prevention beyond ABC to include reproductive health and family planning integration.

 

INTERNATIONAL ASSISTANCE FOR HIV/AIDS IN THE DEVELOPING WORLD: TAKING STOCK OF THE G8, OTHER DONOR GOVERNMENTS AND THE EUROPEAN COMMISSION.
Jennifer Kates and Eric Lief. Kaiser Family Foundation (KFF). July 2006.
Full Report: [pdf format, 21 pages]
Chartpack: [pdf format, 15 pages]

This report analyzes funding by the G8 and other major donor governments for the global HIV/AIDS epidemic, and the gap that still exists between needs and actual funding. The authors summarize: "Within the international community, donor governments, through bilateral and multilateral assistance, have an especially important role to play in filling this gap. This is particularly true of the G8 which, in addition to providing significant resources, has shown a unique, collective ability to lead international action on HIV/AIDS and other infectious diseases."

The report indicates that in 2005, G8 members Canada, France, Germany, Italy, Japan, the United Kingdom, and the United States together provided an estimated 75% of total net ODA [Official Development Assistance] reported by members of the Development Assistance Committee (DAC) of the Organisation for Economic Co-operation and Development (OECD). Russia, also a member of the G8, is currently a net recipient of international assistance for HIV/AIDS, but does provide contributions to the Global Fund. In addition to the G8, other donor governments, particularly the Netherlands and Sweden, provide significant amounts of international assistance overall, and for HIV/AIDS, specifically.

 

U.S. INTERNATIONAL HIV/AIDS, TUBERCULOSIS, AND MALARIA SPENDING: FY2004-FY2007.
Tiaji Salaam-Blyther. Library of Congress, Congressional Research Service. June 19, 2006.
Full Report: [pdf format, 12 pages]

This report reviews U.S. spending on the three diseases between FY2004 and FY2007. For FY2007, the President has requested about $4.3 billion for global HIV/AIDS, TB, and malaria efforts, $3.665 billion of which would be funded through foreign operations appropriations. If Congress fully funds the President's request, the United States will have spent $12.8 billion on fighting the three diseases between FY2004 and FY2007.

Page three of this report features a summary table that lists 18 separate USG programs that provide funding to combat worldwide HIV/AIDS, tuberculosis, and malaria. For each program, actual funding for fiscal years 2004 and 2005 is provided; requests and estimates are listed for fiscal year 2006 and fiscal year 2007.

 

BUSINESS AND MALARIA: A NEGLECTED THREAT?
David Bloom, Lakshmi Bloom, Mark Weston. World Economic Forum, Global Health Initiative; Harvard School of Public Health. June 2006.
Full Report: [pdf format, 54 pages]

[Note: Contains copyrighted material.]

Combating malaria is good for business, governments and the community, say the authors of this report. The report states that Sub-Saharan African businesses are highly likely to be affected by malaria, with 72 percent of them reporting a current effect from malaria, and 39 percent reporting serious impacts to their business. According to the report, which surveyed over 8,000 business leaders worldwide across 100 countries, the global business community is becoming increasingly concerned over the threat of malaria, which costs Sub-Saharan Africa 0.6% of its GDP, with one malaria episode costing up to ten working days in terms of lost labor.

Currently, governments undertake a large portion of malaria control efforts. But many governments lack the resources for effective prevention and treatment, creating a need for greater private sector involvement. This report states that recognition of malaria as a serious workplace issue is vital to the long-term productivity and efficiency of African businesses, which ultimately impacts the health and prosperity of the wider continent.

 

THE G-8, RUSSIA'S PRESIDENCY, AND HIV/AIDS IN EURASIA
J. Stephen Morrison and Jennifer Kates. Center for Strategic and International Studies (CSIS); Kaiser Family Foundation (KFF). June 14, 2006.
Download the document [pdf format, 26 pages]

[Note: Contains copyrighted material.]

In July, Russia will host the Group of Eight (G-8) summit for the first time, presenting important opportunities for Russia, its Eurasian neighbors, and the other members of the G-8. This document focuses on one such opportunity-that of turning the G-8's attention to the Eurasian HIV/AIDS epidemic, particularly in Russia, China, and India. It explores the multiple, shared interests of these three nations and other G-8 members in strengthening their coordinated response to HIV/AIDS and the current and potential role of Russia, China, and India in combating the global epidemic outside their borders. It also offers several options that the G-8 could consider to help achieve greater coordination when it meets next month in Saint Petersburg. An annex includes brief background summaries of the history and status of HIV/AIDS in Russia, China, and India.

 

AIDS IN AFRICA
Cook, Nicolas. Congressional Research Service, Library of Congress. Updated May 5, 2006
Download the document [pdf format, 19 pages]

Sub-Saharan Africa has been more severely affected by AIDS than any other part of the world. According to the 2005 United Nations report, there were about 25.8 million HIV positive adults and children in the region, which is about 11.3% of the world's population but over 64% of the worldwide total of infected people. By the end of 2005, an estimated 27.5 million Africans had died of AIDS since 1982, including the 2.4 million in 2005.

AIDS' severe social and economic consequences are depriving Africa of skilled workers and teachers, and reducing life expectancy by decades in some countries. AIDS is blamed for declines in farm production in some countries and is seen as a major contribution to hunger and famine. Donor governments, non-governmental organizations, and African governments have responded by supporting programs aimed at preventing and reducing the number of new infections and by trying to abate damage done by AIDS to families, societies, and economies.

 

AA06209
Stix, Gary A NEW ASSAULT ON HIV (Scientific American, Vol. 294, No. 6, June 2006, pp. 76-79)
Full text available from your nearest IRC

Protease inhibitors that attack the HIV protease enzyme are part of the drug cocktail used to treat HIV-positive patients, but the HIV virus mutates frequently and can become resistant to the inhibitors. Researchers are investigating other parts of the virus replication cycle to find new treatment options. Several are focused on modifying the GAG protein of the virus to prevent the protease enzyme from functioning properly, thus disrupting replication and preventing formation of a mature virus particle capable of infecting another cell. One biotechnology company has developed a maturation inhibitor drug that has significantly reduced the HIV virus levels in patients in preliminary clinical trials, although not all patients responded to it. After further clinical trials the company hopes to apply for final U.S. Food and Drug Administration approval for the drug in 2008. Other researchers are studying inhibitors that prevent the virus from entering a cell or prevent viral DNA from combining with a cell's DNA.

 

ASSESSING HIV/AIDS INITIATIVES IN CHINA: PERSISTENT CHALLENGES AND PROMISING WAYS FORWARD. A REPORT OF THE CSIS TASK FORCE ON HIV/AIDS
Bates Gill. Center for Strategic and International Studies (CSIS), Task Force on HIV/AIDS. June 28, 2006.
Download the document [pdf format, 53 pages]

[Note: Contains copyrighted material.]

The Chinese Ministry of Health (MOH) estimates that approximately 650,000 persons could be infected with HIV/AIDS in China, with about three-quarters of these persons living in five Chinese provinces: Yunnan, Henan, Xinjiang, Guangxi, and Guangdong. About 80 percent of those HIV positive persons do not know their status and the government does not know who they are.

Official data as of the end of 2005 show that prevalence among injection drug users (IDUs) has tripled from 1.95 percent in 1998 to 6.48 percent in 2004, and from 0.02 percent in 1996 to almost 1.00 percent in 2004 among commercial sex workers (CSWs), a remarkable jump of nearly 50-fold. Among pregnant women in high-risk areas, HIV prevalence has also grown substantially, from nil in 1997 to 0.26 percent in 2004.

The author reviews the key activities to date in ameliorating HIV/AIDS in China, and the emergence of a body of best practices. To accelerate the progress made to date, Gill makes the following recommendations:

• Give primary focus to key marginalized and at-risk populations.
• Work toward a more comprehensive, "full-spectrum," patient management approach.
• Intensify engagement with nongovernmental players.
• Deepen coordination across government agencies and key actors.

 

THE HEALTH CONSEQUENCES OF INVOLUNTARY EXPOSURE TO TOBACCO SMOKE: A REPORT OF THE SURGEON GENERAL
U.S. Department of Health and Human Services, Office of the Surgeon General. June 27, 2006
Download the document [pdf format, 727 pages]
Table of Contents: [pdf format, 4 pages]

[Note: The full report is very technical and very long; readers are advised to first go to the table of contents.]

This comprehensive scientific report concludes that there is no risk-free level of exposure to secondhand smoke. Nonsmokers exposed to secondhand smoke at home or work increase their risk of developing heart disease by 25 to 30 percent, and lung cancer by 20 to 30 percent. The finding is of major public health concern due to the fact that nearly half of all nonsmoking Americans are still regularly exposed to secondhand smoke.

The report finds that even the most sophisticated ventilation systems cannot completely eliminate secondhand smoke exposure and that only smoke-free environments afford full protection. The only way to protect nonsmokers from the dangerous chemicals in secondhand smoke is to eliminate smoking indoors.

 

THE HEALTH CARE CRISIS AND WHAT TO DO ABOUT IT
Krugman, Paul; Wells, Robin (New York Review of Books, vol. 53, no. 5, March 23, 2006, pp. 38-43)
Full text available from your nearest IRC

Health care reform in the US is a highly contentious issue. While there seems to be consensus that reform is necessary, there is little agreement on the right solution to what many consider an intractable problem. In their review of three new books on the US health care system, Krugman and Wells argue that the savings that would result from replacing the current complex mix of health insurance systems with standardized universal coverage such as in Canada and the United Kingdom, would be large enough to cover all those currently uninsured. Whether this is politically possible, given the powerful drug and private medical insurance lobbies, as well as free-market ideology, is a moot point. Krugman and Wells, however, conclude that in the end, "America will end up with national health insurance...simply because nothing else works."

 

2006 REPORT ON THE GLOBAL AIDS EPIDEMIC: A UNAIDS 10TH ANNIVESARY SPECIAL EDITION
Joint United Nations Programme of HIV/AIDS (UNAIDS). May 2006
Download the document [pdf format, 629 pages]

Summary: [pdf format, 28 pages]

 

This report includes country, regional and global estimates for the HIV and AIDS epidemic at the end of 2005 and 2003. It also describes the evidence, the success stories and the challenges that confront countries and the international communitiy in responding to the epidemic.

 

THE WORLD HEALTH REPORT 2006 - WORKING TOGETHER FOR HEALTH
World Health Organization (WHO). 2006
Download the document [pdf format, 237 pages]

Summary: [pdf format, 16 pages]

 

The report contains an expert assessment of the current crisis in the global health workforce and ambitious proposals to tackle it over the next ten years. It reveals an estimated shortage of almost 4.3 million doctors, midwives, nurses and support workers worldwide. The shortage is most severe in the poorest countries, especially in sub-Saharan Africa, where health workers are most needed. The report lays out a ten-year action plan in which countries can build their health workforces, with the support of global partners.

 

PROGRESS ON GLOBAL ACCESS TO HIV ANTIRETROVIRAL THERAPY: A REPORT ON "3 BY 5" AND BEYOND.
World Health Organization (WHO) and Joint United Nations Programme on HIV/AIDS (UNAIDS). March 2006.
Full Report [pdf format, 84 pages]

[Note: Contains copyrighted material.]

WHO and UNAIDS jointly launched the "3 by 5" strategy in December 2003, with the objective of helping low- and middle-income countries provide treatment to 3 million people living with HIV/AIDS by the end of 2005. The "3 by 5" target challenged governments, foundations, corporations and the United Nations system to scale up access to antiretroviral therapy as quickly and effectively as possible. While the "3 by 5" target was not met on time, the ongoing effort to expand access to antiretroviral therapy has brought about positive change.

This report describes the areas in which important progress has been made and lessons learned, and outlines the remaining challenges and roadblocks to treatment access. According to the authors, the experiences described in this report demonstrate that large-scale HIV treatment access is achievable, effective and increasingly affordable, even in the most resource-constrained and challenging settings.

The report lists key actions that must be urgently undertaken to increase momentum in scaling up treatment, including:

• Enhance funding and equity
• Expand testing and counseling
• Maximize prevention
• Strengthen the health sector
• Improve information systems
• Confront budget constraints

 

AA06128
Barnett, Tony HIV/AIDS, POLITICS, GOVERNANCE AND 'SECURITY': SUNDERING THE INTERGENERATIONAL BOND? (International Affairs, vol. 82, no. 2, March 2006, pp. 297-315)
Full text available from your nearest IRC

The author writes that there is a disharmonious resonance between the lifecycle of the human immunodeficiency virus and that of its human host. In heavily affected countries, many people live long enough to have children and then die, leaving behind large numbers of orphans. The long-term consequences of this trend can only be surmised -- while some foresee social disorder arising from legions of poorly socialized and unruly children when they reach adulthood, the evidence is far from clear. Barnet discusses these arguments and reviews the evidence, particularly in relation to the links between premature death and electoral processes in southern Africa. This is one of a special series of articles in this issue, marking the twenty-fifth year of the HIV/AIDS epidemic.

 

Global Health: Spending Requirement Presents Challenges for Allocating Prevention Funding under the President's Emergency Plan for AIDS Relief. [GAO 06-395]
United States General Accounting Office (GAO). April 4, 2005
Full Report [pdf format, 93 pages]

The U.S. Leadership Against HIV/AIDS, Tuberculosis, and Malaria Act of 2003 authorizes the President's Emergency Plan for AIDS Relief (PEPFAR) and promotes the ABC model (Abstain, Be faithful, or use Condoms). It recommends that 20 percent of funds appropriated pursuant to the act be spent on prevention and requires that, starting in fiscal year 2006, 33 percent of prevention funds appropriated pursuant to the act be spent on abstinence-until-marriage. The Office of the U.S. Global AIDS Coordinator (OGAC) is responsible for administering PEPFAR. GAO reviewed PEPFAR prevention funds, described PEPFAR's strategy to prevent sexual HIV transmission, and examined related challenges.

 

SAVING LIVES: CHILDREN'S RIGHT TO HIV AND AIDS TREATMENT.
Global Movement for Children. May 26, 2006.
Full Report [pdf format, 20 pages]

[Note: Contains copyrighted material.]

Although the majority of people living with HIV are adults, HIV-positive children represent a disproportionate number of those needing immediate treatment. More than 90 percent of children with HIV live in sub-Saharan Africa. These children also have the least access to any treatment. But in the current profit-driven climate of drug development, they offer little financial incentive to the pharmaceutical industry, the report states. As a result, despite an urgent need for pediatric formulations of anti retroviral therapy (ART) in developing countries, child appropriate treatment is practically non-existent.

The authors of the report call for specific steps, including:

• Development and increased availability of simple and affordable diagnostic tests.
• Enhancement of research and development for child specific treatment.
• Improvement of health care systems of developing countries to improve drug delivery systems.
• Establishment of child-specific treatment targets.

 

WHO REPORT 2006 GLOBAL TUBERCULOSIS CONTROL: SURVEILLANCE, PLANNING, FINANCING.
World Health Organization (WHO), 2006
Full Report [pdf format, 250 pages]

Summary [pdf format, 3 pages]

 

The 10th WHO annual report on surveillance, planning and financing for global tuberculosis (TB) control includes data on case notifications, treatment outcomes, activities, budgets, costs and expenditures. According to the report there were 9 million new TB cases and approximately 2 million TB deaths in 2004. The number of TB cases was stable or falling in 5 of 6 WHO regions, but growing in Africa where the TB epidemic is still driven by the spread of HIV. More than 80% of all TB patients live in sub-Saharan Africa and Asia.

 

ACTION TODAY, A FOUNDATION FOR TOMORROW: THE PRESIDENT'S EMERGENCY PLAN FOR AIDS RELIEF.
U.S. Global AIDS Coordinator. U.S. Department of State. February 2006.
Full Report: [pdf format, 166 pages]

Required by the United States Leadership Against HIV/AIDS, Tuberculosis, and Malaria Act of 2003, this annual report to the U.S. Congress on the President's Emergency Plan For AIDS Relief (PEPFAR) describes programs and results achieved for fiscal year 2005. According to the report, the United States committed approximately $2.8 billion to the Emergency Plan in FY 2005, up from $2.4 billion in FY 2004 -- the first year of implementation. By its assessment, the $3.2 billion for FY 2006 requested by President Bush and appropriated by Congress, keeps the Emergency Plan on track to meet the President's five year, $15 billion commitment.

The report highlights PEPFAR's investment in partnerships with host nations to build locally led HIV prevention, treatment and care strategies. In FY 2005 PEPFAR worked to build high quality, sustainable programs via bilateral programs in more than 123 countries, including a special emphasis on 15 focus countries in Africa, the Caribbean, and Asia that together account for approximately one-half of the world's 40 million HIV infections. Also highlighted is the United States' continuing leadership role in ensuring the success of the Global Fund to Fight AIDS, Tuberculosis, and Malaria - both as a founding member and as the Fund's largest donor.

The report offers numerous "best practices" from PEPFAR's growing knowledge base, and details the Plan's commitment to a continuous cycle of program improvement. The report concludes: "After two years of the Emergency Plan, it is clear that high-quality programs can work - and are working - in many of the world's most difficult places."

 

HIV/AIDS: CHANGES NEEDED TO IMPROVE THE DISTRIBUTION OF RYAN WHITE CARE ACT AND HOUSING FUNDS. [GAO- 06-332]
Government Accountability Office (GAO). February 28, 2006
Full Report [pdf format, 135 pages]

According to the report GAO was asked to examine how CARE Act and HOPWA funds are allocated among types of services, the extent of funding distribution differences among CARE Act and HOPWA grantees, and how funding formula provisions contribute to these differences, and what distribution differences could result from incorporating HIV case counts in CARE Act and HOPWA funding formulas.

GAO found out that:

• CARE Act and HOPWA grants are allocated by grantees for health care, housing assistance, and a variety of services for people with HIV/AIDS. These grants provide services for persons who have been diagnosed with HIV that has not progressed to AIDS as well as those for whom it has.
• CARE Act and HOPWA grants are allocated by grantees for health care, housing assistance, and a variety of services for people with HIV/AIDS. both the CARE Act and HOPWA use measures of AIDS cases that do not accurately reflect the number of persons living with AIDS. For example, the statutory funding formulas require the use of cumulative AIDS case counts, which could include deceased cases.
• If HIV case counts had been incorporated along with AIDS case counts in allocating fiscal year 2004 CARE Act and HOPWA grants, funding would have shifted among jurisdictions.

GAO recommends that if congress wishes CARE Act and HOPWA funding to more closely reflect the distribution of persons living with AIDS, it should consider taking actions that lead to more comparable funding per case by revising the funding formulas. HHS and HUD generally agreed with GAO's identification of issues in the funding formulas.

 

THE ROLE OF LIBRARIES IN HIV/AIDS INFORMATION DISSEMINATION IN SUB-SAHARAN AFRICA.
The U.S. National Commission on Libraries and Information Science. September 2005
Full Report [pdf format, 165 pages]

The U.S. National Commission on Libraries and Information Science (NCLIS) has published a document on The Role of Libraries in HIV/AIDS Information Dissemination in Sub-Saharan Africa. Believing that a key weapon in the battle against the HIV/AIDS pandemic is education and information targeted directly to the general public, especially young people, the Commission set the goal of this study to explore how information is--or can be--disseminated in parts of the world where the impact of HIV/AIDS has been the greatest, and the resources of the countries impacted have been the smallest. Nowhere is information so crucial and nowhere is information for the general population so lacking as in Africa.

 

AA05397
Gibbs, W. Wayt; Soares, Christine PREPARING FOR A PANDEMIC (Scientific American, Vol. 293, No. 5, November 2005, pp. 44-54)
Full text available from your nearest IRC

As the H5N1 bird flu virus spreads to more countries and new cases of human infection occur, resulting in the death of about half those infected, there is growing concern that this virus could mutate enough to cause a global influenza pandemic and claim millions of lives. Scientists, medical experts, and government officials are assessing the strengths and weaknesses of public health systems and developing plans to respond to such a pandemic. The authors review progress on four lines of defense: surveillance to detect outbreaks, methods to contain outbreaks, vaccine development and medical treatments. The authors note that no government is prepared at this time to deal with a pandemic and "responses will vary locally as individual countries with differing resources make choices based on political priorities as much as on science." The authors are staff at Scientific American.

 

AA06043
Cohen, Jon THE NEW WORLD OF GLOBAL HEALTH (Science, vol. 311, no. 5758, January 13, 2006, pp. 162-167)
Full text available from your nearest IRC

Support and funding for improving public health in developing countries has increased sharply in recent years with the realization that improved health of a population can be a key factor in speeding development and sustainability of a nation as a whole. As increasing sums are being earmarked for public health campaigns and more governments and organizations are taking part, questions arise about the effectiveness and methods of the efforts. "There's no architecture of global health," said one expert quoted in the article. Cohen examines the arguments surrounding the proper means for delivering aid to the developing world and the debate over how to spend assistance to achieve the greatest gains in overall health.

 

ACTION TODAY, A FOUNDATION FOR TOMORROW: THE PRESIDENT'S EMERGENCY PLAN FOR AIDS RELIEF: SECOND ANNUAL REPORT TO CONGRESS.
U.S. Department of State. February 2006
Full Report [pdf format, 166 pages]

Summary [pdf format. 8 page]

 

The fight against this pandemic, if it is to be effective and sustainable, must truly be led by the people and the governments of the host nations. That partnership involves not just meeting the needs of the people we seek to help, but working with them to grow their capacity for the future.

 

AIDS EPIDEMIC UPDATE 2005
Joint United Nations Programme on HIV/AIDS (UNAIDS) and World Health Organization (WHO). December 2005
Download the document [pdf format, 98 pages]

The annual AIDS epidemic update reports on the latest developments in the global AIDS epidemic. With maps and regional summaries, the 2005 edition provides the most recent estimates of the epidemic's scope and human toll, explores new trends in the epidemic's evolution, and features a special section on IV prevention.

 

THE GLOBAL FUND AND PEPFAR IN U.S. INTERNATIONAL AIDS POLICY [RL33135].
Raymond W. Copson. Library of Congress. Congressional Research Service. November 3, 2005
Download the document [pdf format, 16 pages]

This CRS Report provides background on funding issues and policy options pertaining to the President's Emergency Plan for AIDS Relief (PEPFAR) and the Global Fund for AIDS, Tuberculosis, and Malaria. The United States is responding to the international AIDS pandemic through PEPFAR, which includes bilateral programs and contributions to the multilateral Global Fund. PEPFAR overall appears on target to meet the Administration's five-year, $15 billion spending plan. By contrast, the Global Fund, which relies on multiple donors, is reporting a funding gap that may prevent it from awarding new grants to fight the pandemic.

The Fund estimates that it needs $3.3 billion in 2006 and 2007 to cover the renewal of its existing grants, in addition to $3.7 billion in order to fund two new Rounds of grant-making. At a September 2005 Global Fund pledging conference in London, donors offered a total of $3.7 billion for the two years, and unless additional pledges are made, the Fund will be able to do little more than fund existing grants. The United States, at the London meeting, pledged a total $600 million for 2006 and 2007, although Andrew Tobias, the U.S. Global AIDS Coordinator, suggested that Congress might provide a larger amount.

The United States is the largest contributor to the Global Fund through PEPFAR. Nevertheless, advocates for the Global Fund seek a major increase in the U.S. contribution, arguing that it would affirm U.S. leadership in the struggle against AIDS and persuade other donors to increase their support. They believe that the Global Fund has several unique advantages, including its multilateral character, its contribution to capacity building, and its operations in countries other than the 15 PEPFAR focus countries. Supporters of U.S. bilateral programs note that they too build capacity and operate beyond the focus countries, while bringing the capacities of highly experienced U.S. agencies to bear in fighting the pandemic.

 

SIECUS PEPFAR COUNTRY PROFILES: FOCUSING IN ON PREVENTION AND YOUTH
Vanessa Brocato. Sexuality Information and Education Council of the U.S. (SIECUS). November 2005
Download the document [pdf format, 179 pages]

This publication includes individual profiles of the 15 countries receiving HIV/AIDS-related aid under the President's Emergency Plan for AIDS Relief (PEPFAR): Botswana, Côte d'Ivoire, Ethiopia,Guyana, Haiti, Kenya, Mozambique, Namibia, Nigeria, Rwanda, South Africa,Tanzania, Uganda,Viet Nam, and Zambia. These country profiles are intended as a concise guide and resource for policymakers in each country - including the U.S.- as well as educators, service providers, health professionals, and others who are advocating for young people's sexual and reproductive health and rights. We also hope that young people in each of the countries will be able to use this information to advocate on their own behalf for the information and services to which they are entitled.

 

SEXUALLY TRANSMITTED DISEASE SURVEILLANCE 2004
Department of Health and Human Services, Centers for Disease Control and Prevention. September 2005
Download the document [pdf format, 184 pages]

The national syphilis rate in the United States increased for the fourth consecutive year in 2004, according to new data on nationally notifiable sexually transmitted diseases (STDs) released today by the Centers for Disease Control and Prevention (CDC). The report, which provides data on three STDs - chlamydia, gonorrhea and syphilis - also finds that in 2004, the gonorrhea rate reached an all-time low, and chlamydia rates increased, possibly due to expanded and improved screening.

 

AIDS ORPHANS AND VULNERABLE CHILDREN (OVC): PROBLEMS, RESPONSES, AND ISSUES FOR CONGRESS [RL32252]
Tiaji Salaam. Library of Congress. Congressional Research Service. October 26, 2005. Web-posted : November 17, 2005
Full text available from your nearest IRC

The report explores some of the challenges facing children affected by HIV/AIDS and governments with large populations of those children, reviews U.S. and international efforts to address the needs of children affected by HIV/AIDS, and outlines some key issues that may be considered by Congress.

 

GLOBAL MALARIA CONTROL: U.S. AND MULTINATIONAL INVESTMENTS AND IMPLEMENTATION CHALLENGES [GAO-06-147R].
United States Government Accountability Office (GAO). November 16, 2005
Download the document [pdf format, 57 pages]

Each year, hundreds of millions of people are sickened with malaria and more than 1 million people die. Over 80 percent of all malaria deaths occur in Africa, most of them in children under the age of 5. The U.S. government supports the efforts of malaria-endemic countries to control malaria, both directly through agencies such as the U.S. Agency for International Development (USAID) and indirectly through its contributions to multinational organizations such as the Global Fund to Fight HIV/AIDS, Tuberculosis, and Malaria (Global Fund) and its participation in the Roll Back Malaria (RBM) Partnership. The report describe investments that have been made by the U.S. government to support the implementation of national malaria control programs in malaria-endemic countries, both directly and in partnership with other organizations; and also the key challenges to the implementation of national malaria control programs and strategies for addressing those challenges.

 

AA05381
Carey, John AVIAN FLU: BUSINESS THINKS THE UNTHINKABLE (Business Week, November 28, 2005, pp. 36-39)
View article on ProQuest (password required)

This article argues that there will be a global flu pandemic "sometime, somewhere" and details how multinational corporations are preparing for this possibility, as well as the economic problems that a massive viral outbreak could cause. The author states that the pandemic will most likely begin in Asia, due to close mingling of large numbers of people and poultry that is exposed to new strains of flu that could then jump to humans. At the pessimistic end, the direst predictions are that a flu crisis could precipitate a worldwide economic depression and cause hundreds of thousands of deaths in the United States alone, as well as disrupt essential public services throughout the world. Corporations, however, are beginning to plan for this possibility by staying abreast of the latest information, making it possible for employees to work from home, preparing to pull their people out of the worst locations, and cross-training employees in the event of mass absenteeism. Other possible measures: improving air circulation at the office, staggering work hours, and persuading people not to come to work and spread disease to others when they're feeling sick themselves.

 

AA05366
Sachs, Jessica Snyder ARE ANTIBIOTICS KILLING US? (Discover, Vol. 26, No. 11, November 2005, pp. 36-41)
Full text available from your nearest IRC

Hundreds of species of bacteria occur throughout the human body, and their functions are not fully understood. Antibiotic drugs used to kill infection-causing bacteria can kill benign or helpful bacteria, too. Overuse of antibiotics leads to drug-resistant strains of the target species, and scientists have demonstrated that bacteria can exchange genes across species, thus spreading drug resistance. Severe, often deadly infections can occur when resistant bacteria normally found in the digestive system are introduced into other parts of the body via wounds or surgery. Researchers are trying to learn the role of bacteria in chronic disease development, particularly when a species is found in tissue far from where it usually occurs, such as the presence in arteries of oral bacteria commonly found in plaque deposits, or a variety of chlamydia in brain cells of Alzheimer's patients. With more bacterial species becoming drug-resistant, scientists, if not medical practitioners, are becoming alarmed over the widespread use of antibiotics and they wonder if we are learning too late that such use, especially in long-term treatment for chronic disease, may cause greater harm than good. The author is a science and health journalist and former editor of Science Digest.

 

AA05351
Specter, Michael WHAT MONEY CAN BUY (New Yorker, October 24, 2005, pp. 56-71)
View article on ProQuest (password required)

The author writes that malaria kills as many as three million people every year, mostly in Africa; most of the victims are poor children under five. In interviews with those involved in the fight against malaria, the author outlines the history of efforts to eradicate the disease, and explains the science, treatments, and strategies used today by governments, international organizations, scientific research facilities and private foundations. Specter highlights the leading role played by the Bill and Melinda Gates Foundation, noting that "it would be hard to overestimate the impact that the Gates Foundation has had: the research programs of entire countries have been restored, and fields that had languished for years, like tropical medicine, have once again burst to life." Gates himself says about malaria, "by many measures it's easily the worst thing on the planet... And the only way for that to change is to stop malaria. So that is what we are going to have to do."

 

PREVENTING CHRONIC DISEASES: A VITAL INVESTMENT.
World Health Organization (WHO). Web-posted October 2005
Download the document [pdf format, 202 pages]
Download the summary [pdf format, 34 pages]

Note: Contains copyrighted material.

This WHO global report makes the case for urgent action to halt and turn back the growing threat of chronic diseases including cardiovascular and chronic respiratory diseases, cancer, and diabetes. In particular, the report shows that the impact of chronic diseases in many low- and middle-income countries is steadily growing.

The report presents a state-of-the-art guide to effective and feasible interventions, and provides practical suggestions for how countries can implement these interventions to respond successfully to the growing epidemics. The report also features nine country profiles, which were selected on the basis of the size of each country's chronic disease burden, its quality and reliability of available data, and its lessons learned from previous prevention and control experiences.

 

LAW AS A TOOL: THE CHALLENGE OF HIV/AIDS IN UGANDA.
Jenny Kuper. Crisis States Research Center (LSE), Working Paper no.69, October 2005
Download the document [pdf format, 39 pages]

This paper aims to explore, with particular reference to Uganda, the role of human rights law in addressing the HIV/AIDS epidemic. In doing so, it may also contribute to debates concerning: a) the role that law can play in rehabilitating or preventing the formation of 'crisis' states; and b), more generally, the usefulness of law in addressing major development issues."

 

CHILDREN: THE MISSING FACE OF AIDS - A CALL TO ACTION.
Joint United Nations Programme on HIV/AIDS (UNAIDS), October 25, 2005
Download the document [pdf format, 28 pages]

On 25 October, the global campaign "Unite for Children. Unite against AIDS" was launched around by the UNICEF, UNAIDS and other partners in the global AIDS response. According to the report every day there are nearly 1,800 new HIV infections in children under 15 mostly from mother to child transmission, 1,400 children under 15 die from AIDS related illnesses, and more than 6,000 young people aged 15-24 are newly infected with HIV. The world must act now, urgently and decisively to ensure that the next generation of children is AIDS-free.

 

INTENSIFYING HIV PREVENTION: UNAIDS POLICY POSITION PAPER.
Joint United Nations Programme on HIV/AIDS (UNAIDS). August 2005
Download the document [pdf format, 40 pages]

The primary goal of this paper is to energize and mobilize an intensification of HIV prevention with an ultimate aim of universal access to HIV prevention and treatment. It identifies what needs to be done to speedily and effectively bridge the HIV prevention gap.... and to ensure the sustainability of HIV treatment scale-up in the present context. It also highlights the role of UNAIDS in relation to intensifying HIV prevention and points to ways in jointly supportive action can be archived.

 

Laurie Garrett THE LESSONS OF HIV/AIDS (Foreign Affairs, Jul/Aug 2005, Vol.84, Iss. 4; pg. 51)
View article on ProQuest (password required)

The author explores the effect of HIV/AIDS on national and regional security, particularly in Africa and developing countries. Unlike other pandemics, HIV/AIDS spread slowly and its effects on national economies and society were not fully realized by leaders who were slow to respond. However its effects on security are now beginning to be realized, with high infection rates and deaths in national police and defense forces, and regional peacekeeping forces, the basic institutions ensuring regional stability. While these forces may be able to absorb the loss of personnel in the lower ranks, a significant loss within the leadership class is taking place. A similar loss of leadership is being experienced within political institutions. Societies are also experiencing demographic change, with populations skewed toward youth. These factors will have an effect on the political stability and regional security.

Solutions discussed include selective treatment which would provide antiretroviral therapy to key leader and sectors of society such as political leaders and the armed forces. Whatever course of action is taken, HIV/AIDS must form part of any debate on national security issues.

 

AA05292
Bloom, Barry R. PUBLIC HEALTH IN TRANSITION (Scientific American, Vol. 293, No. 3, September 2005, pp. 92-99)
Full text available from your nearest IRC

Bloom, dean of the Harvard University School of Public Health, explores the epidemiological transition of countries with rapidly expanding economies where chronic diseases are becoming the greatest challenge to health systems. In these countries people are living longer and developing diseases such as obesity, diabetes and heart disease, which occur more typically in developed nations like the United States. Bloom illustrates the economic benefits of using measures to prevent or reduce both infectious and chronic diseases. He notes that although health threats often cross national boundaries, there is no global organization in place to develop and coordinate an integrated response to such threats. A sidebar lists eight recommendations that, if implemented, would have significant impact on health around the world.

 

HIV AND NATIONAL SECURITY: WHERE ARE THE LINKS?
Laurie Garrett. Council on Foreign Relations. July 18, 2005
Download the document [pdf format, 72 pages]

The HIV/AIDS pandemic is affecting the security of states throughout the world, weakening economies, government structures, military and police forces, and social structures. The report finds that states with high rates of HIV infection in their productive labor forces and uniformed services have managed to remain intact, from the village level on up, through a plethora of coping mechanisms. But many of these nations are "coping" with HIV while also experiencing massive poverty, tuberculosis, drug-resistant malaria, regional conflicts and a host of other serious challenges. The pandemic now directly afflicts approximately 40 million people, has orphaned more than 12 million children, and killed more than 20 million people.

 

AA05222
Dunavan, Claire Panosian FIGHTING THE PARASITE FROM HELL (Discover, Vol. 26, no. 8, August 2005, pp. 48-53)
Full text available from your nearest IRC

Malaria is caused by a parasite that is transmitted to humans by mosquitoes and attacks the red blood cells. It kills more than one million people each year in the tropics, most of them children whose immune systems haven't developed antibodies against the parasite. Malaria victims suffer recurrent fevers and may develop anemia and become debilitated, causing economic loses in Africa alone estimated at up to $12 billion annually. Chloroquine has been used for more than 50 years to treat malaria, but the drug has lost effectiveness in many areas as the parasite has developed resistance to it. Other medicines such as mefloquine, developed in the United States, and artemisinin, developed in China from a native shrub, were introduced in the 1970s, and a combination of the two drugs is an effective treatment when used for three days. The combination's substantially higher cost than chloroquine limits its availability, so researchers are making synthetic compounds that mimic the action of artemisinin. Currently in clinical trials, these compounds won't be available for use for five years, while millions of children continue to die from malaria. The author is an infectious disease specialist at the University of California at Los Angeles Medical Center.

 

BIOLOGICAL SCIENCE AND BIOTECHNOLOGY IN RUSSIA: CONTROLLING DISEASES AND ENHANCING SECURITY.
The National Academies. 2005
Download the document [html format, 136 pages]
Download the summary [pdf format, 21 pages]

U.S.-Russian collaboration in the biological sciences and biotechnology over the past decade has not only fostered scientific and public health gains for both countries, but also increased mutual confidence that cooperative research in sensitive areas can be directed exclusively to peaceful purposes. To enhance such cooperation and improve Russia's ability to combat disease, the U.S. and Russian governments should establish a joint commission on infectious diseases to identify high-payoff research areas of global significance and promote collaborative activities, says a new report from the National Academies' National Research Council. Furthermore, the United States can play an important role in supporting Russia's efforts to revitalize its public health infrastructure by encouraging balanced partnerships to replace outmoded relationships.

 

Robin Marantz Henig WILL WE EVER ARRIVE AT THE GOOD DEATH? (New York Times Magazine. August 7, 2005)
View article on ProQuest (password required)

No one wants to think about how we will die. However, if we do think about it, we don't imagine ourselves dying in a hospital, in pain, hooked up to a dozen machines that are trying to keep us alive. We would generally prefer to die peacefully at home, surrounded by people we love. But only in the past several decades has the medical establishment begun to recognize this. The growth of the hospice movement, and the more recent development of palliative care, have both made strides in providing elderly and terminally ill people with a more comforting, nurturing and painless dying process. The number of people being cared for in hospices in the United States has increased 6-fold since 1985, particularly since the government sponsored Medicare health plan started paying for hospice care for any patient given 6 months to live. The strength of the hospice is in the palliative care it provides - that is, the prevention and relief from suffering for the terminally ill.

The American Board of Hospice and Palliative Medicine now offers a certifying exam for doctors and others who practice palliative care. This bodes well for patients in hospitals who are near death and would rather be relieved of their suffering than having a feeding tube inserted. However, this begs the question: "Will palliative medicine put physicians back in charge of dying, remedicalizing the experience all over again? Will it turn suffering into just another disease to be cured?

 

COUNCIL REPORT FINDS DIRECT LINK BETWEEN HIV/AIDS PANDEMIC AND NATIONAL SECURITY
Council on Foreign Relations. July 18, 2005
Press release [html format]
Full report [pdf format, 72 pages]

‘The HIV/AIDS pandemic is affecting the security of states throughout the world, weakening economies, government structures, military and police forces, and social structures. ... Authored by Pulitzer Prize-winning journalist Laurie Garrett, Senior Fellow for Global Health at the Council, the report finds that states with high rates of HIV infection in their productive labor forces and uniformed services have managed to remain intact, from the village level on up, through a plethora of coping mechanisms. But many of these nations are "coping" with HIV while also experiencing massive poverty, tuberculosis, drug-resistant malaria, regional conflicts and a host of other serious challenges. HIV is exacerbating each of these problems, and they, in turn, are straining mechanisms designed to cope with AIDS to the point of failure.’ — from the Press Release

 

Jonathon Dee THEIR UNEXPECTED ADOLESCENCE (New York Times Magazine, 26 June 2005)
View article on ProQuest (password required)

In the United States, children who are born infected with HIV aren't dying by the age of 2 or 3 anymore. Instead, with a daily drug regimen, they're becoming teenagers. Focusing on the Family Care Center at Harlem Hospital Center in New York City, one of the first U.S. clinics to treat children with HIV and AIDS, Jonathon Dee asks: What happens when you have to tell a child that they have HIV? Who should tell them? How old should they be? Should they keep it a secret? What happens when they don't? What happens when they do? This article explores the complexities of disclosure, and how children cope knowing, or not knowing, that they have HIV.

 

Laura M. Kelly, Nicholas Eberstadt THE MUSLIM FACE OF AIDS (Foreign Policy, July/Aug 2005, pp 42-48)
View article on ProQuest (password required)

Despite a lack of reliable data, there is growing evidence that AIDS is creeping into the lives of people in Muslim nations. How these nations respond to it will determine the extent that the virus will take hold. Although the Islamic religious culture does to some extent slow the spread of HIV, it does not "inoculate" people against the virus. The authors commend the HIV prevention efforts in Bangladesh and Iran in particular. For example in Bangladesh, imams play a central role in educating people about HIV prevention. The authors warn however that without more public acknowledgement about the existence of the virus, and without coordinated government-led efforts to spread prevention messages to its citizens, the prevalence of the virus will become unmanageable in Muslim nations across the world.

 

PROGRESS ON GLOBAL ACCESS TO HIV ANTIRETROVIRAL THERAPY: AN UPDATE ON "3 BY 5"
UNAIDS, World Health Organization. JUNE 2005
Download the document [pdf format, 34 pages]
Download the Summary [pdf format, 4 pages]

The report shows that the number of people receiving ART is increasing in every region of the world, and the rate of scale-up is also accelerating. In sub-Saharan Africa, the region most severely affected by HIV, approximately 500 000 people are currently receiving ART - more than triple the number of people on ART in June 2004, and nearly double the number just six months ago. Similarly, in Asia -- the second most affected region -- the number of people with access to ART has tripled since June 2004 to approximately 155 000 today. More than 50% of this increase occurred in the first six months of this year.

Today's WHO/UNAIDS report identifies the factors that have helped some countries to achieve important advances in access to ART, as well as the bottlenecks that have slowed progress in many areas. The progress made to date has been possible as a result of the concerted efforts of many countries and donors with technical assistance from UNAIDS, WHO and other partners. The report provides a series of recommendations to increase progress in treatment scale-up, including adopting simplified and standardized treatment approaches that can maximize the number of people receiving quality ART, and help strengthen overall health systems capacity.

 

GLOBAL HEALTH: THE GLOBAL FUND TO FIGHT AIDS, TB AND MALARIA IS RESPONDING TO CHALLENGES BUT NEEDS BETTER INFORMATION AND DOCUMENTATION TO PERFORMANCE-BASED FUNDING.
United States Government Accountability Office (GAO). June 10, 2005
Download the document [pdf format, 66 pages]

This report describes the Global Fund's process for managing grants and disbursing funds, identifies factors that have affected grant performance, reviews the basis and documentation of performance-based funding, and notes recent refinements of Global Fund processes.

 

RYAN WHITE CARE ACT: FACTORS THAT IMPACT HIV AND AIDS FUNDING AND CLIENT COVERAGE.
United States Government Accountability Office (GAO). June 23, 2005
Download the document [pdf format, 49 pages]

This testimony presents preliminary findings on the impact of CARE Act provisions that distribute funds based upon the number of AIDS cases in metropolitan areas, the impact of CARE Act provisions that limit annual funding decreases, the potential shifts in funding among grantees if HIV case counts were incorporated with the AIDS cases that are currently used in funding formulas, and the variation in eligibility criteria and funding sources among state ADAPs.

 

ENGAGING INDIA: THE U.S. ROLE IN INDIA'S FIGHT AGAINST HIV/AIDS
Teresita C. Schaffer, Pramit Mitra. Center for Strategic International studies (CSIS). June 2005.
Download the document [pdf format, 54 pages]

Note: Contains copyrighted material.

The HIV/AIDS epidemic is a major international issue for the United States and one of the most serious questions hanging over India's future. The CSIS Task Force on HIV/AIDS, as part of its ongoing work on U.S. policy toward the HIV/AIDS epidemic in India, organized a workshop on April 26 to assess U.S.-Indian cooperation. The report draws from that workshop and extensive discussions with U.S. and Indian representatives involved in HIV/AIDS work, from the various government agencies in both India and the United States, private universities, nongovernmental organizations (NGOs), foundations, businesses, and Indian-American organizations. The report examines how the United States and India have worked together in meeting the HIV/AIDS challenge.

 

AA05209
Ojcius, David; Darville, Toni; Bavoil, Patrik CAN CHLAMYDIA BE STOPPED? (Scientific American, vol. 292, no. 5, May 2005, pp. 72-79)
Full text available from your nearest IRC

Chlamydia is a rampant sexually-transmitted disease, and is the world's leading cause of preventable blindness. Unfortunately, symptoms rarely occur early on, and most people afflicted with Chlamydia do not get antibiotics until after the damage is done, or do not have access to adequate hygiene or medical care. As a result, about 600 million people worldwide are infected with the various strains of Chlamydia. The best hope for treatment is a vaccine, although the authors note that this will be a difficult challenge, because the microbe has various modes of attack.

 

HEALTH INFORMATION TECHNOLOGY: HHS IS TAKING STEPS TO DEVELOP A NATIONAL STRATEGY.
United States Government Accountability Office (GAO). May 27, 2005; Web-posted May 31, 2005.
Download the document [pdf format, 92 pages]

Health Information Technology (IT) is used to support health care quality and efficiency by providing tools to improve patient care and to reduce administration overhead.

Examples include the following:

• Electronic health records (EHRs) provide patients and their caregivers the necessary information required for optimal care while reducing costs and administrative overhead, such as that associated with patient registration, admission, discharge, and billing.
• Computer-assisted clinical decision support tools increase the ability of health care providers to take advantage of current medical knowledge from online medical references as they make treatment decisions.
• Computerized provider order entry allows providers to electronically order tests, medicine, and procedures for patients, reducing errors associated with hand-written orders and prescriptions.
• Telehealth is used to provide health care to rural and remote areas through the use of communications technologies.

To prevent medical errors, reduce costs, improve quality, and produce greater value for health care expenditures, President Bush has called for the Department of Health and Human Services (HHS) to develop and implement a strategic plan to guide the nationwide implementation of health information technology in both the public and private health care sectors. The Departments of Defense (DOD) and Veterans Affairs (VA), along with other countries, have already taken steps to improve health care delivery and administration by implementing IT solutions. GAO was asked to provide an overview of HHS's recent efforts to develop a national health IT and to identify lessons learned from DOD's, VA's, and other countries' experiences in implementing health IT.

From DOD and VA, GAO provides the following lessons:

• Obtain full endorsement of top leadership,
• define and adopt common standards and terminology,
• recognize and address the needs of the varied stakeholder communities, and
• deploy in small increments and build on success.

Among lessons learned from initiatives in Canada, Denmark, and New Zealand to establish national health IT infrastructures with government support and identified lessons learned from their experiences are these:

• Focus on creating standards first,
• establish a central organization to lead health IT efforts, and
• implement solutions incrementally.

 

PREVENTION INDICATORS FOR THE PRESIDENT'S EMERGENCY PLAN FOR AIDS RELIEF: A REPORT OF THE CSIS TASK FORCE ON HIV/AIDS WORKING COMMITTEE ON PREVENTION.
Jennifer Kates and Phip Nieburg. Center on Strategic and International Studies (CSIS). May 2005.
Download the document [pdf format, 20 pages]

Note: Contains copyrighted material.

The U.S. President's Emergency Plan for AIDS Relief (PEPFAR), now in its second year of full funding, has an ambitious goal of preventing 7 million new HIV infections over a five-year period. The Office of the U.S. Global AIDS Coordinator (OGAC), within the Department of State, has identified a set of HIV prevention indicators intended to gauge progress in reaching this goal in PEPFAR focus countries. Care and treatment indicators have also been identified. Country teams in the 15 PEPFAR focus countries -- Botswana, Côte d'Ivoire, Ethiopia, Guyana, Haiti, Kenya, Mozambique, Namibia, Nigeria, Rwanda, South Africa, Tanzania, Uganda, Vietnam, and Zambia -- are required to report data for these indicators in their annual reports. Preliminary FY 2004 indicator data for the 15 focus countries were presented in PEPFAR's first annual report to Congress

. Indicators for nonfocus countries -- including China, India, and Russia, considered part of the epidemic's "second wave" -- are currently being developed by OGAC, and guidance is expected in 2006.

 

This report characterizes the PEPFAR indicators, including the following points:

• The majority of prevention indicators developed or chosen by PEPFAR are designed to track PEPFAR program inputs and outputs versus national-level outcomes and impacts.
• There is consistency and overlap between many of the PEPFAR indicators and those used by other international initiatives, particularly those identified by the Global Fund's Joint Monitoring and Evaluation (M&E) Toolkit.
• PEPFAR program-level indicators are disaggregated according to the "ABC" approach, with a major emphasis on measuring activities focused on abstinence and/or faithfulness.
• The PEPFAR prevention program indicators include several indicators of training activities (e.g., number of individuals trained).
• There are currently no PEPFAR prevention indicators that specifically measure prevention interventions designed to address nonmedical injecting drug transmission (e.g., referral of injecting drug users to addiction treatment).

 

RUSSIA AND HIV/AIDS: OPPORTUNITIES FOR LEADERSHIP AND COOPERATION: A REPORT OF THE CSIS TASK FORCE ON HIV/AIDS; BROOKINGS/CSIS JOINT DELEGATION TO RUSSIA (FEB. 20-26, 2005).
Brookings Institution and the Center on Strategic and International Studies (CSIS). May 2005.
Download the document [pdf format, 40 pages]

In Russia the HIV/AIDS epidemic has reached serious proportions. Credible estimates are that 1 million or more Russians, or just over 1 percent of the adult population, are infected with HIV, concentrated among injection drug users (IDUs), commercial sex workers (CSWs), and to a less well understood degree, men who have sex with men (MSM). This report warns that it could become a far larger, more generalized epidemic that threatens Russia's youth, women, and others. Already the costs borne of HIV/AIDS in Russia are intensifying demographic, economic, and security concerns.

A joint delegation of the Brookings Institution and the Center for Strategic and International Studies (CSIS) visited Moscow and St. Petersburg in February 2005 as part of the CSIS Task Force on HIV/AIDS, a project mandated to strengthen U.S. leadership in battling the HIV/AIDS pandemic. The principal goal of the February mission to Russia was to gain an understanding of the country's current HIV/AIDS situation; learn about official and private efforts in prevention, treatment, and care; and provide practical recommendations to policymakers in Congress and the Bush administration, along with interested policy experts, for increased U.S.-Russian cooperation to control the disease both in Russia and globally. Specifically, the mission was charged with examining whether there are concrete, emergent openings for expanded U.S. engagement with Russia, with special reference to the Russia-hosted G-8 summit in 2006.

The authors stress that the United States should maintain HIV/AIDS as a diplomatic priority and further enlarge its engagement with Russia on HIV/AIDS. There are numerous opportunities to develop strong collaborations:

• Help upgrade the quality of HIV/AIDS and HIV-TB surveillance and data management;
• Provide support to strengthen Russian NGOs, especially in the area of prevention;
• Increase the training of doctors, nurses, and community workers in treatment, care, and prevention;
• Expand collaboration in scientific research, including in the development of vaccines and microbicides; and
• Create new collaborations between Russian and American faith-based groups, businesses, and media.

 

STRENGTHENING HIV/AIDS PROGRAMS FOR WOMEN: LESSONS FOR U.S. POLICY FROM ZAMBIA AND KENYA.
Janet Fleischman. Center for Strategic and International Studies (CSIS). May 2005.
Download the document [pdf format, 28 pages]

Note: Contains copyrighted material.

This report, based on a field mission to Kenya and Zimbabwe in February 2005, examines the gender perspective of the HIV/AIDS epidemic -- that is, the disproportionate impact on females -- and proffers suggestions to refine the U.S. President's Emergency Plan for AIDS Relief (PEPFAR).

Among the many recommendations Fleishman makes are the following:

• "In preparing the [Country Operational Programs] COPs for 2006, [the Office of the U.S. Global AIDS Coordinator] OGAC should issue guidance to the field . that it expects to see programs targeting women and girls under each program element and that these should include explicit issues and responses to gender considerations."
• "OGAC should issue guidance to the field regarding expectations for strengthening linkages and funding possibilities between PEPFAR and the broader set of U.S. programs working on women's social and economic empowerment."
• "PEPFAR programs should include benchmarks and indicators to monitor the access of women and girls [to treatment, care, and prevention programs.]"
• "Development of PEPFAR guidance and program strategies for addressing gender-based violence should be a priority task."

 

GLOBAL HEALTH PRIORITIES - PRIORITIES OF WEALTHY?
Eeva Ollila. Globalization and Health, April 2005
Download the document [pdf format, 5 pages]

Health has gained importance on the global agenda. It has become recognized in forums where it was once not addressed. In this article three issues are considered: global health policy actors, global health priorities and the means of addressing the identified health priorities. The author argues that the arenas for global health policy-making have shifted from the public spheres towards arenas that include the transnational for-profit sector. Global health policy has become increasingly fragmented and verticalized. Infectious diseases have gained ground as global health priorities, while non-communicable diseases and the broader issues of health systems development have been neglected. Approaches to tackling the health problems are increasingly influenced by trade and industrial interests with the emphasis on technological solutions.

 

WORLD HEALTH ASSEMBLY ADOPTS NEW INTERNATIONAL HEALTH REGULATIONS.
World Health Organization, May 2005
Download the document [pdf format, 60 pages]

The World Health Assembly has approved a new set of International Health Regulations to manage public health emergencies of international concern. The new rules will prevent, protect against, control and provide a public health response to the international spread of disease.

 

AA05130
Rosenberg, Tina THINK AGAIN: AIDS (Foreign Policy, No. 147, March/April 2005, pp. 22-24, 26-27)
View article on ProQuest (password required)

Rosenberg, an editorial writer for the New York Times, reviews the status of the fight against the AIDS epidemic by addressing what she terms misperceptions about the battle. Among these are: recognition of the severity of the disease, funding, effectiveness of drug regimens, treatment and risky behaviors, status of the disease in socially conservative nations, differences in the disease in Asia and Africa, and the role of poverty. She concludes, "The grace for China, India, Russia, and other countries poised on the edge of today's epidemics is that the world is realizing that the prevention of millions of deaths is wholly within its power."

 

AA05141
Corrigan, Paul; Glomm, Gerhard; Mendez, Fabio AIDS CRISIS AND GROWTH (Journal of Development Economics, Vol. 77, No. 1, June 2005, pp. 107-124)
Full text available from your nearest IRC

The authors examine the economic growth effects of an AIDS epidemic in a community in sub-Sahara Africa. Economic growth factors impacted by AIDS are many, but the authors focus on two: the effect of decreased life expectancy on investment in physical and human capital, and the changes wrought by a large generation of orphans. They use models to evaluate the economic behavior of an AIDS community and make suggestions for further study. The authors note that understanding the economic behavior of communities impacted by AIDS is essential to providing the best possible policies to mitigate the economic devastation.

 

AA05144
Kluger, Jeffrey CONQUERING POLIO (Smithsonian, vol. 36, no. 1, April 2005, pp. 82-89)
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Fifty years ago, during a press conference at the University of Michigan at Ann Arbor, the announcement was made that a polio vaccine developed by 40-year-old physician and researcher Jonas Salk was effective against that disease. This summary of Salk's work on the vaccine was adapted by the author from his book, SPLENDID SOLUTION: JONAS SALK AND THE CONQUEST OF POLIO. It describes New York in the years 1952-1955, when every summer polio would cripple tens of thousands of children. Doctors knew little about infantile paralysis and people were terrorized. In the late 1940s, Salk and celebrated microbiologist Thomas Francis developed a vaccine against influenza. In 1947 Salk went to work for the National Foundation for Infantile Paralysis (now the March of Dimes) -- founded by Franklin Roosevelt, the world's best-known polio victim -- and began the research that led to the polio vaccine he developed from a killed virus. The article also mentions the work of Albert Sabin, who created a vaccine from a live but weakened virus. Both vaccines are in use today, although Salk's is considered safest.

 

HHS SECRETARY AND LEADING U.S. COMPANIES SAY HEALTH INFORMATION TECHNOLOGY SHOULD BE URGENT PRIORITY
Department of Health and Human Services, March 2005
Download the document [pdf format, 45 pages]

"HHS Secretary Mike Leavitt issued a new report today citing investment in information technology (IT) as an essential, high priority for the American health care system and the U.S. economy. "Information technology is a pivotal part of transforming our health care system," Secretary Leavitt said. "We are at a critical juncture. Working in close collaboration, the federal government and private sector can drive changes that will lead to fewer medical errors, lower costs, less hassle and better care." The report, "Health Information Technology Leadership Panel: Final Report," was released at the Business Rountable's Chief Executive Officer (CEO) Health Care Summit where Secretary Leavitt and Treasury Secretary John Snow discussed the burden of rising health care costs on the U.S. economy and global competitiveness and the role of health IT in managing these costs. The meeting was chaired by Michael B. McCallister, CEO of Humana, Chairman of the Roundtable's Health and Retirement Task Force, and leader of the Roundtable's efforts to improve the health care system.

 

AA05128
Kilgannon, Corey STUDYING THE RHYTHM OF THE HEALTHY HEART (San Diego Union-Tribune, November 24, 2004)
Full text available from your nearest IRC

Milton Graves, 63, is a talented jazz drummer who made his mark in the 1960s, but after years of hard living as a musician, began studying and teaching holistic healing, and became interested in the effects of music on physiological function. Curious about the heartbeat as a source of musical rhythm, he created computer programs to analyze the heart's rhythms and pitches, and realized that he was able to detect faulty heartbeats, and maybe even correct them through biofeedback. His work earned him a grant from the Guggenheim Foundation in 2000 to buy equipment. Dr. Baruch Krauss, who teaches pediatrics at Harvard Medical School and is an emergency physician at Boston Children's Hospital, says that the medical establishment has only recently begun to appreciate the rhythmic importance of the heartbeat. Says Krauss, "this is what a Renaissance man looks like today ... Milford is right on the cutting edge of this stuff. He brings to it what doctors can't, because he approaches it as a musician."

 

Epstein, Helen. GOD AND THE FIGHT AGAINST AIDS (The New York Review of Books, Vol. 52, No. 7, April 28, 2005)
Full text available from your nearest IRC

This report is based on a study from Uganda that has been underway for more than a decade. During the 1990s HIV infection rates in Uganda fell, from around 15 percent to around 6 percent, a success that is unique on the continent. Most countries relied too heavily on condom promotion alone, whereas Uganda had a range of programs that encouraged abstinence and faithfulness as well as condoms, a strategy that came to be known as ABC — Abstain, Be faithful, or use Condoms.

 

WORLD HEALTH REPORT 2005 — MAKE EVERY MOTHER AND CHILD COUNT
World Health Organization. 2005
Download the document [html format]

The World Health Report 2005 — Make Every Mother and Child Count, says that this year almost 11 million children under five years of age will die from causes that are largely preventable. Among them are 4 million babies who will not survive the first month of life. At the same time, more than half a million women will die in pregnancy, childbirth or soon after. The report says that reducing this toll in line with the Millennium Development Goals depends largely on every mother and every child having the right to access to health care from pregnancy through childbirth, the neonatal period and childhood. The World Health Report 2005 - Make Every Mother and Child Count, says that this year almost 11 million children under five years of age will die from causes that are largely preventable. Among them are 4 million babies who will not survive the first month of life. At the same time, more than half a million women will die in pregnancy, childbirth or soon after. The report says that reducing this toll in line with the Millennium Development Goals depends largely on every mother and every child having the right to access to health care from pregnancy through childbirth, the neonatal period and childhood.

 

PROGRESS & PROMISES: TRENDS IN INTERNATIONAL ASSISTANCE FOR REPRODUCTIVE HEALTH AND POPULATION.
Sally Ethelston with Amanda Bechtel, Nada Chaya, Andrew Kantner and Carolyn Gibb Vogel. Population Action International. 2004
Download the document [pdf format, 164 pages]

“The largest generation of young people ever is about to reach reproductive age, yet hundreds of millions of women still lack access to basic care in pregnancy and childbirth. PAI examined this disconnect between women's needs and financial resources in our own report, Progress & Promises, and the research is conclusive: donor funding is increasing, but not nearly fast enough to keep pace with growing sexual and reproductive health needs, including those related to the burgeoning HIV/AIDS pandemic.”

 

AA05080
Barrett, Chris L. IF SMALLPOX STRIKES PORTLAND... (Scientific American, Vol. 292, No. 3, March 2005, pp. 54-61)
Full text available from your nearest IRC

EpiSims, an advanced epidemiology computer simulation model, was developed at the Department of Energy's Los Alamos National Laboratory beginning in 2000 to unleash "virtual" plagues in computerized models of U.S. cities to see how social networks spread disease. Modeling the interactions of each individual in a population allows epidemiologists to simulate the path of a disease and discover where the outbreak could most effectively be intercepted. The rate at which susceptible people become infected depends on their individual state of health, the duration and nature of their interactions with contagious people, and specific properties of the disease pathogen. Truer models of outbreaks, such as EpiSims, must capture the probability of disease transmission from one person to another, which means stimulating the properties of the disease, the health of each individual, and detailed interactions between every pair of individuals in the group. The authors describe the development of EpiSims, which was built on a model called TRANSIMS, whose simulation was based on Portland, Oregon. They also describe the complexities of social networks, disease models, and response scenarios.

 

HIV/AIDS AND FOOD AND NUTRITION SECURITY: FROM EVIDENCE TO ACTION.
Stuart Gillespie and Suneetha Kadiyala. International Food Policy Research Institute (IFPRI). March 2005.
Download the document [pdf format, 184 pages]

[Note: Contains copyrighted material.]

HIV/AIDS and food and nutrition insecurity are becoming increasingly entwined in a vicious cycle, with food insecurity heightening susceptibility to HIV exposure and infection, and HIV/AIDS in turn heightening vulnerability to food insecurity. The HIV/AIDS pandemic is a global crisis with consequences that will be felt for decades to come. Thirty-nine million people are currently infected with the virus, including more than 25 million from Sub-Saharan Africa. More and more the focus of the spread of the disease is turning to other areas, such as parts of Asia and Eastern Europe. The ability of households and communities to ensure their own food and nutrition security is increasingly being threatened. With the most detailed evidence base yet assembled, this review systematically maps our growing knowledge of the interactions between HIV/AIDS and food and nutrition security, pointing to where and how future policy needs to change to remain relevant and effective.

 

TOBACCO SETTLEMENT: STATES' ALLOCATIONS OF FISCAL YEAR 2004 AND EXPECTED FISCAL YEAR 2005 PAYMENTS.
United States Government Accountability Office (GAO). March 21, 2005; Web-posted March 22, 2005.
Download the document [pdf format, 78 pages]

In the 1990s, states sued major tobacco companies to obtain reimbursement for health impairments caused by the public's use of tobacco. In 1998, 46 states (all but Florida, Minnesota, Mississippi and Texas) and four of the nation's largest tobacco companies signed a Master Settlement Agreement (MSA) that requires the tobacco companies to make annual payments to the states in perpetuity as reimbursement for past tobacco-related health care costs. The MSA commits the tobacco companies to pay the states approximately $206 billion over the first 25 years. Some of the states have arranged to receive upfront proceeds based on the amounts that tobacco companies owe by issuing bonds backed by future payments.

The MSA allows states to use their tobacco settlement payments for any purpose. States reported that they used the largest portions of the fiscal year 2004 payments to address budget shortfalls (about 44 percent) and to fund health-related programs (20 percent). Compared with fiscal year 2004, states in fiscal year 2005 expect to decrease allocations to address budget shortfalls (11 percent) and to increase allocations to both health-related programs (32 percent) and debt service on securitized funds (23 percent).

 

 

ASHP NATIONAL SURVEY OF PHARMACY PRACTICE IN HOSPITAL SETTINGS: PRESCRIBING AND TRANSCRIBING-2004 (American Journal of Health-System Pharmacy, Vol. 62, Feb 15, 2005)
Download the document [pdf format, 13 pages]

In assessing the role of pharmacists in prescribing and transcribing, the present study sought to describe pharmacy and therapeutics (P&T) committee activities, the process of formulary system management, the use of clinical practice guidelines, medication-use evaluation activities, the use of trend data to improve prescribing, the extent of pharmacist consultations, the provision of drug information to prescribers, the evaluation of medication orders, the use of computerized prescriber-order-entry (CPOE) systems, and actions taken to ensure accurate transcription of medication orders.

 

AIDS IN AFRICA: THREE SCENARIOS TO 2025.
Joint United Nations Programme on HIV/AIDS (UNAIDS). March 4, 2005.
Full Report [pdf format, 224 pages]
Table of Contents [sections in pdf format, various pagings]
Executive Summary [English-language, pdf format, 28 pages]
Executive Summary [French-language, pdf format, 28 pages]

This report presents three possible case studies for how the AIDS epidemic in Africa could evolve over the next 20 years. Each scenario is based on possible policy decisions taken today by African leaders and the rest of the world. The scenarios set out to answer one central question: "Over the next 20 years, what factors will drive Africa's and the world's responses to the AIDS epidemic, and what kind of future will there be for the next generation?"

The scenarios project was based on two key assumptions:

• AIDS is not a short-term problem; AIDS will affect Africa 20 years from now. What is uncertain is in what ways and to what extent AIDS will shape Africa's future.
• Decisions taken now will shape the future of the continent. The scenarios also address the factors fuelling Africa's AIDS epidemics, including poverty, gender inequality, and underdevelopment.

 

THE CHALLENGES OF CREATING A GLOBAL HEALTH RESOURCE TRACKING SYSTEM.
Elisa Eiseman and Donna Fossum. RAND. Web-posted March 4, 2005.
Full Report [pdf format, 141 pages]
Summary [pdf format, 8 pages]

[Note: Contains copyrighted material.]

After extensive research, the authors conclude that in developing countries existing data collections are of limited use in addressing key health policy issues, such as resource mobilization and allocation, for which they were not designed to serve.

They summarize the major weakness of existing collections:

• They are not always sufficiently comprehensive.
• The data are sometimes inaccurate.
• They are often lacking in timeliness and detail.

The result is that policymakers in developing and developed countries alike have no ongoing access to complete, accurate, up-to-date, detailed data on the resources being devoted to health in developing countries.

Eiseman and Fossman characterize an "ideal health resource tracking system" as a system that would seamlessly follow and integrate all cash and in-kind resource streams in real time without double-counting, and that would do so without placing a reporting burden on any of the entities involved.

They state that a truly global health resource tracking system would:

• Contain valid, detailed data (who, what, where, how much) on all health resources (cash and in-kind) provided last year (expenditures) and this year (obligations) and to be provided next year (budgeted) to all developing countries by all public and private entities in virtually real time without double-counting any resources.
• Impose on any public or private entity no more than a minimal burden in terms of its provision of the information needed to populate the system.
• Readily harmonize with and connect to the existing data systems of receiving countries and all donor entities.
• Be easily accessible via the Web and flexibly searchable by every data element in a variety of languages.
• Enjoy broad ownership, official buy-in, and use, with long-term support from a diversified funding base.

 

DOES NEIGHBORHOOD DETERIORATION LEAD TO POOR HEALTH?
[RAND Research Brief] RAND. Web-posted March 2, 2005.
Download the document [pdf format, 5 pages]

[Note: Contains copyrighted material.]

Among the main findings of this report are the following points:

• Even after controlling for poverty, residents of deteriorated neighborhoods had higher rates of gonorrhea, premature death in general, and death from cardiovascular disease and homicide.
• A neighborhood's collective efficacy - i.e., residents' willingness to help out for the common good - was associated, after controlling for poverty, with lower rates of premature death in general and death from cardiovascular disease and homicide.
• However, the association between collective efficacy and lower rates of premature death was not seen in neighborhoods with a high percentage of boarded-up stores and homes, litter, and graffiti.

 

AA05066
Hard, Ben AGAINST THE MIGRAINE. (Science News, Vol. 167, No. 8, February 19, 2005)
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Migraines are throbbing headaches that, for many people, focus on one side of the head and often involve sensitivity to light, sound and motion; an estimated 28 million people in the U.S. suffer migraines. More than a year after Swiss neurologist Roman Sztajzel treated a female patient for a stroke, he received a letter from her thanking him for curing her migraine headaches -- though he had not seen her for migraines. However, while searching for an explanation of why she had the stroke, he screened the woman for an abnormal opening between the heart's upper chambers. This opening functions in human fetuses to let circulating blood bypass the lungs, which the body doesn't rely on until a newborn starts breathing air; if the opening doesn't close up soon after the baby is born, the condition is called a patent foramen ovale (PFO). To reduce the chances of the patient having another stroke, Sztajzel and his colleagues performed surgery to close her PFO; the patient claimed her migraines stopped immediately.

Studies of stroke survivors suggest that half of migraine sufferers have PFOs. Sztajzel wasn't the only researcher discovering these surprising clues to a cause for migraines -- teams in Italy, Belgium and the U.S. have been examining that possibility. In contrast to drugs, PFO closure appears highly effective against migraines and usually has no side effects, says another researcher. However, most researchers discourage people from seeking the treatment before more data becomes available.

 

Orent, Wendy. WORRYING ABOUT KILLER FLU (Discover. Vol. 26, No. 2, February 2005, pp. 44-49)
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Is it likely that avian flu, which rampaged through poultry flocks in Asia in 2004 and killed 32 people, could cause a widespread epidemic in humans? Epidemiologists studying the H5N1 flu strains that caused the deaths found that those strains did not infect most humans who had contact with infected birds, nor did the flu spread easily among humans. They warn, however, that future mutations in the virus could make it more virulent in humans. Controlling the disease in poultry would provide the best protection for humans because there is no vaccine for humans against avian flu. The article also examines how the 2003 outbreak of SARS, another virus that moved from animals in an Asian market to humans and killed at least 800 people worldwide, differed from the avian flu outbreak.

 

AA 05036
Eberstadt, Nicholas. RUSSIA'S DEMOGRAPHIC STRAIGHTJACKET (SAIS Review. vol. 24, no. 2, Summer-Fall 2004, pp. 9-25)
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Eberstadt, a scholar at the American Enterprise Institute, warns that Russia is on the verge of a steep population decline -- a drastic drop in the birth rate and an astonishing surge in the death rate. Russia currently reports over 170 deaths for every 100 births; if current trends are extrapolated, Eberstadt says that each successive Russian generation will be 40 percent smaller than the previous one. The "demographic shock" that began with the collapse of the Soviet Union in the early 1990s shows no signs of abating, he notes, and a series of powerful factors are working to keep fertility low and mortality high. Infertility among Russian women has soared, largely due to the explosion of sexually transmitted diseases and the widespread reliance on abortion. Everyday violence and poor health habits such as heavy smoking and drinking have contributed to an alarming increase in death from injury and cardiovascular disease. Finally, Eberstadt notes that HIV-AIDS is spreading fast in Russia, and bysome estimates, its prevalence could be as high as 3 percent. These trends have unambiguously negative implications for Russia's economic potential and international influence, writes Eberstadt, yet Russia's leadership and the voting public have not yet begun to address the magnitude of the problem.

 

Holly Burkhalteer. THE POLITICS OF AIDS: ENGAGING CONSERVATIVE ACTIVISTS (Foreign Affairs, Jan/Feb 2004, pp. 8-14)
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American evangelicals have put the fight against AIDS on Washington's map, even while clashing with other activists over strategy. Now all must unite behind a comprehensive approach stressing effective practices in prevention and treatment.

 

Kylie Thomas. A BETTER LIFE FOR SOME: THE LOVELIFE CAMPAIGN AND HIV/AIDS IN SOUTH AFRICA (Agenda, no.62, 2004 pp. 29-35)
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Thomas presents a critique of LoveLife's idealised representations of young South Africans and their sexuality. The central argument is that LoveLife's highly visible HIV/AIDS awareness and prevention campaign obscures rather than addresses the social factors that shape gendered identities and determine the course of the epidemic in South Africa. She criticizes the absence of representations of HIV-positive people from loveLife's campaigns and urgues for the need for awareness and prevention campaigns to address crucial issues such as transactional sex, sexual violence, sex work and treatment access.

 

Martin J. Blaser. AN ENDANGERED SPECIES IN THE STOMACH: IS THE DECLINE OF HELICOBACTER PYLORI, A BACTERIUM LIVING IN THE HUMAN STOMACH SINCE TIME IMMEMORIAL, GOOD OR BAD FOR PUBLIC HEALTH? (Scientific American, February 2004, pp. 38-45)
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Although Helicobacter pylori has long colonized human stomachs, improved sanitation and antibiotics have drastically cut the bacterium's prevalence in developed countries over the past century. People carrying Helicobacter pylori have a highest risk of developing peptic ulcers and stomach cancer but a lower risk of aquiring diseases of the esophagus, including a very deadly type of esophageal cancer.

Studies of the interactions between Helicobacter pylori and humans may lead to better treatments for disorders of the digestive tract as well as a greater understanding of other bacteria that colonize the human body.

 

GLOBAL HIV/AIDS EPIDEMIC: SELECTION OF ANTIRETROVIRAL MEDICATIONS PROVIDED UNDER U.S. EMERGENCY PLAN IS LIMITED. [GAO-05-133]
United States Government Accountability Office (GAO). January 11, 2005; Web-posted January 27, 2005.
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In developing countries, only about 7 percent of people with HIV/AIDS receive treatment. In 2003, the Congress authorized the President's Emergency Plan for AIDS Relief, a 5-year, $15 billion initiative under the Office of the U.S. Global AIDS Coordinator. The Emergency Plan focuses on 15 developing countries, with a goal of supporting treatment for 2 million people. Treatment regimens use multiple antiretroviral medications (ARV), which can be original or generic. Fixed-dose combinations (FDC) combine two or three ARVs into one pill. Questions have been raised about whether the plan is providing ARVs preferred by the focus countries at reasonable prices. GAO compared the selection of ARVs provided under the plan with that provided under other major treatment initiatives, compared the prices of those selections, and determined what the Coordinator's Office is doing to expand the plan's selection of quality-assured lower-priced ARVs.

The report finds that the Emergency Plan provides a smaller selection of ARV products than the selection provided under the initiatives funded by the World Bank, UNICEF, and the Global Fund. Under the Coordinator's Office's application of the Emergency Plan's quality assurance requirement, the ARV products the plan provides must have approval from either FDA or another acceptable regulatory authority. Because six original ARV products have met this requirement, the plan provides these six in its selection. Although this selection includes one double-ARV FDC that can be used in two of the four regimens recommended by WHO as first-line treatments in countries with limited resources, it does not include the triple-ARV FDCs preferred by the majority of the focus countries. In contrast, the other initiatives provide a selection of ARV products that includes not only those that meet the plan's quality assurance requirement but also generic ARVs and one of the preferred tripl! e-ARV FDCs that have met the quality assurance requirements of these initiatives. GAO also concludes that the Emergency Plan's selection of ARV products results in higher prices for most of the first-line treatment regimens.

 

A Public Health Approach to "Prevention With Positives": The New York State HIV/AIDS Service Delivery System.
Klein, Susan J.L. Cruz, Humberto. Journal of Public Health Management & Practice; Jan/Feb2005, Vol. 11 Issue 1, p7, 11p
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Prevention of new HIV infections through meeting the prevention needs of HIV-infected persons, known as 'prevention with positives,' is a national priority. State health departments administer complex HIV/AIDS prevention, health care, and supportive service programs and shape the context for prevention services in their states. This larger context provides opportunities for development and enhancement of HIV prevention interventions. This article presents results of an assessment conducted by the New York State Department of Health of the extent to which the New York State HIV service delivery system, conceptualized as a continuum of services, supports prevention with positives and identifies opportunities for new initiatives. The New York State service continuum offers a comprehensive yet flexible framework into which effective HIV prevention interventions and services are embedded. It is mobilized in support of meeting individuals' HIV prevention needs. The service continuum continues to evolve and requires constant attention on the part of New York State Department of Health to keep pace with the ever-changing HIV epidemic. Additional features of New York State's comprehensive approach to prevention with positives are also discussed. This simple assessment, which can be adapted for use elsewhere, was effective in pinpointing how the current service delivery system supports prevention with positives. Approaches used by state health departments to advance prevention with positives warrant support and recognition.

 

The Time Is Now! The State of AIDS in Black America.
Kai Wright. Black AIDS Institute, February 2005
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The report explains the policies and politics that have helped shape the HIV/AIDS epidemic in Black America and our nation's response to it. It articulates the challenges faced by Black Americans in reshaping and ultimately stopping the HIV/AIDS epidemic. The report speaks to both AIDS experts and members of the community who may have just become aware of the problem and now need information on how and where to get involved.

 

2004 Obese Patient Care Survey Market Research Report
Source: VHA, Inc./Novation, December 2004
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A nationwide survey of VHA Inc. hospitals shows that caring for obese patients is an increasing challenge as providers continue to experience spiraling costs, increases in worker injuries and a significant number of patients who are obese, even in pediatrics. Hospitals have seen the need for new equipment, supplies and training to properly care for this population.