Two countries, opposite approaches: HIV on the rise in Russia and the Philippines

Note: This was cross-posted to my own blog.


Two different articles on rising HIV rates in two different countries crossed my social media news feeds today; I though I would juxtapose them here because they embody very different approaches to a problem (embedded within two very different sociopolitical environments, of course).

The first piece from the BBC focuses on an alarming rise in HIV rates in Russia:

For years Russia has remained remarkably silent on the challenge it faces from HIV and Aids. Now that silence has been broken by an epidemiologist who has been working in the field for more than two decades – and he calls the situation “a national catastrophe”.

Vadim Pokrovsky, the softly spoken head of the Federal Aids Centre in Moscow, has watched as the figures have climbed remorselessly upwards.

There are about one million people living with HIV today in Russia and year on year the rate of infection is rising, unlike sub-Saharan Africa where the rate of increase is slowing. This is according to Russia’s official figures, which almost everyone agrees are a substantial underestimate of the true position.

The epidemic in Russia, argues Mr. Pokrovsky, has been driven by ideological (rather than evidence-based) policies on sex education and injection drug therapy that have been pushed by the Russian Orthodox Church and a conservative government. Education officials argue that comprehensive sex education will encourage kids to have sex (despite plenty of evidence to the contrary), while the use of methadone replacement as a harm reduction strategy for injection drug users is ridiculed and banned (despite the method’s success in reducing HIV transmission through injection drug use in Europe and Australia). HIV infections have predominantly been driven by injection drug use in the past, but sexual transmission is on the rise. Apparently Russia is not on the evidence-based health policy bandwagon.

According to Al Jazeera, meanwhile, the picture of rising HIV rates in the Philippines looks quite different:

In the last five years, HIV cases have gone up 277 percent in the Philippines. While the total number is less than one percent of the 100 million population, it continues to rise. From one reported case every three days in 2000, there are now 21 new cases recorded every day, according to the latest government report.

A separate UN study ranks the Philippines as among the seven countries with over 25 percent or more increase in HIV cases annually from 2001 to 2009, even as the worldwide trend continues to fall.

“Unlike in other parts of the world, the AIDS Epidemic in the Philippines has been growing rapidly,” the Philippine National AIDS Council said.

Danton Remoto, university professor and gay rights activist, however, said that the real number could be 10 to 20 times higher. And he attributed the underreporting to the stigma associated with the disease, particularly among the gay community, the section of the Philippine society worst hit by the disease.

In the case of the Philippines, it has largely been government inaction (rather than counterproductive policies) and social stigma surrounding homosexuality and safer sex practices in the overwhelmingly Catholic country that have driven the epidemic. There is a silver lining here, however, as governments have begun to move (albeit slowly):

Cortes said that only a handful of the 1,634 cities and towns in the country, have programmes related to HIV prevention. She also said that a “very low condom use and low overall knowledge” about reproductive health has contributed to Filipinos engaging in risky sexual behaviours.

It was only in 2014, when the country’s reproductive health law was given a greenlight by the Supreme Court, after it was challenged by the Catholic Church as unconstitutional. The law mandates sex education and access to artificial birth control methods, including condom use.

It also includes provisions on HIV-AIDS awareness and treatment.

Global Health Weekly News Round-Up

UNICEF celebrated its 65th anniversary on December 11, 2011 (Source: http://www.unicefusa.org/news/news-from-the-field/unicef-at-65-looking-back.html).

Politics and Policies

  • The US Department of Health and Human Services announced that, beginning in 2014, states will be allowed a basic set of essential health benefits for millions of Americans who would qualify for coverage through state based insurance exchanges (Source: http://www.politicalnewsnow.com/2011/12/17/states-to-weigh-in-on-basic-health-coverage-reuters/).
  • The US National Transportation and Safety Board (NTSB) called for the first ever nation-wide ban on drive use of portable electronic devices (PEDs) while operating a motor vehicle (Source: http://www.ntsb.gov/news/2011/111213.html).
  • The Association of American Physicians and Surgeons (AAPS) have opposed a rule that required the health care facilities workers to have an annual influenza vaccine or they lose their jobs (Source: http://www.reuters.com/article/2011/12/14/idUS205180+14-Dec-2011+GNW20111214).
  • First United Nations (UN) report on human rights, sexual orientation and gender identity, titled, “Discriminatory laws and practices and acts of violence against individuals based on their sexual orientation and gender identity, A.HRC.19.41.” was released on Wednesday, December 15th, 2011 (Source: http://www.windycitymediagroup.com/gay/lesbian/news/ARTICLE.php?AID=35274).
  • The United States Conference of Mayors issued a report indicating emergency food assistance increased over the past year by an average of 15%. This report, prepared by City Policy Associates, contains each city (29 cities) survey report with their individual profiles – median household income, the metro unemployment rate, the monthly foreclosure rate, percentage of people in city who fall below the poverty line and contact information for individual service providers (Source: http://www.usmayors.org/pressreleases/uploads/20111215-release-hhr-en.pdf).

Programs

Research

Diseases and Disasters

These headlines were compiled by Vani Nanda, MPH Candidate at West Chester University PA.

Global Health News, Week of September 26-30

SECTION NEWS
The Advocacy/Policy Committee would like to invite you to participate in our first Advocacy Day, led in partnership with the Global Health Council. The day, scheduled for Thursday, November 3rd, 2011, immediately following the annual meeting in Washington, D.C., will be an opportunity for us to voice support for a continued focus on international health to our elected officials. With the intense Congressional pressure to cut the budget, our voices can make a real difference. As a participant during this exciting day, you will be provided with training materials on effective advocacy techniques to ensure your message is clearly heard. Even if you do not have advocacy experience, you need not hesitate to sign up because you will be teamed with others. Please consider joining your fellow International Health Section members on Thursday, November 3rd, 2011 on Capitol Hill to advocate for a healthy globe. Interested parties should register here. Please note that registration will close on October 14th. Any questions should be directed to Peter Freeman, Advocacy/Policy Committee Chair, at pffreeman@gmail.com or 773.318.4842.


The University of Washington has launched the first full year of its Global Health Minor program!

POLITICS AND POLICY

  • Tobacco companies knew that cigarettes contained a radioactive substance called polonium-210, but hid that knowledge from the public for over four decades, a new study of historical documents revealed.
  • Latin American leaders have agreed to accelerate their efforts to address maternal health at the 51st Directing Council of the Pan American Health Organization/World Health Organization.
  • Journalist Georgianne Nienaber looks at the impact of PEPFAR and how it may be impacted by budget battles in Congress.
  • Earlier this week, the World Health Organization released a report analyzing air pollution levels in nearly 1100 cities in 91 countries. The analysis was based on air particulate levels between 2003 and 2010.
  • When it came out a while ago that the CIA had used a fake vaccination scheme to try to find out where Osama bin Laden might be in Pakistan, many said it would undermine real health and humanitarian efforts. Here’s one group’s story.
  • Foreign aid has acquired a bad reputation in recent years, as something usually wasteful and useless. Yet all this sound and fury has overshadowed the evidence that aid often can work.
  • A report by the Partnership for Maternal, Newborn & Child Health finds that over 100 countries have increased financing for maternal and child health initiatives.
  • The humanitarian impact of the world economic crisis became clearer this week, as the UN warned of huge job losses, a rise in the number of people afflicted by chronic undernourishment, and the “extraordinary price” being paid by children as “austerity programs” constrict the developing world.
  • There is enough water in the world’s rivers to meet the demands of the expanding global population, but the rivers have to be better managed, according to a series of studies released today at the 14th World Water Congress in Porto de Galinhas, Brazil.
  • UNICEF has called on the IMF and World Bank to ensure that children are not negatively impacted by austerity measures carried out by various countries.

PROGRAMS

  • The New York Times shows how male circumcision is one of the most effective and simple solutions in HIV reduction, but has so far been hard to implement.  Meanwhile, a group of economists, including Bjorn Lomborg, are casting doubt on the cost-effectiveness of voluntary male circumcision campaigns as an HIV prevention measure.
  • The New York Times features an article about the simple innovation of using vinegar to detect if a woman has cervical cancer by applying it with a brush to the cervix.
  • The Global Fund, the world’s largest funder of global health, is set to radically shake up the way it disburses and manages donor money, in a move to boost efficiency that could reallocate a third of its financing in order to save more lives.
  • On Tuesday, the Global Alliance for Vaccines and Immunization announced that it will be expanding its target vaccine areas to directly address diarrhea and pneumonia.
  • UNFPA has announced that it is now collaborating with UNICEF to combat Female Genital Mutilation.

RESEARCH AND INNOVATION

DISEASES AND DISASTERS

  • Roads may accelerate spread of antibiotic resistance: Samples from villages by major roads in Ecuador compared to more rural villages shows antibiotic resistant E. coli is spreading along roads.
  • The recent heavy flooding caused by the monsoon in Pakistan, most devastating in Sindh, has affected the lives of over five million people. The Health and Nutrition Cluster is appealing for US$45.9 million. WHO requires US$14.8 for response for Health, Nutrition and Water and Sanitation intervention.
  • New enterovirus causes respiratory disease: Promed reports on 6 clusters of respiratory illness associated with human enterovirus 68 in Asia, Europe, and the United States during 2008–2010.
  • More than 20 percent of the population of Latin America and the Caribbean lacks basic sanitation and 15 percent has no access to drinking water because of poor management, said experts at a meeting that ended Thursday in Brazil.
  • The likelihood of water-borne disease outbreaks is high in areas in Philippines recently devastated by Typhoon Nesat.
  • Aid groups are criticizing the U.S.government delay on deciding whether to resume large-scale food donations to North Korea. The charities warn that many vulnerable people in the impoverished communist state could die from starvation.
  • In a new report on rabies, the WHO finds that 45% of cases in the world take place in Southeast Asia.
  • A decade-long study of 135,000 men found that those who did not have children had a higher risk of dying from heart disease than those who did, raising new questions over the links between fertility and overall health,U.S. researchers said on Monday.
  • More money is needed to save lives in famine-ravaged East Africa, with the UN saying it’s something like $700 million through year’s end. The World Bank announced from Washington it would boost its aid to area countries to nearly $1.9 billion.  As if famine weren’t enough, Nick Kristoff tells us that as Somalis stream across the border into Kenya, at a rate of about 1,000 a day, they are frequently prey to armed bandits who rob men and rape women in the 50-mile stretch before they reach Dadaab, now the world’s largest refugee camp.
  • An explosion of new technologies and treatments for cancer coupled with a rapid rise in cases of the disease worldwide mean cancer care is rapidly becoming unaffordable in many developed countries, oncology experts said on Monday.

TOTALLY UNRELATED TO ANYTHING – Twitter knows what you’re feeling!

Global Health News Last Week

September 5 was Labor Day.

POLITICS AND POLICY

  • The State Department has announced the official US Delegation to the UN High Level Meeting on NCDs, which will take place September 19-20.
  • Access to affordable lifesaving medicines will be threatened where they are needed most—in parts of the developing world—if the U.S.insists on implementing restrictive intellectual property policies in the Trans-Pacific Partnership (TPP) trade agreement, says Médecins sans Frontières (Doctors without Borders).
  • Sarah Boseley shares the great news that Kenya has officially made female genital mutilation illegal.
  • A federal appeals court in Virginia has dismissed two lawsuits challenging the constitutionality of President Barack Obama’s health care overhaul.
  • United Nations chief Ban Ki-moon singled out sustainable development as the top issue facing the planet with the world’s seven billionth person expected to be born next month. Key to this was climate change, and he said time was running out with the population set to explode this century.
  • Thousands of proposed cuts in the US Congress could lead to significant cuts to USAID.
  • The Philippines reproductive health bill is still making its way through the senate.  Meanwhile, 7 villages in Bataan, the Philippines have banned “artificial contraception” amid national debate over the bill.
  • A report co-authored by an Australian academic highlights the need for healthy ecosystems as the basis for sustainable water resources and stable food security for people around the world.

PROGRAMS

  • Sometime this fall, the world’s population will reach 7 billion people. Experts now forecast that by 2050, the population could be 10 billion. Some say those numbers should force policy makers to focus more intently on making family planning much more widely available in the developing world.
  • The Institution of Mechanical Engineers has put together a one day conference bringing together innovators and health workers to share ideas about ways to more easily deliver interventions.
  • It has been commonly held that insecticide treated bed nets reduce the rate of malaria for people who use them. Now there is hard evidence to back up that assumption.

RESEARCH AND INNOVATIONS

  • A new study shows that less than three doses of the vaccine against cervical cancer can effectively protect women in the developing world where 80% of global deaths due to cervical cancer take place.
  • Only three African countries are on track to achieve MGD 5, according to an African Institute for Development Policy study.
  • Most efforts in the Western world seeking to find solutions for developing world problems tend to think of inventing new technologies or, at least, using the tools we typically use to fix things — modern drugs for diseases, improved seeds for crops, a better mousetrap. Sometimes, all you need is a newly geared donkey
  • Scientists may have developed a new TB vaccine after tests showed the elimination of TB from infected tissue in mice.
  • A socially active lifestyle can dramatically speed up weight loss through the burning of fat in mice, a study shows. Researchers at Ohio State University in the US identified a link between the amount of social interaction in a mouse’s environment and its weight.
  • An easy-to-use diagnostic chip for HIV could “give results in minutes” and be a game changer in the field of cheap diagnostics for remote regions, claim the researchers who developed it.

DISEASES AND DISASTERS

  • Having to contend with U.S.army drones and the crossfire between the Taliban and the Pakistani army, the residents of Pakistan’s tribal areas find access to treatment for HIV/AIDS harder than in most other parts of the world.
  • Three-quarters of a million people are facing death by starvation in Somalia according the United Nations, who declared Monday that famine had spread to a sixth southern region of the beleaguered Horn of Africa state.  Meanwhile, an investigation has revealed that masses of food meant for famine victims in Somalia are being stolen. There have also been reports of rioting and killings during food distribution at camps for famine victims.
  • A magnitude 6.6 earthquake struck 100km southwest of the city of Medan, Sumatra and 110km beneath the earth’s crust.
  • A New York Times editorial castigates the international community’s response to the cholera outbreak in Haiti.
  • The CEO of insulin manufacturer Novo Nordisk says the WHO should buy low cost diabetes drugs in bulk for the developing world.
  • Messages of good health and positive self-esteem for girls aren’t hard to come by in kid lit, so what’s the deal with all the attention for a not-yet-published rhyming picture book about an obese, unhappy 14-year-old named Maggie?

INFOGRAPHICS AND OTHER MEDIA

Global Health News Last Week

POLITICS AND POLICY

Human Rights Watch has urged the Bahraini authorities to halt what it said was a “systematic campaign” to intimidate doctors and other medical staff suspected of sympathising with recent anti-government protests.

PROGRAMS

  • The GlobalPost has been doing an excellent series of stories examining President Barack Obama’s Global Health Initiative (GHI) is focusing on in Guatemala. Slow in its implementation and hampered by little new money, GHI was supposed to be an example of Obama’s new, innovative commitment to global health.
  • The King of Swaziland has called for all of the men in the South African nation to get circumcised in order to prevent the spread of HIV/AIDS.
  • Results from a pilot program in Philippines have shown that deaths from rabies can be dramatically reduced when taking a community driven bottom up approach.
  • A child in Khartoum, Sudan is the first to receive a rotavirus vaccine, kicking off a campaign to vaccinate children in 40 low and middle-income countries.

RESEARCH

  • A recent report from UNAIDS cites data from a recently released South African study that shows the effectiveness of male circumcision reducing HIV prevalence in men.
  • A campaign to encourage African men to get circumcised to prevent infection by HIV gained a powerful boost on Wednesday by three new studies unveiled at an international AIDS forum in Rome.
  • A new study has found that women in conflict areas want to utilize
    contraceptives, but only 4 to 16 percent are able to gain access.
  • At the International AIDS Society, one of the big stories is a CDC study showing the drug Truvada prevented HIV transmissions in more than 60 percent of heterosexuals. The study’s author Dr. Michael Thigpen discusses how much Truvada costs, why HIV is so pervasive among women in Botswana, and how much people must take the drug for it to be effective.
  • Researchers have discovered that chloroquine, often used to treat malaria, may be effective in treating other autoimmune diseases.
  • An antiviral drug to combat HIV/AIDS synthesised by genetically modified plants is being tested on a small number of women in the UK to establish its safety, reports the Guardian.
  • A recent study has shown that stress experienced by a pregnant mother can have a negative impact on the development of the child in the womb.
  • Researchers presenting at the 6th International AIDS Society Conference on HIV Pathogens, Treatment, and Prevention in Rome, say that they have inched closer to a vaccine by leveraging a genetically altered version of SIV.

DISEASES AND DISASTERS

  • The World Health Organization is sounding the alarm on hospital safety and infections acquired while patients are in a health care facility, saying that a hospital  stay is riskier than air travel.
  • Researchers have determined that Hepatitis C can be transmitted sexually, after performing a 5 year study on HIV positive MSM.
  • Famine in parts of southern Somalia has killed tens of thousands of people, mostly children, the UN said Wednesday in an official declaration of what aid officials describe as the worst humanitarian crisis in the troubled country in two decades.
  • A new study warns that Pakistan “risks becoming the last global outpost of [polio], this vicious disease.” The disease has also resurfaced in four other countries.
  • Even in developing countries where child mortality is falling, the poorest under-fives are at high risk of dying from entirely preventable diseases because they do not receive basic immunization and have no treatment for diarrhea.
  • Peter Hotez, president of the Sabin Vaccine Institute, says new studies indicate a parasitic infection, schistosomiasis, may be one of the most important — and least recognized — co-infections increasing the risk of HIV transmission.
  • An All Africa editorial examines how the price of drugs leads to deaths that could be otherwise averted.