global health problem
Thursday, July 29, 2010
Media outlets continued to reflect on news from the International AIDS Conference-AIDS 2010, which attracted over 19,000 participants from 197 countries to Vienna last week, according to the conference blog.
The Washington Post reports that "concerns about [the] costs" of global HIV treatment programs "dominated the talk" of the conference. The newspaper notes that some HIV/AIDS advocates used the conference as an opportunity to voice their criticisms of the Obama administration, which "many … say is reneging on a commitment to continue big annual increases in global AIDS spending."
The article examines how under the Obama administration, global HIV/AIDS funding has been folded into the president's $63 billion, six-year Global Health Initiative [GHI]. Whereas, "[t]he portion devoted to HIV and tuberculosis, an infection to which AIDS patients are particularly prone, is $44 billion," the rest of the funds will be focused on malaria, maternal and child health and strengthening health systems, according to the newspaper. "Although larger than Bush's revolutionary President's Emergency Plan for AIDS Relief (PEPFAR), Obama's GHI is spread across more agencies. It is less a bullet aimed at the heart of AIDS than a net cast to capture a flock of health problems," the Washington Post writes.
Though the U.S. is "the biggest donor" to combat HIV/AIDS in developing countries, "last year providing 58 percent of the $7.6 billion given by governments," HIV/AIDS advocates point to flatlining of international HIV/AIDS assistance in 2008 and 2009 as a sign "big gains in generosity and economizing have mostly stopped."
According to the newspaper, "Although there's argument about the exact numbers, there's little doubt the Obama administration is on track to spend less than planned by either the GHI or the Lantos-Hyde Act of 2008, which renewed PEPFAR and authorized spending $48 billion from 2009 through 2013. Many other donor countries are taking a similar go-slower approach."
The article includes comments by Joanne Carter, director of the anti-poverty group RESULTS and board member of the Global Fund to Fight AIDS, Tuberculosis and Malaria; Paul Zeitz, director of the Global AIDS Alliance; and references recent comments in defense of the president's global AIDS strategy made by Gayle Smith, Obama's special assistant for development and democracy, and Ezekiel Emanuel, the president's special adviser for health policy, published in two blogs last week (Brown, 7/29).
NPR's Talk of the Nation also examines the major news out of AIDS 2010, through conversations between host Tony Cox and Jon Cohen, a correspondent with Science magazine and Steffanie Strathdee, associate dean of global health at the University of California San Diego. Cohen and Strathdee discussed the results of the recent microbicide gel trial, where things stand on progress towards developing an HIV vaccine, the search for an AIDS cure, injection drug use and the aims of Vienna Declaration as well as funding for HIV/AIDS (Cox, 7/27).
Vaccines; Global HIV/AIDS Patient Survey
Meanwhile, Nature News/Scientific American examines "the results of a handful of successful, but small, early-phase clinical trials for therapeutic vaccines – once thought to be a dead end for tackling HIV" that were presented at AIDS 2010. "Normal vaccines are designed to prevent infections, but so far none has worked for HIV," the news service writes. "Therapeutic vaccines, in contrast, aim to treat infected people – in the case of HIV, by boosting ravaged immune systems."
The article examines the potential advantages a therapeutic vaccine could have over current HIV/AIDS treatments and details several approaches companies are taking towards the development of therapeutic vaccines.
"All of the vaccines, which were developed by several small biotechnology companies, modestly but significantly reduced viral levels in the blood of patients, who responded for months or longer," the news service writes. "In some cases, the vaccines also increased levels of CD4+ T cells – the vital immune-regulator cells that HIV depletes. In theory, the vaccines would only need to be administered every few months."
"The ultimate value of the vaccines will only become clear as larger phase III trials roll out over the next few years. For now, leaders in AIDS research are cautious about the results," Nature News/Scientific American continues. The piece includes comments by Anthony Fauci, director of the U.S. National Institute of Allergy and Infectious Diseases (NIAID), who expresses cautious optimism about the potential for therapeutic vaccines in treating patients with HIV/AIDS, and Carl Dieffenbach, head of the NIAID AIDS division (Abbott, 7/27).
In related news, "The AIDS Treatment for Life International Survey (ATLIS 2010) of more than 2,000 HIV-positive patients in 12 countries around the world, found that most respondents also had health conditions such as depression, hepatitis C or kidney disease, which could affect their antiretroviral (ARV) treatment, but less than half had ever discussed these with their healthcare providers," IRIN/PlusNews reports. "Similarly, about half the respondents said their ARV medication had had a negative impact on their lives, but only 43 percent had ever asked their doctor about new treatment options with fewer side effects," according to the news service. The survey, released at AIDS 2010 last week, also documented gaps in patient knowledge about drug resistance (7/26). According to a press release (.pdf), survey participants were interviewed "January-March 2010, via a combination of Internet, phone, and in-person recruitment methods" (7/20).
The University of California today launched a new Global Health Institute with nearly $4 million in start-up funding from the Bill & Melinda Gates Foundation. The institute will focus the combined expertise of the university’s 10 campuses on solving increasingly complex global health problems and meeting the health-care needs of the world’s most vulnerable populations.
The institute will include three centers of expertise. Two of the centers will be co-directed by faculty members at the University of California, Davis: one will address the health issues of migrating people, and the other will concentrate on the effects of nutrition, water, animals and the environment on human health.
The new institute was unveiled today during a conference at UC San Francisco that highlighted the $75 billion impact of global health on the California economy. The global health sector, which includes companies that specialize in enterprises ranging from biopharmaceuticals to agriculture and clean energy, also supports 350,000 high-quality jobs in California and provides $19.7 billion in wages and salaries, according to a recent UC study of the effects of global health on the California economy. The study is available online at http://ucghi.universityofcalifornia.edu/news/eir.
“I am proud that California is such a leader in the emerging academic discipline of global health,” Gov. Arnold Schwarzenegger wrote in the foreword for the economic impact report. “The formation of the University of California multi-campus Global Health Institute and the efforts undertaken by other universities, nonprofit organizations and the business sector directly impact the health of California and the world.”
The institute will begin by offering a one-year master’s degree, enrolling its first students in fall 2011. Eventually, it also will offer two-year master’s and doctoral degree programs, granted by the UC campuses at which the students conduct their work. Under the institute’s umbrella, centers of expertise at the individual campuses will spearhead development of the graduate degree programs and design field projects for students at partnership sites throughout the world.
“UC Davis is well-positioned to play a leadership role in creating solutions to the world’s global health challenges,” said Claire Pomeroy, UC Davis vice chancellor for human health sciences and dean of the School of Medicine. “We transform health through our tradition of working together collaboratively across multiple disciplines on our campus, including human health, veterinary medicine, agriculture and environmental sciences, and more. Our vision of health recognizes the interconnectedness of people, animals and the environment and aims to identify and address the fundamental causes of poor health to improve the well-being of all.”
UC San Francisco's Global Health Sciences is administering the $3.99 million two-year grant from the Bill & Melinda Gates Foundation to plan the institute, which is intended to become self-supporting through gifts, grants and revenue from enrollment fees.
Centers of expertise
The new institute will include three multi-campus, multi-disciplinary centers of expertise: Migration and Health; One Health: Water, Animals, Food and Society; and Women’s Health and Empowerment. The first two centers will be co-directed by faculty members in UC Davis’ School of Medicine and School of Veterinary Medicine, respectively. The third center will be led by faculty members at UCSF and UCLA.
“With experience in wildlife health issues and diseases that spread from animals to people, our veterinary faculty will make a significant contribution to the development of practical solutions to complex health problems involving people, animals, and environmental quality,” said Bennie Osburn, dean of the UC Davis School of Veterinary Medicine. “Working in this multi-campus effort will also help us provide unique opportunities for education and training in holistic health principles and practice.”
The centers were chosen using a competitive application process that involved proposals from 12 teams of faculty across the UC system. During the 2009-2010 academic year, center leaders will work with the institute’s administrative core, based at UC San Francisco, to plan education, research and partnership programs and intervention activities.
Migration and Health center
The Migration and Health center will be led by Marc Schenker, a professor in UC Davis School of Medicine’s Department of Public Health Sciences, in collaboration with Steffanie Strathdee, associate dean of Global Health Sciences at UC San Diego. The other eight UC campuses also will participate in this center.
“Today we live in a vast global community, linked not only by trade and travel, but also by the people who are permanently relocating from their countries of birth,” Schenker said. “They bring with them a rich mix of talents and cultural diversity but all too often they endure higher rates of occupational injuries and illnesses, and yet have less access to health care.”
Some of the problems that are especially of interest for researchers studying the health problems of migrating people include domestic violence; alcohol, tobacco and substance abuse; type two diabetes and other nutrition-related diseases; occupational health and safety; reproductive health; and chronic disorders such as heart and lung disease.
Schenker noted that the new center will work closely with the new Migration and Health Research Center located at UC Davis and UC Berkeley, which was established in September to conduct and sponsor research related to acute and chronic illnesses and injuries among migrating people in California and around the world.
One Health: Water, Animals, Food and Society center
The One Health: Water, Animals, Food and Society center will be led by Patricia Conrad, a professor in the UC Davis School of Veterinary Medicine, in collaboration with Anil Deolalikar, an economics professor and associate dean of the UC Riverside College of Humanities, Arts and Social Sciences. Also participating in this center will be the Berkeley, Irvine, UCLA, San Diego, UCSF, Santa Barbara and Santa Cruz campuses.
“It is becoming very clear that we in the United States both receive and contribute to global health problems,” Conrad said. “This year we saw how new diseases like H1N1 influenza, (“swine flu”), are only a short flight away from us in California and how, within days, they can spread worldwide. We also are seeing how financial decisions made in the United States can profoundly impact the entire world’s economy, just as our carbon use can alter the world’s climate.
“Our students see this clearly, and they want the practical skills, relevant knowledge and opportunities to help solve the resulting health problems that impact vulnerable people in California and globally,” she said. “Now is the best time for the University of California to help prepare students for those challenges.”
Conrad noted that the new One Health center will capitalize on the success of a new UC Davis-based international effort, named PREDICT, which is aimed at detecting and controlling diseases that move between wildlife and people. That global early warning system was established in October with a $75 million grant from the U.S. Agency for International Development to help the world prevent and prepare for outbreaks of infectious diseases like the H1N1 flu, avian flu, SARS and Ebola.
About UC Davis
For 100 years, UC Davis has engaged in teaching, research and public service that matter to California and transform the world. Located close to the state capital, UC Davis has 31,000 students, an annual research budget that exceeds $500 million, a comprehensive health system and 13 specialized research centers. The university offers interdisciplinary graduate study and more than 100 undergraduate majors in four colleges — Agricultural and Environmental Sciences, Biological Sciences, Engineering, and Letters and Science — and advanced degrees from six professional schools — Education, Law, Management, Medicine, Veterinary Medicine and the Betty Irene Moore School of Nursing.