IHSJ Reader     March 2012     Issue 19         

Note: Triple asterisk (***) indicates subscription-only sources.



***High Rate of Hypothyroidism Among Patients Treated for Multidrug-Resistant Tuberculosis in Lesotho (H. Satti, A. Mafukidze, P.L. Jooste, M.M. McLaughlin, P.E. Farmer, K.J. Seung, The International Journal of Tuberculosis and Lung Disease, March 1, 2012)
A retrospective study of 212 patients with multidrug-resistant tuberculosis (MDR-TB) in Lesotho found that two drugs commonly used to treat MDR-TB likely increase the frequency of hypothyroidism among patients. Second-line anti-tuberculosis drugs used to treat MDR- and extensively drug-resistant (XDR) tuberculosis have many known side effects; in fact para-aminosalicylic acid (PAS) was removed from standard TB treatment in the 1960s due to its severe gastrointestinal side effects, but is still commonly used for the treatment of MDR- and XDR-TB. To address the common prevalence of hypothyroidism during MDR-TB treatment, authors suggest screening all patients within 2-3 months of starting MDR-TB treatment, instead of the 5-6 months recommended by the World Health Organization.

Starke: Combat TB Before it Strengthens (Jeffrey Starke, The Statesman, February 23, 2012)
In response to recent tuberculosis outbreaks in Texas, Jeffrey Starke highlights the need for investment in new TB drugs and diagnostics, and expanded TB control efforts in developing countries. Current treatment regimens for tuberculosis are severely outdated with no new drugs in over 40 years.  And now clinical trials for medications that could shorten treatment time and reduce side effects face dramatic funding shortfalls. It is critical that we continue strengthening health care infrastructure in developing countries to prevent the rapid spread of tuberculosis and further emergence of drug-resistant strains.



 Why Cutting PEPFAR Is Bad Policy (Chris Collins, The Hill, March 13, 2012)
HIV International Assistance and Adult Mortality: Africa (Eran Bendavid, C. Holmes, and G. Miller, 19th Conference on Retroviruses and Opportunistic Infections, March 5, 2012)
A new study from Stanford University finds that adults living in countries supported by the President's Emergency Plan for AIDS Relief (PEPFAR) were 20% less likely to die between 2004 and 2008 than adults in non-PEPFAR sub-Saharan African countries. Drawing on this important finding, Chris Collins outlines six reasons why the US Congress must increase the Administration’s Fiscal Year 2013 budget request which cuts PEPFAR’s budget by nearly $550 million (11%).  Cutting funds from the most effective bipartisan, bilateral global health program would undermine broadly-shared economic, humanitarian, and diplomatic interests and make it unlikely that the US can achieve an AIDS-free generation.

Money or Die: A Watershed Moment for Global Public Health (Laurie Garrett, Foreign Affairs, March 6, 2012)
Global health programs “now teeter on the edge of disaster” due to dramatic cuts in global health funding from public, private, and civil society donors.  Faith-based and nongovernmental organizations (NGOs) reduced global health spending by 33% between 2008 and 2010. And with the exception of the Gates Foundation, private sector donors cut contributions by 50% over the same time period. Laurie Garrett argues that the US Government and the Gates Foundation are the last barriers to averting a global health catastrophe. The international community must recommit to improving the health of the poor.

Global Fund Needs Cash to Stem Deaths (Richard Feachem, South Florida Sun-Sentinel, February 27, 2012)
Richard Feachem, former Executive Director of the Global Fund to Fight AIDS, TB, and Malaria (GFATM), calls on the United States to urgently convene an emergency donor meeting to address the Global Fund’s significant funding shortfalls. Since the launch of the GFATM in 2002, the Fund has treated 170 million cases of malaria, 8.6 million cases of TB, and has provided antiretroviral treatment for 3.3 million people living with HIV/AIDS. Nearly half of all people currently on AIDS treatment in low- and middle-income countries depend on the Global Fund to stay alive. Unless international donors take urgent and coordinated action to address the Global Fund’s resource gaps, progress made in the last decade could be lost.



The Time is Now for Food Aid Reform: Five Reasons Why U.S. Policies are Ripe for Reform in the Next Farm Bill (American Jewish World Service, February 2012)
A recent report by the American Jewish World Service outlines five opportunities in the current political and economic climate that make food aid conducive for reform in the 2012 Farm Bill. The US food aid program has the potential to save lives, curb malnutrition, and support local pathways out of poverty, but is seriously hampered by special interests. By taking advantage of this opportunity to reform food aid in the farm bill, Members of Congress can lay the groundwork for a more stable food supply for generations to come. 

***Freshwater Availability and Water Fetching Distance Affect Child Health in Sub-Saharan Africa (Amy Pickering and Jennifer Davis, Environmental Science and Technology, January 2012)  
In Sub-Saharan Africa, A Shorter Walk to Water Saves Lives (Andrew Myers, Stanford University News, March 5, 2012)
This recent study is the first to show that reducing time spent collecting water can significantly improve child health. Cutting the time spent walking to a water source by just 15 minutes can reduce under-five child mortality by 11%.



Guidelines for Improving Entry Into and Retention in Care and Antiretroviral Adherence for Persons with HIV: Evidence Based Recommendations from an International Association of Physicians in AIDS Care Panel (Melanie A. Thompson, Michael J. Mugavero, K. Rivet Amico, Victoria A. Cargill, Larry W. Chang, Robert Gross, Catherine Orrell, Frederick L. Altice, et al., Annals of Internal Medicine, March 5, 2012)
A panel convened by the International Association of Physicians in AIDS Care recently developed guidelines and recommendations to optimize testing and treatment for people living with HIV. The 36 evidenced-based recommendations provide crucial strategies to improve care and treatment and guide international funding to continue addressing, and perhaps end, the global HIV/AIDS epidemic.



Abolishing User Fees for Cesarean Sections in Mali: A Success Story? (Yussif Nagumse, Anna Marriott, Global Health Check, February 22, 2012)  
Improving Access to Life Saving Maternal Health Services: The Effects of Removing User Fees for Cesareans in Mali (Marianne El-Khoury, Timothee Gandaho, Aneesa Arur, Binta Keita, and Lisa Nichols, USAID, April 8, 2011)
In 2005, the Government of Mali implemented a policy to increase access to emergency obstetric care which included free Cesarean sections. A recent USAID evaluation linked the policy to an increase in facility-based deliveries and Cesarean sections, and a reduction in maternal and neonatal mortality nationwide. These findings support the growing body of evidence that removing user fees for health services is an effective way of enhancing access to health care and saving lives. However, challenges remain, including more comprehensive plans for the removal of basic health, drug, and transport fees, improved referral and emergency transport systems, and more reliable infrastructure and supplies. PIH partner Project Muso continues to engage the Ministry of Health in Mali in an evidence-based discussion about broader user fee removal and universal access to health care.

World Bank Must Re-Evaluate Its Strategies to Cut Maternal Mortality (Elizabeth Arend, Poverty Matters Blog, the Guardian, March 6, 2012)
This post in the Guardian’s informative Poverty Matters Blog lays out several steps the World Bank should take in order to live up to its boast that it is a “global leader” in reproductive health.  These steps include providing more aid in the form of grants rather than loans; targeting aid to address all the causes of maternal mortality; and supporting the removal of user fees for women’s and children’s health care. Time and again user fees have been shown to discourage women from seeking care thus perpetuating high maternal morbidity and mortality. 



Remembering Congressman Donald Payne (Antoinette Habinshuti, Partners In Health, March 9, 2012)
Toni Habinshuti from PIH’s Rwandan sister organization, Inshuti Mu Buzima, reflects on the Congressman Payne’s incredible commitment to and impact on global health and development funding for Africa.

WHO Panel on Human Rights Mainstreaming, 19th Session Human Rights Council (World Health Organization, February 28, 2012)  
Written Statement
Watch the Assistant Director-General for Family, Women’s and Children’s Health at the World Health Organization (WHO) discuss the importance of integrating a human-rights based approach into all programming at WHO.