Health Problems

Russia defies growing consensus with declaration of ‘total war on drugs’

Drug dealers are to be “treated like serial killers” and could be sent to forced labour camps under harsh laws being drawn up by Russia’s Kremlin-controlled parliament.

Boris Gryzlov, the speaker of the state duma, the lower house, said a “total war on drugs” was needed to stem a soaring abuse rate driven by the flow of Afghan heroin through central Asia to Europe.

Russia has as many as 6 million addicts (one in 25 people). Every year 100,000 people die from using drugs, Gryzlov said in a newspaper. The scale of the problem “threatens Russia’s gene pool”, he said. “We are standing on the edge of a precipice.

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MSF Website Lends Voice To TB Patients

“Medecins Sans Frontieres, whose volunteer doctors run TB clinics around the world, has launched a website called TB and Me, where patients are regularly blogging on their experiences,” Sarah Boseley writes in the Guardian’s “Global Health Blog.” Bloggers from Australia, India, Uganda, and Swaziland currently write for the site, which is meant to give people living with multi-drug resistant TB (MDR-TB) a voice and express their needs, she writes (6/30).


Another Push for Reproductive Rights

In addition, according to the Reproductive Health Supplies Coalition RHSC, the number of family planning users will soar from 603 million to 709 million – an increase of 64 million users across 66 developing countries, and 42 million spanning 89 middle-income countries – by the middle of the decade The increased cost associated with this skyrocketing demand is an estimated 57 billion dollars per annum for both low- and middle-income countries – including the expenses of procuring more contraceptive commodities, securing transportation for the products, expanding communication capabilities to educate the public, and stepping up training for health providers to distribute reproductive products and services “Today, there are over 200 million women in the developing world who want to prevent or delay pregnancy, but are not using any means of modern contraception,” John Skibiak, director of the RHSC, wrote earlier this month “This is, without a doubt, a horrifying figure But the greatest tragedy for us – those of us who have dedicated our professional lives to ensuring global access to family planning – is that this figure has not budged in nearly two decades… Each step forward is more than matched by comparable increases in demand in new users, [so] despite our best efforts, we are caught in a deadlock” According to Skibiak, 424 million dollars worth of commodities will be needed to satisfy demand for contraceptives by the year 2020, in donor-depent countries alone If donor funding continues at its current rate, the world can expect a shortfall of nearly 200 million dollars annually, or a total deficit of 14 billion dollars between 2008 and 2020 “What we need now is a reinvigorated effort to ensure [reproductive health and commodity security],” Skibiak said “True contraceptive security exists when every person is able to choose, obtain and use quality contraceptives and condoms for family planning and for the prevention of HIV and AIDS and other sexually transmitted infections” Simple Technologies, Huge Results Coming on the heels of the successful Global Alliance for Vaccines and Immunisation GAVI pledging conference earlier this week, which raised over 4 billion dollars to push the global health aga forward, a congressional hearing on public-private partnerships in Washington DC Thursday raised the bar a little higher The Program for Appropriate Technology in Health PATH, Research!America, the Global Health Technologies Coalition, and Bioventures for Global Health, in collaboration with Congressmen Albio Sires and Mario Diaz-Balart, presented ‘Partnerships for innovation: Simple solutions that save lives, which outlined the use of fast solutions to immense global issues “The briefing on the Hill is meant to highlight the benefits of investment by the United States government and the US Agency for International Development USAID in innovation, and to spotlight how weve been able to use this funding to produce technology that is greatly improving peoples lives,” Christopher Elias, president and CEO of PATH, told IPS With 32 field offices spanning 23 countries worldwide, PATH employs a user-driven design process, whereby its innovation efforts are fed directly from the grassroots PATH believes that it is only by monitoring and understanding local and community needs that the characteristics of a particular solution can be properly identified “One of the problems our field staff encountered was that the basic contraceptive diaphragm was not available in developing countries because it required gynaecology exams to determine which size should be used on the woman,” Elias told IPS “As a result, scores of women in low-income countries were missing out on a simple method of birth control because of the absence of the necessary intermediary” So PATH worked to design a new silicone “one-size fits most” contraceptive diaphragm that eliminates the need for gynaecologists and that has been welcomed by women from Africa to Latin America and South Asia “We worked on this for ten years and went through over 20 different designs in a totally interactive design process, so that the product was something the women would definitely use,” Elias told IPS “One thing we were not expecting was that colour mattered a lot to the women – and in fact the final product is a very soft shade of purple, almost lilac, something that was universally popular This is something we could not have anticipated without worldwide feedback!” he added In addition to creating new products, PATH believes that public-private partnerships are essential for deploying already-existing technologies to the women most in need Last year, the United Kingdom-based HIV/AIDS charity, AVERT, reported that in 2009, over 400,000 children under the age of 15 became infected with HIV – the large majority of them through mother-to- child transmission MTCT In fact, the absence of proper treatment means that HIV-positive pregnant mothers face a one in four chance of passing the infection to their newborns Given the current statistic of 18 million HIV-positive women in the world today, these numbers port an almost-certain tragedy Nevirapine, an antiretroviral that has been made available free of charge by the German manufacturer Boehringer Ingelheim, reduces the risk of MTCT by 50 percent; however most women – especially those in remote rural areas – have been unable to access the required dose, delivered in syrup form, since their last visits to health workers often take place several weeks before birth “So PATH worked with USAID funding and Kenyan health workers to create the nevirapine pouch,” Elias told IPS “We developed a very simple system where nurses in antenatal clinics could fill a syringe with the right dose, cap it and seal it in a foil pouch with very simple, low-literacy instructions on it so that a mother could safely and easily give her baby the six drops of medicine to prevent MTCT, in her own home, minutes after delivery” “All it took was a simple packaging solution to enable millions of mothers to prevent unnecessary transmission to their children,” he added “This is just one more example of the immense possibility of partnerships in reaching the most vulnerable populations” Luckily, PATH is not alone in its efforts Next week, various members of the reproductive health community will converge in Addis Ababa, Ethiopia, to observe the tenth anniversary of the 2001 Istanbul conference ‘Meeting the Challenge, which pioneered the global reproductive health supplies movement The RHSCs two-day-long ‘Access for All: Supplying a new decade for reproductive health workshop series will form the nucleus of the conference, harnessing voices and strategies from the health community to meet the challenges of the coming decade


IPS Examines Access To Treatment For Drug-Resistant TB

“Access to treatment for drug-resistant tuberculosis (DR-TB) remains compromised, especially in developing countries, because too few pharmaceutical companies manufacture quality-assured drugs,” Inter Press Service reports in an article examining how a lack of competition and a working mechanism to keep prices low “has led to skyrocketing prices.”

The article also looks at the WHO’s “Green Light Committee (GLC), which reviews governmental and non-governmental treatment projects and ‘green-lights’ them for access quality-assured drugs at reduced prices.

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If you’re HIV positive, safe sex isn’t just about condoms | Deborah Jack

As the HIV epidemic has evolved over three decades, the “just use a condom” message has remained the cornerstone of prevention. But stubbornly high levels of new HIV infections in the UK show we’ve struggled to always translate this simple message into real life.

Most monogamous couples will decide to stop using condoms at some point, but what if one half of the couple is HIV positive? Until recently, it has been assumed there is no safe option other than condoms for life. But new research into the preventive benefits of HIV treatment (antiretroviral therapy) is set to change this, and could potentially revolutionise the way we think about HIV prevention and safer sex advice.

HIV treatment works by reducing the level of HIV in the body (the viral load) to such an extent that a person’s infectiousness is almost zero (clinically referred to as “undetectable”).

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Navigating Challenges, Brazil Steps Up AIDS Response

Not only has the government set human rights at the core of its public health system, committing itself to universal treatment access for persons living with HIV, but it has also challenged aspects of global international property provisions, which in other countries have hindered access to the affordable generic drugs that have been so crucial to Brazil’s success According to the Brazilian Ministry of Health, the infection rate in Brazil has remained stable since 2003, and the mortality rate stabilised in 1998 Last year 630,000 in the country were estimated to be infected with HIV Much of Brazil’s achievement in stabilising the epidemic has been attributed to the government’s providing free universal access to antiretroviral ARV drugs that reduce the amount of HIV virus in the body, delaying the onset of AIDS Most recently, ARVs were shown to reduce transmission of HIV by 96 percent The free treatment reaches about 210,000 citizens in Brazil today Recently, the Brazilian government announced that it would donate two dollars to the UNITAID treatment access coalition for every passenger flying abroad Travelers themselves have the option of donating that amount to the government The money will to go to developing countries, particularly in sub-Saharan Africa, to fight AIDS Alexandre Padilha, Brazil’s minister of health, told IPS that this year, his country has also been trying to strengthen its response by focusing on women and youth, particularly with education campaigns regarding violence against women “Our public programmes are very closely connected to youth and women nowadays,” he said in an interview They specifically target young women and girls, “empowering them to ask for the use of condoms,” he added Moreover, many youth “lack awareness of the risks of infections and the risk of HIV/AIDS, so we are trying to reinforce among youth the importance of the use of condoms and the importance of safe sex” On an industrial front, Brazil established a state-owned condom factory in 2008 It uses latex from native rubber trees, thus offering an option for HIV prevention that is both sustainable and economically beneficial to the country Brazil’s success in stymieing new infections and reducing vertical mother to child transmission rates can also be attributed to its aggressive campaign for affordable generic drugs, whose production and accessibility have been complicated by intellectual property right laws Generic drugs worldwide have played a significant role in HIV treatment because they are more affordable than brand-name drugs They have also served as competition to bring down the price of non- generics The problem is that developed countries with corporations that hold patents for ARV medicines have often resisted the production of generic rugs by pushing for stricter intellectual property rights, such as longer patent terms, in free trade agreements and other negotiations But a study conducted by Oxfam on a free trade agreement between the US and Jordan concluded that the TRIPS-plus rules in the agreement had contributed to increases in medicine prices, and that the rules “will delay or prevent use of public health safeguards to reduce he price of new medicines in the future” Developing countries less able to afford expensive brand name drugs have pushed back, taking advantage of flexibilities – fairly and legally – within the World Trade Organization’s Trade-Related Aspects of Intellectual Property Rights TRIPS Agreement One of the flexibilities allows governments to issue compulsory licenses to manufacture or import generic versions of drugs for public health purposes Brazil has been a leader in taking advantage of these flexibilities, and its efforts have paid off In the early 2000s, a WTO panel ruled that for the Brazilian government to allow Brazilian firms to copy patented foreign pharmaceutical products and sell them as generics was acceptable, and did not violate the TRIPS agreement, according to Roy Nelson, associate professor at the Thunderbird School of Global Management The European Union and the United States have fought most diligently for stricter intellectual property rights, known as TRIPS plus provisions TRIPS plus provisions were a hot topic of debate during the High Level Meeting on AIDS held at the United Nations in New York at the beginning of this month These additional restrictions have proved a stumbling block in other arenas as well Specifically, free trade negotiations between the EU and Mercosur, a bloc of Latin American countries, stalled yet again last week According to Scripintelligence, a news, analysis, and data provider for the pharmaceutical industry, and MercoPress, a South Atlantic news agency, Mercosur countries, Brazil included, are reluctant to accept EU demands for stricter patent rights, although this concern was not the only cause reason negotiations failed to proceed “Negotiations between Mercosur and the EU to susp tariff and nontariff barriers between the economic blocs may inhibit local production of drugs, especially generics,” Padilha told IPS In order to ensure the affordability of HIV/AIDS drugs, the Brazilian government, he said, “adopts strategies for negotiating prices” with companies holding drug patents Brazil respects intellectual property, he insisted, “But we def that intellectual property laws have to be compliant to help public health priority” Rohit Malpani, senior policy advisor for Oxfam America, told IPS, “Brazil and all developing countries are facing enormous challenges to provide affordable access to anti-retroviral treatment” Not only must the government continue providing care while simultaneously expanding access to treatment, he said, but existing patients will also eventually have to switch to more expensive second and third line ARVs, boosting expenses further “Brazil must continue to use flexibilities to reduce the costs of these medicines even as the country continues to evolve into a wealthier, emerging market country,” he concluded


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