World AIDS day: What does it mean to me?

International AIDS society

World AIDS Day is held on 1 December each year and is an opportunity for people worldwide to unite in the fight against HIV, show their support for people living with HIV and to commemorate people who have died. World AIDS Day was the first ever global health day and the first one was held in 1988.In this day we also reflect on  what  so far have been done in fighting the HIV/AIDS pandemic. It is  a day to remember our loved ones who  died or are in critical conditions due to AIDS. In most sub-Saharan African countries, no single family has not been at least once felt the presence of HIV/AIDS.
To some, the world AIDS day reminds them the worst experience they have ever had in their lives,  for example death of a parent, partner or relative . To others, this day reminds them the fact that they are living with HIV  (and of course they are not alone) and the world is trying its level best to find a solution (a permanent cure) to their problems. To others, especially in places that have fewer infections, it is just another normal day, but it might be interesting to read about different stories or news  about the disease or just go on with normal daily activities.
Regardless of the situation: The world through its international organisations such as the United Nations, the International Non-governmental organisations, multinational corporations, national governments, civil society organisations, communities and concerned individuals, see this day as a special day for all people in the world  because  the HIV infection  does not care about your current situation. The virus  does not know geographical borders , it does not know  the race  you belong to, it does not know  your social-economic status, it does not know  your religion, it does not know any of the admirable personal characteristics that  you have and  human beings admire or are attached to.
For that reason, in this day everybody should reflect how s/he has been contributing to the fight of the pandemic from the individual level to the greater role in the community. It is a day that at least at individual level you have to do something( I belive you can), do it with your immediate family members (if you are parent discuss with your children about AIDS and if you are a child or youth ask your parents or guardians about HIV/AIDS). It is a time for everybody to say something on this disease to friends, family, community or  Nation.
 It is also a time to reflect what has been done and what is left to accomplish the desired goal of bringing HIV infection to zero infection. For many people in the developed world, HIV is a manageable disease, it is no longer a death sentence like what happened in the 1980s at the beginning of the pandemic (but it is still deadly). Through the discovery of the antiretroviral drugs, it means that people have managed to live long productive life. Recent studies report that people diagnosed with the disease can live 30 years plus after the diagnosis if they are on antiretroviral therapy.
However, one in four of the HIV positive people have not been diagnosed and half of those who are diagnosed are diagnosed late. Unless we tackle this problem of diagnosing the undiagnosed, death is going to continue.
According to United Nations, the situation in Africa is also encouraging. The number of new HIV infection is falling. In sub-Saharan Africa they droped by a quarter between 2001 to 2011. Tim Martineau speaking with DW said that “What’s strongest is the response in a number of eastern and southern African countries where the epidemic is perhaps at its greatest. Malawi has seen a 72 percent change in incidence, Zambia 58 percent, Namibia 68 percent. Ethiopia has seen a 90 percent decline and South Africa, the country with the biggest epidemic in the world, has seen a decline of 41 percent and there's been a rapidly expanding response there with the new commitment in that country".He also pointed out at the challenges in funding HIV/AIDS interventions in developing countries, pointing to the irregularities in managing HIV/AIDS funds in some countries.
According to TACAIDS, the prevalence of HIV infection in Tanzania is slightly declining. The national prevalence among the sexually active populations (between 15 and 49 years of age) is reported to be 5.7 %. The data shows more women (6.6 %) are infected than men (4.6%). These data shows that there is a lot to do to make Tanzania a HIV/AIDS free country.
Finally, an HIV free generation can be realised only if there is a political commitment in addressing  the HIV/AIDS pandemic.
 NB: Inspired by the International AIDS society call for its members to say something on  what World AIDS day mean to them, I thought of saying something on it! 

Promoting Health policy and system Research in Developing countries

EVs in Beijing 

It is of no doubt that not only the number of health policy and systems researchers in developing countries that is low, but also the challenges these researchers face in terms of necessary infrastructure to enable them conduct state of the art research independently .The Emerging Voice for Global Health (EVGH) initative of the Institute of Tropical Medicine might probably shade light to addressing the aforementioned issues in developing countries. Allison Stevens, from the Consortium for Health Policy and Systems Analysis in Africa (CHEPSAA) provides a detailed account on the potentials of EVGH in impacting health policy and systems research in developing countries. EVGH initiative is viewed as a platform for young researchers, which encourages them to have their voice heard through presenting research in conference formats and getting intensive skills training as well as content training in methodology. EV4GH brings together 50 young health policy and system researchers, from low and middle income countries and this year, it was Beijing that was the chosen meeting point during the 2nd Global symposium for Health systems research.

Malaria candidate vaccine reduces Malaria by approximately one third

http://static.ibnlive.in.com/ibnlive/pix/sitepix/10_2011/malaria_1910.jpg

The multicounty malaria vaccine trial that included 6537 children aged between 6 to 12 weeks has proved to be protective only for about 30% .These findings came as a dissapointment because this study was one of the most promising large scale phase III vaccine trial.

The RTS, S malaria candidate vaccine that was expected to protect African children from malaria has shown an unacceptably low protection level. However, the investigators found that, in addition the vaccine reduces episodes of severe Malaria among infants for about 26% up to 14 months after the babies immunised.

The results of this trial were presented at the International African Vaccinology conference in South Africa and simultaneously the New England journal of Medicine (NEJM) published the results.

Dr.Salim Abdulla one of the investigators from Ifakara Health Institute in Tanzania  said that  "and we should may be thinking of first generation vaccine that is targeted only for certain children".

On the other hand, Blaise Genton from Swiss Tropical and Public Health Institute in Basel, Switzerland that the vaccine might work better at some trial sites than the average reported today.

Despite these results, many scientists acknowledged that this trial has a greater contribution to the science of Malaria Vaccine; also the intensive cooperation of African research centres towards working successfully in this trial was congulatulated. However WHO could not commend anything on these results because the study is yet to be finalised.The study is scheduled to be completed in 2014.

Some insights from the Beijing Symposium on HSR

http://www.who.int/alliance-hpsr/whostrategyhpsr/en/index.html

The Symposium on Health system research was concluded on 3rd November this year.Remarkable progress has been noted interms  of form, content and organisation.The first global  Strategy on  Health policy and system research was announced by WHO.The strategy has three major aims; unifying the world of research and decision making in connection to various displines of research to strengthen health systems. It also aims at contributing to the broader understanding of this field by clarifying the scope of Health policy and systems research.In addition, this strategy is envesieged to serve as an agent for change and calls for more prominent role for Health policy and systems research especially this time when the focus is towards a broader goal of Universal health coverage.
"Inclusion of inovations towards Universal health coverage " was the overall theme of the conference; says Kristof DeCoster when giving his  reflections on the symposium  in the IHP blog. He also points out on the impact health system researchers and the public health community have on power and politicians at country level to the grassroots.
The Beijing statement higlights the concluding statement of the conference and provides the prospects for the 2014 3rd Global symposium on Health systems research.

2nd Global symposium on Health system Research

The second Global symposium on health system research is scheduled to start tomorrow in Beijing. It is impressive to see that everything and everybody (plenary speakers and participants) is ready.The symposium is dedicated to evaluate progress, sharing insights and recalibrating the agenda of science to accelerate universal health coverage (UHC).
In this symposium , participants will share new state-of-the art evidence on universal health coverage, review the progress towards UHC including progress since the World Healt report of 2010, facilitate greater collaboration and learning communities across desplines, sectors, initiatives and countries. It will also identify and discuss the approaches to strengthern the scientific rigor of health systems research including concepts, frameworks , measures and methods.

The main themes of the conference will be; knowlege translation, state-of-the art research on Health Systems Research (HSR)  and HSR methodologies.Cross-cutting themes include; Innovations in HSR, neglected priorities or population groups in HSR and financing and capacity building for HSR.Moreover the new international society called Health systems global will be officially launched. As in the 1st global symposium on HSR that took place in 2010 in Montreux, Swirtzeland, the emerging voices will actively participate in the symposium. 

Fake ARVs in Tanzania: Consumers at a crossroads

Counterfeit drugs around the World

It is well known that fake drugs cost a lot of lives in developing countries, where it is a home of most of fake drugs. This has been a serious challenge to the integrity of public health systems as well as serious threat to the national security in these countries and probably is a major cause of death (from curable diseases) than anything else.

Of recent, in Tanzania, the Minister of Health and social Welfare , Dr. Hussein Mwinyi  suspended top officials of the Medical sores department (MSD) and halted the production of all drugs by TPI ( alleged to have manufactured fake ARVs) to allow investigation to take place. He also urged all people under medication to continue using ARVs drugs because they are safe as the fake ones have already been removed from the hospitals.

It is by now a public knowledge that most of the drugs produced locally are of low quality due to the widespread corruption in political circles in the country. Also, the fact that global counterfeit black market thrives better in poor countries, makes Tanzania vulnerable in all aspects. The profits from this “crime” are being co-opted by an array of organised criminal groups, who see that this the only way they can survive.

Although the Minister of Health and social welfare has assured the public that the drugs that are in the market today are of good quality, critics can still think that the MSD officials who were suspended are the ones who know exactly what the public is consuming. Earlier this year I posted an article on  fake malaria drugs circulating in the country. The issue here is; who exactly knows the network behind these fake drugs in the country? How can we make our medicines safe? What about the patients who have consumed these fake drugs? The first question might probably be answered by the committee formed by the Minister. I am not sure about the remaining questions!

It has been always said (at least by most policy makers) that having appropriate policies and adequate power to reinforce the policies is the only way to control these crimes. This might be true at least in theory. Corruption has made the aforementioned statement useless because people who are supposed to make (guide the formulation of) such policies and reinforce are the ones who are involved in these criminal networks. I think, it is a time now for the consumers (the victims) to do something rather than waiting for committees or flawed expert reports. Here you are talking of about 500,000 Tanzanians  who are on Antiretroviral therapy

Public-Private Partnerships in health care: Any prospects for equity?

"We are living in an unfair world, and that gonna not change whether you like or not"!..This was an opening statement by  one of the speakers in a conference on  "the role of Public Private Partnerships (PPP) in equity in health care". He was representing a Multinational corporation that has signed more that 200 PPPs in the world, especially in developing countries, where because of poverty, governments find themselves signing such PPPs in order that they can at least provide social services to their people. The company having been working in health care technologies, have facilitated building up to date health care facilities and supplied up to date medical equipment to these countries. The fact that they have technologies and are looking for profits, it is without doubt that they will not provide services to the people without profit. At the time when these deals are signed and implemented, no one can clearly see  that" this as a profit making business" as the recipient governments and the citizens look at what they get at that time, but they don't attribute to what is  going to happen later. The dark side of these partnerships is making the governments or the people dependent to the technologies brought by a partnering company ,in which afterwards, you might find these technologies to be very expensive. These deals have contributed to increased inequalities and poverty in most of the developing countries. It has become at least difficult talking about Social justice when these companies are involved in PPPs
The Private sector ( especially the Multinational corporations and Foundations) is becoming more powerful than governments in developing countries, they take advantage of corrupt governments to sign PPPs that are not advantageous to these countries, but to themselves and the countries they represent.
As a point of departure from imaginary world, he pointed out of the fact that we can not eliminate inequalities in this world, what we can do is just to reduce it by few kilometers.
Public-Private Partneships can take different forms, and sometimes it is difficult  even to know how does a Private sector differ from a public one.
However, this was an example of the Private for profit Multinational companies, that might not represent all what is done by the Private sector in eliminating inequalities in the health sector. The private sector in the health sector  in many developing countries is composed of  Non-for profit foundations, Faith based organisations, Private for profit institutions and Private practitioners (who on part time basis work in Private clinics/ hospitals). Through the Non-for profit and Faith based organisations, alot have been done in eliminating inequalities in the health sector. Different innovations have been encouraged to increase access to health care services even to hard to reach areas. The fact that the role of the government is to provide services its citizens, non-for profit and religious organisations share this goal; therefore this partnership is a partnership that has the same goal, unlike the private for profit multinational corporations.
Should governments in developing countries opt out partnering with profit making multinational corporations  in order to provide equitable social service?