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Census Bureau Updates Interactive HIV/AIDS Database; New Prevalence Estimates from More Than 100 Countries

July 22, 2014 Comments off

Census Bureau Updates Interactive HIV/AIDS Database; New Prevalence Estimates from More Than 100 Countries
Source: U.S. Census Bureau

The U.S. Census Bureau today released its annually updated interactive global resource on the prevalence of HIV infection and AIDS cases and deaths. First developed in 1987, the database now holds more than 164,000 statistics, an increase of approximately 5,900 new estimates in the last year, and is the most comprehensive resource of its kind in the world.

The Census Bureau database is maintained with funding from the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) through the United States Agency for International Development (USAID).

The tool consists of a library of statistics from more than 14,900 sources in international scientific and medical journals, individual countries’ annual HIV/AIDS surveillance reports, and papers and posters presented at international conferences. China represents 28 percent of the new records in the database, the largest increase by a single country.

The menu-driven access tool enables users to search for statistical information in countries and territories across the world, as well as by subpopulation, geographic subarea (such as urban and rural), age, sex and year from the 1960s to 2013.

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UNAIDS report shows that 19 million of the 35 million people living with HIV today do not know that they have the virus

July 17, 2014 Comments off

UNAIDS report shows that 19 million of the 35 million people living with HIV today do not know that they have the virus
Source: Joint United Nations Programme on HIV/AIDS (UNAIDS)

A new report by UNAIDS shows that 19 million of the 35 million people living with HIV globally do not know their HIV-positive status.

The UNAIDS Gap report shows that as people find out their HIV-positive status they will seek life-saving treatment. In sub-Saharan Africa, almost 90% of people who tested positive for HIV went on to access antiretroviral therapy (ART). Research shows that in sub-Saharan Africa, 76% of people on ART have achieved viral suppression, whereby they are unlikely to transmit the virus to their sexual partners. New data analysis demonstrates that for every 10% increase in treatment coverage there is a 1% decline in the percentage of new infections among people living with HIV.

The report highlights that efforts to increase access to ART are working. In 2013, an additional 2.3 million people gained access to the life-saving medicines. This brings the global number of people accessing ART to nearly 13 million by the end of 2013. Based on past scale-up, UNAIDS projects that as of July 2014 as many as 13 950 296 people were accessing ART.

Behavioral and Clinical Characteristics of Persons Receiving Medical Care for HIV Infection — Medical Monitoring Project, United States, 2009

June 21, 2014 Comments off

Behavioral and Clinical Characteristics of Persons Receiving Medical Care for HIV Infection — Medical Monitoring Project, United States, 2009
Source: Morbidity and Mortality Weekly Report (CDC)

Problem:
As of December 31, 2009, an estimated 864,748 persons were living with human immunodeficiency virus (HIV) infection in the 50 U.S. states, the District of Columbia, and six U.S.-dependent areas. Whereas HIV surveillance programs in the United States collect information about persons with a diagnosis of HIV infection, supplemental surveillance systems collect in-depth information about the behavioral and clinical characteristics of persons receiving outpatient medical care for HIV infection. These data are needed to reduce HIV-related morbidity and mortality and HIV transmission.

Reporting Period Covered:
Data were collected during June 2009–May 2010 for patients receiving medical care at least once during January–April 2009.

Description of the System:
The Medical Monitoring Project (MMP) is an ongoing surveillance system that assesses behaviors and clinical characteristics of HIV-infected persons who have received outpatient medical care. For the 2009 data collection cycle, participants must have been aged ≥18 years and have received medical care during January–April 2009 at sampled facilities that provide HIV medical care within participating MMP project areas. Behavioral and selected clinical data were collected using an in-person interview, and most clinical data were collected using medical record abstraction. A total of 23 project areas in 16 states and Puerto Rico were funded to collect data during the 2009 data collection cycle. The data were weighted for probability of selection and nonresponse to be representative of adults receiving outpatient medical care for HIV infection in the United States and Puerto Rico. Prevalence estimates are presented as weighted percentages. The period of reference is the 12 months before the patient interview unless otherwise noted.

Results:
The patients in MMP represent 421,186 adults who received outpatient medical care for HIV infection in the United States and Puerto Rico during January–April 2009. Of adults who received medical care for HIV infection, an estimated 71.2% were male, 27.2% were female, and 1.6% were transgender. An estimated 41.4% were black or African American, 34.6% were white, and 19.1% were Hispanic or Latino. The largest proportion (23.1%) were aged 45–49 years. Most patients (81.1%) had medical coverage; 40.3% had Medicaid, 30.6% had private health insurance, and 25.7% had Medicare.

An estimated 69.6% of patients had three or more documented CD4+ T-lymphocyte cell (CD4+) or HIV viral load tests. Most patients (88.7%) were prescribed antiretroviral therapy (ART), and 71.6% had a documented viral load that was undetectable or ≤200 copies/mL at their most recent test. Among sexually active patients, 55.0% had documentation in the medical record of being tested for syphilis, 23.2% for gonorrhea, and 23.9% for chlamydia.

Noninjection drugs were used for nonmedical purposes by an estimated 27.1% of patients, whereas injection drugs were used for nonmedical purposes by 2.1% of patients. Overall, 12.9% of patients engaged in unprotected sex with a partner of negative or unknown HIV status.

Unmet supportive service needs were prevalent, with an estimated 22.8% in need of dental care and 12.0% in need of public benefits, including Social Security Income or Social Security Disability Insurance. Fewer than half of patients (44.8%) reported receiving HIV and sexually transmitted disease prevention counseling from a health-care provider.

Interpretation:
The findings in this report indicate that most adults living with HIV who received medical care in 2009 were taking ART, had CD4+ and HIV viral load testing at regular intervals, and had health insurance or other coverage. However, some patients did not receive clinical services and treatment in accordance with guidelines. Some patients engaged in behaviors, such as unprotected sex, that increase the risk for transmitting HIV to sex partners, and some used noninjection or injection drugs or both.

Public Health Actions:
Local and state health departments and federal agencies can use MMP data for program planning to determine allocation of services and resources, guide prevention planning, assess unmet medical and supportive service needs, inform health-care providers, and help focus intervention programs and health policies at the local, state, and national levels.

The Role of Substance Use and Mental Health Problems in Medication Adherence Among HIV-Infected MSM

June 19, 2014 Comments off

The Role of Substance Use and Mental Health Problems in Medication Adherence Among HIV-Infected MSM
Source: LGBT Health

Mental health and substance abuse problems are highly prevalent among HIV-infected men who have sex with men (MSM) and frequently interfere with antiretroviral therapy (ART) adherence. Novel interventions that address underlying psychosocial health problems are necessary for improving ART adherence to enhance HIV-related health outcomes and suppress HIV viral load in an effort to prevent transmission to uninfected partners. This brief review describes the mental health problems and specific substances that pose the greatest threat to medication adherence among MSM and summarizes findings from recent intervention trials that simultaneously address ART adherence and comorbid psychosocial factors among HIV-infected MSM.

New Report Recommends Federal Action to Address Pervasive Profiling, Punishment, and Imprisonment of LGBT People and People Living with HIV

May 23, 2014 Comments off

New Report Recommends Federal Action to Address Pervasive Profiling, Punishment, and Imprisonment of LGBT People and People Living with HIV
Source: Center for American Progress

Lesbian, gay, bisexual, and transgender, or LGBT, people and people living with HIV, or PLWH, face sweeping discrimination at all stages of the criminal legal system—including policing, adjudication, and incarceration—according to a new report published by the Center for Gender & Sexuality Law at Columbia Law School and co-authored by the Center for American Progress, The Center for HIV Law and Policy, and Streetwise & Safe, or SAS.

The report, “A Roadmap for Change: Federal Policy Recommendations for Addressing the Criminalization of LGBT People and People with HIV,” is one of the first reports of its kind to offer comprehensive federal policy recommendations to address the cycles of criminalization and discriminatory treatment faced by LGBT people and PLWH. Co-authored by Catherine Hanssens, Aisha C. Moodie-Mills, Andrea J. Ritchie, Dean Spade, and Urvashi Vaid with input from more than 50 legal, advocacy, and grassroots organizations working on LGBT and criminal justice policy, the report provides an extensive outline of policy measures that federal agencies can adopt to address discriminatory and abusive policing practices, improve conditions for LGBT prisoners and immigrants in detention, decriminalize HIV, and prevent LGBT youth and adults from coming in contact with the system in the first place.

Prophylaxis for the Prevention of HIV Infection — 2014 Available Online

May 16, 2014 Comments off

Prophylaxis for the Prevention of HIV Infection — 2014 Available Online
Source: Morbidity and Mortality Weekly Report (CDC)

The documents Preexposure Prophylaxis for the Prevention of HIV Infection — 2014: a PHS Clinical Practice Guideline* and a Clinical Providers’ Supplement† are now available online.

The guideline and supplement are intended for use by clinicians in the United States providing medical care for persons without human immunodeficiency virus (HIV) infection who are at substantial risk for acquiring it by their sexual or injection drug use behaviors. The guideline is the first federal resource that provides comprehensive, evidence-based information about the provision of daily oral antiretroviral preexposure prophylaxis (PrEP), including how to identify patients with indications for PrEP, guidance for safe prescribing practices, monitoring clinical safety for patients taking PrEP medications, and supporting medication adherence and the reduction of HIV risk behaviors. The supplement provides additional tools and information that might be useful to clinicians prescribing PrEP.

Voluntary Medical Male Circumcision for HIV Prevention: Improving Quality, Efficiency, Cost Effectiveness, and Demand for Services during an Accelerated Scale-up

May 8, 2014 Comments off

Voluntary Medical Male Circumcision for HIV Prevention: Improving Quality, Efficiency, Cost Effectiveness, and Demand for Services during an Accelerated Scale-up
Source: PLoS Collections

With new HIV infections in Sub-Saharan Africa occurring at a rate of 2.3 million each year, this new Collection, featuring research published in PLOS Medicine and PLOS ONE, presents interim results from a large public health intervention of voluntary medical male circumcision (VMMC) performed by health care practitioners in low-resource settings to prevent new infections.

The Collection examines lessons learned from the scaled-up VMMC program since 2008. Research papers focus on programs in Kenya, South Africa, Tanzania, Zimbabwe and Lesotho, identifying strengths and challenges in key program areas, including demand creation, the quality of surgical services, operational efficiencies, data collection and cost controls.

The VMMC program faces challenges at multiple levels, such as maintaining quality of services while rapidly scaling up, generating demand, and resource and capacity constraints. In order to accelerate scale-up and impact, the Collection authors recommendations include increasing program efficiency by identifying and prioritizing those most at risk of acquiring HIV, matching supply with demand, and exploring the role of technology.

Evidence-Based HIV/STD Prevention Intervention for Black Men Who Have Sex with Men

April 23, 2014 Comments off

Evidence-Based HIV/STD Prevention Intervention for Black Men Who Have Sex with Men
Source: Morbidity and Mortality Weekly Report (CDC)

This report summarizes published findings of a community-based organization in New York City that evaluated and demonstrated the efficacy of the Many Men, Many Voices (3MV) human immunodeficiency virus (HIV)/sexually transmitted disease (STD) prevention intervention in reducing sexual risk behaviors and increasing protective behaviors among black men who have sex with men (MSM). The intervention addressed social determinants of health (e.g., stigma, discrimination, and homophobia) that can influence the health and well-being of black MSM at high risk for HIV infection. This report also highlights efforts by CDC to disseminate this evidence-based behavioral intervention throughout the United States. CDC’s Office of Minority Health and Health Equity selected the intervention analysis and discussion to provide an example of a program that might be effective for reducing HIV infection- and STD-related disparities in the United States.

3MV uses small group education and interaction to increase knowledge and change attitudes and behaviors related to HIV/STD risk among black MSM. Since its dissemination by CDC in 2004, 3MV has been used in many settings, including health department- and community-based organization programs. The 3MV intervention is an important component of a comprehensive HIV and STD prevention portfolio for at-risk black MSM. As CDC continues to support HIV prevention programming consistent with the National HIV/AIDS Strategy and its high-impact HIV prevention approach, 3MV will remain an important tool for addressing the needs of black MSM at high risk for HIV infection and other STDs.

Excess Burden of Depression among HIV-Infected Persons Receiving Medical Care in the United States: Data from the Medical Monitoring Project and the Behavioral Risk Factor Surveillance System

April 14, 2014 Comments off

Excess Burden of Depression among HIV-Infected Persons Receiving Medical Care in the United States: Data from the Medical Monitoring Project and the Behavioral Risk Factor Surveillance System
Source: PLoS ONE

Background
With increased life expectancy for HIV-infected persons, there is concern regarding comorbid depression because of its common occurrence and association with behaviors that may facilitate HIV transmission. Our objectives were to estimate the prevalence of current depression among HIV-infected persons receiving care and assess the burden of major depression, relative to that in the general population.

Methods and Findings
We used data from the Medical Monitoring Project (MMP) and the Behavioral Risk Factors Surveillance System (BRFSS). The eight-item Patient Health Questionnaire was used to identify depression. To assess the burden of major depression among HIV-infected persons receiving care, we compared the prevalence of current major depression between the MMP and BRFSS populations using stratified analyses that simultaneously controlled for gender and, in turn, each of the potentially confounding demographic factors of age, race/ethnicity, education, and income. Each unadjusted comparison was summarized as a prevalence ratio (PR), and each of the adjusted comparisons was summarized as a standardized prevalence ratio (SPR). Among HIV-infected persons receiving care, the prevalence of a current episode of major depression and other depression, respectively, was 12.4% (95% CI: 11.2, 13.7) and 13.2% (95% CI: 12.0%, 14.4%). Overall, the PR comparing the prevalence of current major depression between HIV-infected persons receiving care and the general population was 3.1. When controlling for gender and each of the factors age, race/ethnicity, and education, the SPR (3.3, 3.0, and 2.9, respectively) was similar to the PR. However, when controlling for gender and annual household income, the SPR decreased to 1.5.

Conclusions
Depression remains a common comorbidity among HIV-infected persons. The overall excess burden among HIV-infected persons receiving care is about three-times that among the general population and is associated with differences in annual household income between the two populations. Relevant efforts are needed to reduce this burden.

Guideline on the Use of Devices for Adult Male Circumcision for HIV Prevention

March 14, 2014 Comments off

Guideline on the Use of Devices for Adult Male Circumcision for HIV Prevention
Source: World Health Organization (via National Center for Biotechnology Information)

This guideline provides an evidence-based recommendation on the use of adult male circumcision devices for HIV prevention in public health programmes in high HIV prevalence, resource-limited settings. It also presents key programmatic considerations for the introduction and use of these devices in public health HIV prevention programmes. The primary audiences are policy- and decision-makers, programme managers, health-care providers, donors and implementing agencies.

The guideline was developed according to the WHO standards and requirements for guideline development. The process involved internal and external consultations with technical experts, national programme managers, consumer advocates and an evidence review methodologist. Two complementary annexes are also available.

In Harm’s Way: State Response to Sex Workers, Drug Users and HIV in New Orleans

January 1, 2014 Comments off

In Harm’s Way: State Response to Sex Workers, Drug Users and HIV in New Orleans
Source: Human Rights Watch

This 57-page report documents government violations of the right to health and other abuses of at-risk populations in New Orleans. It calls for changes in state and local laws and policies that stigmatize, discriminate against, and facilitate police abuse of sex workers and drug users, and interfere with health services for people at high risk for HIV. The report was released in advance of the third annual Southern Harm Reduction and Drug Policy Conference, which opens in New Orleans on December 12, 2013.

New From the GAO

November 22, 2013 Comments off

New GAO Report
Source: Government Accountability Office

Minority AIDS Initiative: Consolidation of Fragmented HIV/AIDS Funding Could Reduce Administrative Challenges. GAO-14-84, November 22.
http://www.gao.gov/products/GAO-14-84
Highlights – http://www.gao.gov/assets/660/659217.pdf

Estimated Percentages and Characteristics of Men Who Have Sex with Men and Use Injection Drugs — United States, 1999–2011

October 7, 2013 Comments off

Estimated Percentages and Characteristics of Men Who Have Sex with Men and Use Injection Drugs — United States, 1999–2011
Source: Morbidity and Mortality Weekly Report (CDC)

Male-to-male sex and illicit injection drug use are important transmission routes for human immunodeficiency virus (HIV) infection. Of all new HIV infections in 2010, 80% were among men, of which 78% were among men who have sex with men (MSM), 6% among male injection drug users (IDU), and 4% among men who have sex with men and inject drugs (MSM/IDU) (1). MSM/IDU might have different prevention needs from men who are either MSM or IDU, but not both. A combination of effective, scalable, and evidence-based approaches that address male-to-male sex and injection drug use behaviors might reduce HIV infections among MSM/IDU. To refine calculations of disease rates attributed to MSM and IDU (2,3) by accounting for MSM/IDU, CDC used data from 1999–2008 National Health and Nutrition Examination Survey (NHANES) to estimate the percentage and number of MSM/IDU in the general population. To further describe demographic similarities and differences of MSM/IDU identified by different surveillance systems, CDC also compared data from four HIV surveillance systems: the 2008 and 2009 National HIV Behavioral Surveillance System (NHBS), the 2011 National HIV Surveillance System (NHSS), and the 2007–2009 Medical Monitoring Project (MMP). Of males aged ≥18 years, MSM/IDU comprised an estimated 0.35% in NHANES, 7%–20% in NHBS, an estimated 4%–8% in NHSS, and 9% in MMP. Across surveillance systems, MSM/IDU accounted for 4%–12% of MSM and 11%–39% of male IDU. Risk reduction programs and interventions targeted toward male IDU populations might be more effective if they also incorporate messages about male-to-male sex.
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CRS — The President’s Emergency Plan for AIDS Relief (PEPFAR), U.S. Global HIV/AIDS, Tuberculosis, and Malaria Programs: A Description of Permanent and Expiring Authorities

October 1, 2013 Comments off

The President’s Emergency Plan for AIDS Relief (PEPFAR), U.S. Global HIV/AIDS, Tuberculosis, and Malaria Programs: A Description of Permanent and Expiring Authorities (PDF)
Source: Congressional Research Service (via Federation of American Scientists)

Fighting HIV/AIDS, tuberculosis (TB), and malaria globally is a priority for Congress. The 108th and 110th Congresses enacted two pieces of legislation that have shaped U.S. responses to these diseases: P.L. 108-25, the United States Leadership Against HIV/AIDS, Tuberculosis, and Malaria Act of 2003 (Leadership Act), and P.L. 110-293, the Tom Lantos and Henry J. Hyde United States Global Leadership Against HIV/AIDS, Tuberculosis, and Malaria Reauthorization Act of 2008 (Lantos-Hyde Act). The Leadership Act authorized $15 billion to be spent from FY2004 through FY2008 on fighting HIV/AIDS, TB, and malaria. The Lantos-Hyde Act amended the Leadership Act to authorize $48 billion for fighting the three diseases from FY2009 through FY2013.

The Leadership Act (and the legislation that it amends) is the primary vehicle through which U.S. global assistance for fighting these diseases is authorized. The Lantos-Hyde Act mostly amends the Leadership Act, though it amends some other acts, such as the Foreign Assistance Act of 1961, and includes some stand-alone authorities. The Leadership Act and the Lantos-Hyde Act (primarily through amendments to the Leadership Act) created frameworks for how the funds should be spent, established program goals and targets, and established coordinating offices for managing government-wide responses.

The Leadership Act required the President to establish the Coordinator of the United States Government Activities to Combat HIV/AIDS Globally (known as the Global AIDS Coordinator) at the Department of State. Congress appropriates the bulk of global HIV/AIDS funds to the Office of the Global AIDS Coordinator, which leads the President’s Emergency Plan for AIDS Relief (PEPFAR). The Global AIDS Coordinator distributes the majority of these funds to U.S. federal agencies and departments and multilateral groups like the Global Fund to Fight AIDS, Tuberculosis and Malaria. The Lantos-Hyde Act amended the Leadership Act to establish the Coordinator of the United States Government Activities to Combat Malaria Globally (known as the Malaria Coordinator) at the U.S. Agency for International Development (USAID) to oversee implementation of related efforts by USAID and the Centers for Disease Control and Prevention. Some authorities within these Acts are enduring, such as those that created the Global AIDS and Malaria Coordinator positions (Leadership Act, as amended) and permitted U.S. participation in advance market commitments for vaccine development (Lantos-Hyde Act). Other authorities, however, are set to expire, such as language authorizing funding for global HIV/AIDS, TB, and malaria programs.

This report explains which authorities within the Leadership and Lantos-Hyde Acts are set to expire and which are permanent. Table A-1 in the Appendix A offers a side-by-side comparison of the Leadership Act in its original form and the Lantos-Hyde Act, which amends the Leadership Act and other legislation. A third column explains which sections are set to expire and summarizes language in S. 1545 and H.R. 3177 that amend the Leadership Act, as amended. The Leadership Act, as amended and Lantos-Hyde Act include comprehensive reporting requirements. Table A-2 in the Appendix A lists the reporting requirements and describes the extent to which the Administration has complied with the requirements.

Rather than revisit some of the contentious issues that dominated debate when crafting the Lantos-Hyde Act, House and Senate Members introduced legislation (H.R. 3177 and S. 1545) that is narrowly aimed at key priorities: enhancing oversight of U.S. global HIV/AIDS, TB, and malaria programs; authorizing appropriations for the Global Fund through FY2018; and allocating a portion of HIV/AIDS funds for orphans and vulnerable children (OVC) and for HIV/AIDS treatment and care. Table B-1 in Appendix B summarizes key amendments in the bills, entitled the PEPFAR Stewardship and Oversight Act.

UNAIDS reports a 52% reduction in new HIV infections among children and a combined 33% reduction among adults and children since 2001

September 30, 2013 Comments off

UNAIDS reports a 52% reduction in new HIV infections among children and a combined 33% reduction among adults and children since 2001
Source: UNAIDS

As world leaders prepare to meet at the United Nations General Assembly to review progress towards the Millennium Development Goals—a new report from the Joint United Nations Programme on HIV/AIDS (UNAIDS) shows dramatic acceleration towards reaching 2015 global targets on HIV.

New HIV infections among adults and children were estimated at 2.3 million in 2012, a 33% reduction since 2001. New HIV infections among children have been reduced to 260 000 in 2012, a reduction of 52% since 2001. AIDS-related deaths have also dropped by 30% since the peak in 2005 as access to antiretroviral treatment expands.

By the end of 2012, some 9.7 million people in low- and middle-income countries were accessing antiretroviral therapy, an increase of nearly 20% in just one year. In 2011, UN Member States agreed to a 2015 target of reaching 15 million people with HIV treatment. However, as countries scaled up their treatment coverage and as new evidence emerged showing the HIV prevention benefits of antiretroviral therapy, the World Health Organization set new HIV treatment guidelines, expanding the total number of people estimated to be in need of treatment by more than 10 million.

CA — HIV/AIDS – Past, Present and Future

August 6, 2013 Comments off

HIV/AIDS – Past, Present and Future
Source: Library of Parliament (Canada)

The first case of AIDS (acquired immune deficiency syndrome) in Canada was reported in February 1982, and the virus responsible, the human immunodeficiency virus (HIV), was discovered in 1983. For over 25 years, governments around the world have spent billions of dollars and scientists have worked tirelessly to develop treatments, preventative vaccines and a cure for this fatal disease. This paper will briefly describe the origins and present state of HIV/AIDS, as well as recent scientific advances in treatment and disease control.

New From the GAO

July 8, 2013 Comments off

New GAO Reports

Source: Government Accountability Office

1. Internet Pharmacies: Federal Agencies and States Face Challenges Combating Rogue Sites, Particularly Those Abroad. GAO-13-560, July 8.
http://www.gao.gov/products/GAO-13-560
Highlights – http://www.gao.gov/assets/660/655752.pdf

2. Investment Advisers: Requirements and Costs Associated with the Custody Rule. GAO-13-569, July 8.
http://www.gao.gov/products/GAO-13-569
Highlights – http://www.gao.gov/assets/660/655755.pdf

3. Electronic Drug Labeling: No Consensus on the Advantages and Disadvantages of Its Exclusive Use. GAO-13-592, July 8.
http://www.gao.gov/products/GAO-13-592
Highlights – http://www.gao.gov/assets/660/655761.pdf

4. Troubled Asset Relief Program: Treasury’s Use of Auctions to Exit the Capital Purchase Program. GAO-13-630, July 8.
http://www.gao.gov/products/GAO-13-630
Highlights – http://www.gao.gov/assets/660/655759.pdf

5. Defense Acquisition Workforce: The Air Force Needs to Evaluate Changes in Funding for Civilians Engaged in Space Acquisition. GAO-13-638, July 8.
http://www.gao.gov/products/GAO-13-638
Highlights – http://www.gao.gov/assets/660/655769.pdf

6. President’s Emergency Plan for AIDS Relief: Millions Being Treated, but Better Information Management Needed to Further Improve and Expand Treatment. GAO-13-688, July 8.
http://www.gao.gov/products/GAO-13-688
Highlights – http://www.gao.gov/assets/660/655765.pdf

CRS — U.S. Global Health Assistance: Background and Issues for the 113th Congress

July 5, 2013 Comments off

U.S. Global Health Assistance: Background and Issues for the 113th Congress (PDF)
Source: Congressional Research Service (via U.S. Department of State Foreign Press Center)

Congressional support for global health programs has been increasing, particularly during the George W. Bush Administration. Combined global health funding from State-Foreign Operations, Labor-HHS and Defense appropriations rose from $1.7 billion in FY2001 to $8.9 billion in FY2012. The FY2013 Consolidated Appropriations Ac t (P.L. 113-6) includes approximately $8.4 billion for global health programs funded through State-Foreign Operations appropriations, up from $8.2 billion in FY2012. (FY2013 funding levels will likely change, however, due to sequestration.) These funds support global health programs implemented and managed by the U.S. Agency for International Development (USA ID), State Department and the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund)—a multilateral organization aimed at fighting HIV/AIDS, TB, and malaria worldwide. The act does not specify how much should be spent on global health programs through other appropriations.

Concern about infectious diseases, especially HIV/AIDS, has driven much of the budgetary increases. Excluding funding for the Global Fund, roughly 34% of the FY2001 U.S. global health budget was aimed at programs that address HIV/ AIDS. By 2012, about 57% of U.S. global health spending was aimed at fighting HIV/AIDS worldwide, and the FY2014 budget request calls for nearly 54% of global health spending to be aimed at the disease.

In the 112 th Congress, concerns about the strength of the U.S. economy and federal spending precipitated discussions about the role and effica cy of U.S. foreign aid, including global health programs. Critics began to push for U.S. global health programs to demonstrate impact and improve cost-efficiency. At the same time, supporters underscored the advances U.S. global health programs had made, the millions of lives saved in part with U.S. resources, and the promise of innovative health solutions. It is likely that this debate will continue in the 113 th Congress. Other issues the 113 th Congress may face include

  • deliberating funding levels for U.S. global health programs;
  • examining U.S. leadership of U.S. global health programs;
  • maintaining global HIV/AIDS commitments;
  • deliberating the reauthorization of the President’s Emergency Plan for AIDS Relief (PEPFAR) in FY2013; and
  • determining the appropriate mix of multilateral and bilateral spending for global HIV/AIDS, TB, and malaria programs.

Evaluation of PEPFAR

July 2, 2013 Comments off

Evaluation of PEPFAR
Source: Institute of Medicine

The U.S. government supports programs to combat global HIV/AIDS through an initiative that is known as the President’s Emergency Plan for AIDS Relief (PEPFAR). This initiative was originally authorized in the U.S. Leadership Against HIV/AIDS, Tuberculosis, and Malaria Act of 2003 and focused on an emergency response to the HIV/AIDS pandemic to deliver lifesaving care and treatment in low- and middle-income countries (LMICs) with the highest burdens of disease. It was subsequently reauthorized in the Tom Lantos and Henry J. Hyde U.S. Global Leadership Against HIV/AIDS, Tuberculosis, and Malaria Reauthorization Act of 2008 (the Lantos-Hyde Act).

Evaluation of PEPFAR makes recommendations for improving the U.S. government’s bilateral programs as part of the U.S. response to global HIV/AIDS. The overall aim of this evaluation is a forward-looking approach to track and anticipate the evolution of the U.S. response to global HIV to be positioned to inform the ability of the U.S. government to address key issues under consideration at the time of the report release.

HIV in the European Region: Using Evidence to Strengthen Policy and Programmes

June 7, 2013 Comments off

HIV in the European Region: Using Evidence to Strengthen Policy and Programmes

Source: World Bank

Social and structural factors – like poverty, marginalization and stigma – and not just individual behaviors are shaping the HIV epidemic in Europe and Central Asia. This is the main conclusion of a new report released today by the World Bank Group, the World Health Organization Regional Office for Europe and the London School of Hygiene & Tropical Medicine.

The study systematically reviews evidence on HIV vulnerability and response in all 53 countries of the WHO European Region, stretching from Iceland to the borders of China.

The report focuses on key populations most at risk of HIV infection: people who inject drugs, sex workers and men who have sex with men. It confirms that they are disproportionately affected by the growing HIV epidemic in Europe, where the number of reported HIV cases reached more than 1.5 million in 2011.

HIV cases in these three groups account for approximately 50% of total diagnoses. Economic volatility and recession risks are increasing vulnerability to HIV and infections.

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