Health

  • Two perspectives on the life-changing DREAMS partnership

    The Determined, Resilient, Empowered, AIDS-free, Mentored and Safe women (DREAMS) partnership aspires to reduce HIV infections among adolescent girls and young women in 10 sub-Saharan African countries. These countries alone accounted for more than half of the HIV infections that occurred among adolescent girls and young women globally in 2015.

    DREAMS reaches beyond the health sector to address the direct and indirect factors that increase girls’ HIV risk, such as poverty, gender inequality, sexual violence and inadequate education. Interventions can include paying school fees, providing bicycles to girls who would otherwise walk long distances to school, supplying sanitary napkins for menstrual hygiene management and offering mentoring to help girls avoid early pregnancy, gender-based violence and discrimination. DREAMS is supported by the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), the Bill & Melinda Gates Foundation, Girl Effect, Johnson & Johnson, Gilead Sciences and ViiV Healthcare.

    Two young women who participate in DREAMS projects attended FHI 360’s 2018 Gender 360 Summit and discussed how DREAMS is making a difference in their lives. Here are their stories.

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  • New journal supplement on key populations is here!

    A version of this post originally appeared on the LINKAGES blog. Reprinted with permission.

    JIAS July 2018 issue coverThe USAID– and PEPFAR-supported LINKAGES project is excited to announce the arrival of a new supplement in the Journal of the International AIDS Society (JIAS) titled Optimizing the Impact of Key Population Programming Across the HIV Cascade.

    A collaboration among LINKAGES, USAID, CDC, amfAR, and JIAS, this supplement contributes new evidence and data-driven strategies for improving programming with men who have sex with men, sex workers, transgender people and people who inject drugs. It contains 14 original articles that represent a range of multidisciplinary efforts from diverse geographies to advance key population science and practice across the HIV prevention, care and treatment cascade.

    As HIV services are scaled up in pursuit of 90-90-90 targets, investments to address the epidemic among key populations must be central to these efforts. Global data indicate that gains made among key populations lag substantially behind those made in the general population. This supplement aims to accelerate progress toward controlling the epidemic by bringing visibility to new evidence and approaches that can make key population programming smarter and more effective.

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  • A future without AIDS begins and ends with key populations

    A version of this post originally appeared on the LINKAGES blog. Reprinted with permission.

    “We will only achieve HIV/AIDS epidemic control if we reach the UNAIDS 90-90-90 targets for all ages, genders, and at-risk groups, including key populations.”

    – Ambassador Deborah L. Birx, MD, U.S. Global AIDS Coordinator and U.S. Special Representative for Global Health Diplomacy, June 2018

    In 2013, UNAIDS set out to establish new global targets for HIV testing, care and treatment. Stakeholder consultations were conducted at country and regional levels around the world, ultimately resulting in the creation of the ambitious 90-90-90 targets to help bring an end to the AIDS epidemic:

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  • Achieving HIV epidemic control: Going the last mile and beyond

    The focus of the global effort to end the HIV/AIDS epidemic, now 37 years on, is epidemic control, which the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) defines as limiting the annual number of new HIV infections in a country to less than the number of deaths among people living with HIV.

    Sub-Saharan Africa, home to 26 million (70 percent) of the global total of 36.9 million people living with HIV, is where the battle must be won. To succeed and sustain the gains achieved in the past 15 years, countries in Africa will need to assume greater responsibility for managing their epidemics.

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  • Reducing commodity costs when scaling up contraceptive implants … A classic chicken vs. egg dilemma

    A version of this post originally appeared on Exchanges, the Contraceptive Technology Innovation Exchange blog. Reprinted with permission.

    Listen to an interview with Markus Steiner and Kate Rademacher on the reductions in the prices of implant commodities.

    Contraceptive implants have been available for over 30 years and are one of the most effective methods available. Until recently, however, international donors did not procure significant quantities, and use of the method in developing countries was very low. This access barrier was largely due to the high cost of implant commodities. The situation mirrored the classic, paradoxical question: which came first, the chicken or the egg? In this case, without lower commodity prices, procurements of implants would not increase in many international settings. But without higher volumes, manufacturers couldn’t lower their prices and still achieve a sustainable business model.

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  • There’s no more time to waste: Let’s find the missing cases of TB

    Tuberculosis (TB) has now overtaken HIV as the world’s leading cause of mortality. There were about 10.4 million TB cases in 2016, despite the fact that TB is an old and often curable disease whose incidence declined in industrialized countries long before the introduction of the TB vaccine and anti-TB drugs. TB continues to disproportionately affect low-income countries. For those of us who work in public health, this is tragic — we ought to be moving forward at a much faster pace to end TB for good.

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  • Building the case for contraceptive technology innovation

    Why do women who do not want to get pregnant choose not to use modern family planning methods? While this question is not bounded by geographies, the most recent Guttmacher Institute report, which focused on the low- and middle-income countries, is most illuminating. The two most common answers given by married women were health reasons/side effects or fear of side effects (26 percent) and claims of infrequent sex or not being sexually active (24 percent). Among unmarried women, infrequent sex (49 percent) was the top reason.

    Equally informative are recent FHI 360 findings from a user preference study in Uganda and Burkina Faso showing that 75 percent of women currently using a method would be open to trying new technologies. It quickly becomes clear that existing methods do not satisfactorily address the changing needs of women throughout their 30- to 40-year reproductive journey.

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  • Outsmarting TB using research and collaboration

    A version of this post originally appeared on FHI 360’s R&E Search for Evidence blog.

    Tuberculosis (TB), which in 2016 killed an estimated 1.7 million people, is an ancient disease found in the bones of mummies dug up from Peru. It has evolved with humans, and like other successful organisms, finds ways to avoid death, so it can thrive and spread to the next person. Trying to get ahead of this successful adversary requires pursuing a consistent, aggressive research agenda aided by international collaboration.

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  • The importance of clinical trials in epidemic preparedness: Three FHI 360 experiences

    One of the biggest challenges in international development is anticipating when the next pandemic health threat will strike and how we can minimize its damage. Pandemics can be unpredictable, and it is hard to know when and where to focus attention. Having safe, effective drugs ready to use when they are needed saves lives. Clinical trials, which focus on safety and efficacy, are pivotal to the development of these drugs.

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  • It is time for a bold approach to end the HIV epidemic

    Big breakthroughs in HIV science, such as antiretroviral therapy and the “universal test and treat” policy, create hope and galvanize efforts to bring the epidemic to an end. Yet, no matter how promising the strategy, we know from experience that it is not easy to incorporate the latest approaches into poorly resourced, over-stretched health systems. Nor is it reasonable to expect that health systems can absorb the increased volume of patients that seems to go hand in hand with innovations.

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