By Carol Sanders, Winnipeg Free Press
February 3, 2010
Source: Montreal Gazette
WINNIPEG — The longer Parliament is on hold, the longer prison inmates are sharing dirty needles and diseases with the community at large, former prisoners and health advocates say.

The Canadian HIV/AIDS Legal Network was supposed to appear Tuesday before the Commons Standing Committee on Public Safety and National Security calling for a needle exchange where inmates can trade dirty needles for clean ones.

“Prorogation swept us off the table,” said spokesman Gilles Marchildon. “Every day we delay in taking a better approach is a day where more prisoners are contracting HIV and hepatitis C.”

Prison employees and, eventually the public at large, are also at risk, he said.

“Ninety per cent (of inmates) get back into the community,” Marchildon said. “This is a grave public health matter.”

Inmates also have at least 10 to 20 times higher rates of HIV and hepatitis C than the population as a whole.
[...]
Read more: Montreal Gazette

Tue Jan 19, 2010 6:04pm GMT
By Kate Kelland
Source: Reuters

LONDON (Reuters) - Circumcising newborn boys to stop them becoming infected with the AIDS virus in later life is more cost-effective than circumcising adult men, Rwandan health experts said on Tuesday.

A study by Agnes Binagwaho and colleagues at Rwanda’s health ministry found that the operation, which has been shown to cut dramatically the virus’ transmission from women to men, is quicker, simpler and more cost-effective in newborns.

The findings suggest “Rwanda should be simultaneously scaling up circumcision across a broad range of age groups, with high priority to the very young,” Binagwaho wrote in the study in the Public Library of Science (PLoS) Medicine journal.

The researchers analysed the balance between the costs of medical intervention and its overall benefits. They found each newborn male circumcision would cost $15, while each adolescent or adult operation would cost $59.

They also found that circumcising male babies would ultimately save more money than it costs, because the operation would prevent HIV infections that are expensive to treat and lead to AIDS, which kills.
[...]
Read more Reuters

Thursday, January 14, 2010
Source: Kaiser Global Health Policy Report

The Atlantic examines the emergence of drug-resistant strains of tuberculosis around the world, with a look at the situation in South Africa. “[T]he resurgence of tuberculosis is not limited to South Africa. India and China have the largest numbers of tuberculosis cases, and multi-drug-resistant tuberculosis (MDR-TB) has been found in nearly every country, with XDR [extensively drug resistant]-TB in at least 57 countries,” according to the article.

Treatment for drug-resistant strains of TB can last “up to two years and is 200 to 1,000 times more expensive than regular TB drugs,” according to the Atlantic. “Even with treatment, multi-drug-resistant tuberculosis kills 30 percent of those infected, while XDR-TB kills roughly 60 percent. Unless the world gets ahead of the epidemic, drug-resistant forms of tuberculosis may not only kill hundreds of thousands, but also render moot global efforts to roll out HIV/AIDS antiretrovirals,” the magazine writes.

[...]
Read more Kaiser Global Health Policy Report

By Eben Harrell
Thursday, Jan. 14, 2010
Source: Time

Last January a team of scientists at the World Health Organization (WHO) published a study in the British medical journal the Lancet making the audacious claim that the tools already exist to end the AIDS epidemic. Doctors have long noted that antiretrovirals — the drugs commonly used to treat HIV — are so successful at suppressing the number of viruses in an infected patient’s blood that they can render a person no longer contagious. Using mathematical models, the researchers claimed that universal HIV testing followed by the immediate treatment of newly infected patients with antiretroviral drugs could eliminate the disease from even the most heavily infected populations within 10 years.

But a new study in the journal Science suggests that such thinking is too good to be true. And the problem is drug resistance. Extensive antiretroviral treatment can result in the development and transmission of drug-resistant strains of HIV — something the Lancet study did not consider. In the new study, published on Thursday, a team of scientists from the University of California, the University of Tennessee and the University of Ottawa analyzed data from San Francisco, where antiretroviral drugs have been extensively prescribed to HIV patients since AZT was introduced in 1987. In that city, drug resistance has grown steadily and, according to the team’s models, drug-resistant infections are now on the verge of spiking.

“According to our models, drug resistance in San Francisco will increase by around 30% in the next three to five years,” says Sally Blower, a professor at the David Geffen School of Medicine at UCLA. “That will present its own challenges to that city, but the most significant implications of our work are for countries where treatment is just being rolled out. San Francisco is always the canary in the mine.”

Current treatment guidelines do not call for the prescription of antiretroviral drugs until there is evidence of progressive damage to the immune system. But in the wake of last year’s Lancet study, some health experts have begun promoting a “test and treat” policy for populations with high HIV rates, as in major Western cities and parts of the developing world. Test and treat calls for the immediate treatment of all HIV-infected patients to reduce transmission rates. In November, WHO held a conference in Geneva to discuss whether the policy should be rolled out through its various agency programs. According to the team behind the Science study, however, that could prove disastrous. “Test and treat has been designed based on overly simplistic modeling. It is misguided and could lead to very serious public-health problems in resource-constrained countries,” Blower says.
[...]
Read more: Time